At Least We All Now Know What the Health Care Reform Debate Is About

This was the week that was for Barack Obama's efforts at health care reform (although many more will follow). The following five developments made clear that America is not prepared for what it must do, although the outlines of what this is are emerging.

(1) Liberal Americans ask the question, "How can a civilized nation fail to provide health care coverage for so many of its citizens?" Their answer is a government sponsored health care system like those in European countries. But while HuffPo readers say "aye" to a single payer, universal coverage system, they say "What, me worry?" to the fact that the existing, inadequate American system is already twice as costly as comparable European systems.

(2) But the American idea of reform will increase - not reduce - health care costs. The Congressional Budget Office estimates that the proposed reforms would cost $1 trillion (a figure we have become strangely used to), but would not curtail skyrocketing health care costs, as the Obama Administration has claimed. The non-partisan CBO has thus become for Congressional leaders the enemy of the people. When the director of the CBO, respected economist Douglas Elmendorf, testified before the Senate Budget Committee that health care legislation proposed by House Democrats would not slow unsustainable government spending on medical care, but would actually accelerate it, he was immediately attacked by Harry Reid and Nancy Pelosi - just like stem cell and global warming researchers are attacked by Republicans.

(3) Americans are STILL not ready to question the liberal bromides of "more care all the time." To take one of scores of examples, research has shown that the decades-long campaign to encourage screening for cancer (like that for prostrate screening) has shown no benefits for those screened, and may be a net health care loss: According to the Times,"For many cancers, early detection efforts offer little benefit at high expense, and present a real risk of harm." This reality that the care we clamor for is often the feather Dumbo clasps in his trunk is repeated time and again in assessments of the sacred cows of American health care.

(4) But, finally, pundits and knowledgeable commentators are presenting to Americans that their idea of health care is grossly distorted. Paying for wildly expensive treatments whose results are uncertain and, even when successful, leave patients (especially neonates and the elderly) with disastrously reduced quality of life, means withholding payments for better-guaranteed forms of care for people who may remain healthy and productive for years. For the first time, an important article in the Times makes the argument for health care rationing, also called managed care - two American bugaboos.

(5) And the Obama administration is going down the tubes on health care (as did the Clinton administration before it) out of a fear of making clear that we will all have to do more with less. Although this is not a politically viable message, we are witnessing how the inability to come to grips with this reality will lead to another failed administration.