I hope the bill works. I hope many, many people are helped.  We all know our system needs reform.  The only reason anyone was arguing for a continuance of the status quo is because of the perceived potential for this approach to make things worse.  

There are two potentially staggering problems with the health care reform plan: The cost and the accessibility to health care – the two things the 2,000 plus page bill set out to fix.  

Forgive me if I’m skeptical that a group of persons that have contributed trillions of dollars to the national debt you and I are on the hook for is capable of running this program efficiently.  The rapidly approaching bankruptcies of Social Security and Medicare does not endorse the capabilities of this group.  Forgive me, but I don’t trust the makers of the $600 toilet seat to save $100 billion over 10 years while adding 32 million people to our health care system.  

According to a former director of the CBO in an opinion piece in the New York Times, the following are some of the ways the health care reform bill will meet its “mathemagical” deficit reduction:

-Taxes will be collected for four years before benefits begin, while calculating the initial deficit reduction based on a 10 year period that only includes six years of benefits, but 10 years of taxes.

-Approximately $500 billion will be cut from Medicare.

-Over $100 billion will be borrowed from Social Security and Long Term Care Insurance programs without factoring in repayment.

-Over $100 billion of administration costs are not included.

And these are just the costs we can identify.  Inevitably, nearly every government program of this scale comes in well over budget.  This program alone, even at its likely substantial cost, will not “bankrupt” the United States.  I’m highly skeptical that any one program could. But it’s grossly irresponsible to continue a course of behavior both Democrats and Republicans have perpetuated that will eventually lead to some economic collapse if we do not get our spending under control.  We cannot continue to spend money we do not have.

When the cost of this program cannot be met from revenues, expect to see taxes go up – that’s really the only way to pay for overcoming a shortfall without cutting benefits, which Washington will not do.  And this is where the poor are most likely to be hurt. The “rich” and businesses will be taxed, and in a country were unemployment is 10 percent and underemployment is 20 percent, who will create jobs for the poor when the “rich” and middle class can no longer afford to?  

For those who believe this reform is worth it at any cost, perhaps you’re concerned as I am that there aren’t enough doctors, nurses and hospitals.  Assuming 32 million Americans are added to the system in 2014 when benefits begin, where are the doctors and nurses?  Most doctors do not support this proposal, and based on a survey published in the New England Journal of Medicine, as many as 29 percent of doctors would consider leaving medical practice.  I personally doubt this many doctors will actually leave, but it makes sense that some, perhaps a large number will if this reform moves forward, given the added burden it is likely to place on doctors.

I hope this whole thing works. I hope I’m wrong about the high price tag and the medical care shortages. But I really wish there was better leadership in Washington D.C. that was more concerned about actually solving problems and helping people, than feeling good and capitalizing on crises for political gain.  Happy thoughts won’t protect us from hyper-inflation, it won’t create jobs and it can’t provide medical care.  It’s time to start living in the gristle and grime of the real word and deal with the fact that we can’t have everything we want.