The U.S. House of Representative has passed a 1,910 page health care bill essentially along party lines. The Senate is now considering its own 2,074 page bill, again along party lines.

The President's failure to gain bipartisan support for his health care overhaul is disappointing. The country wants and deserves a bipartisan effort on reform, since health care represents one sixth of our economy.

Responding to public concern, the Republicans have offered well over fifty amendments and over thirty health care bills, yet none has receive even a simple congressional hearing. The Democrats seem driven to pass health care legislation regardless of the concerns of the American public. Americans are understandably worried.

People are suspicious about the high cost of the proposed reform. The House-passed bill would cost $848 billion in the first ten years, while the Senate bill would cost $1.05 trillion over the same period, according to the non-partisan Congressional Budget Office (CBO). The Senate bill alone creates 70 new programs, and gives the IRS up to $10 billion more to enforce new mandates on citizens. Both bills would supposedly cut the deficit over the first ten years. Although these huge numbers are breathtaking enough, the real concern is the bait-and-switch of revenue vs. expenses.

The two bills are written so that revenue, i.e. taxes, is calculated to begin in 2010, while the expense, i.e. spending, doesn't start until 2014. Hence, the CBO's calculations are based on ten years of taxes but only six years of spending. This manipulation was key to gaining the votes of senators who didnt want to appear to be adding to the federal deficit. The real cost explosion will occur after 2019, outside the period covered by the CBO's cost analysis, and will extend indefinitely into the future. We can compare this to Medicare, a government entitlement with nearly forty-five years of history. Medicare cost nine times more than its original budget estimate within the first twenty-five years of enactment.

Today Medicare is slowly going bankrupt. Most people agree that adding significantly to the federal deficit during this current major recession would be foolhardy. Next, the American public has been told that major health care reform and upheaval will provide universal coverage. Yet the House-passed bill would leave 12 to 15 million people uninsured and the proposed Senate bill is even worse, leaving about 24 million uninsured. These numbers argue against passing any health care reform at all, since today the number of chronically uninsured is only eight to ten million people. Also, people are worried about laws that would require them, for the first time in history, to buy something simply because they live in the United States.

Both the House and Senate bills make Americans buy health insurance or else pay a fine or go to jail. Although states require automobile insurance for drivers, there has never been a federal mandate imposed on all American citizens. An individual mandate may not only be unfair, it may be unconstitutional. The President assured Americans that if they like their current health insurance plan, they can keep it. One of the funding mechanisms for both the House and Senate bills is a $465 billion cut in Medicare. One of the major proposed cuts would be in the elimination of Medicare Advantage. In Washington state alone, this would mean over 205,000 seniors would lose their current health insurance plan.

People are also concerned about the government competing again private insurance companies through the federally-run "public option." The backers of the public option say they would like to use the government plan as the first step toward universal, socialized health care in this country. Since almost 85% of Americans like the health care they have now, it is understandable that people are worried about losing their current insurance.

They realize that private firms won't be able to compete against the government and will likely go out of business. Many people remember that Medicare began in 1965 as a form of public option for seniors, but by 1970 private insurance for seniors, except for some co-pays and deductibles, was gone.

There are dozens of votes yet to take in Congress on the health care bills. The American public can only hope that Congress starts listening to their concerns, and protects people's right to buy private health insurance.

by Roger Stark, MD

Dr. Roger Stark is a health care policy analyst with Washington Policy Center, a non-partisan independent policy research organization in Seattle and Olympia. You can reach Dr. Stark at rstark@washingtonpolicy.org.