I think that may not be a valid measure.

In the first place, these are elected officials. They have to consider not merely what would be desirable in principle, if they had unlimited political capital, but what can be sold to the voters with the limited political capital they have. And any statement they might make will either add to or subtract from that political capital. You can figure that most people who get into Congress do that accounting almost reflexively before they say anything at all; it's news when someone misestimates or gets caught saying what they really think.

And selling abolition of Medicare would be very difficult; it's a benefit to the elderly, which they don't pay for, and the elderly pay close attention to politics, and vote in disproportionate numbers. The AARP is a lobbying group as powerful as the health insurance industry. That no more proves that this is a good policy than the lobbying power of the health insurance industry proves that "business as usual" for them is a good policy. Both can be explained perfectly well as rent-seeking, or in the case of the elderly and Medicare, as entitlements.

Beyond that, in what sense is Medicare "government health care"? It's not comparable to the VA, which, as I understand it, runs its own medical facilities where beneficiaries can come in and have medical services performed at no charge. It's certainly not comparable to the system Canada had until very recently, where the only legal way to acquire health services was to go to a government funded provider, because you could not legally spend your own money on your own doctor unless you came across the US border. Rather, it's a program of massive government subsidy for the purchase of health care by the elderly. They're allowed to find their own vendors, and to pay for extra services out of pocket; indeed, they're actively encouraged to buy supplemental insurance that they pay for. This is "government health care" in the same sense that farm price supports are "state run farms."

And in the second place, so far as the real problems of health care are concerned . . . the upward spiral of health care costs . . . Medicare is part of the problem. It's a subsidy, and subsidizing an industry always forces its prices upward, as people who get to buy its products at a discounted rate compete to buy more of them, forcing people who don't get the subsidy to pay extra to get a share. Continued reliance on this mechanism will result in continued upward movement of health care costs. To bring them under control through government health care, it would be necessary to forbid the elderly to obtain health care from private sources, or with their own funds, and limit them to what the government was prepared to fund in public clinics and hospitals . . . and that would be immensely politically unpopular.

The way we're headed appears to be massive rent seeking by the health insurance industry. They'll accept government control over how much they can charge for policies, and who they can accept; and in return they'll get laws under which people are forced to pay for policies, no matter how ruinous the cost (if they're poor) or how able they are to pay for their own health care (if they're rich). And actually bringing health care costs under control will be politically unpopular, as was shown when HMOs starting trying to provide "managed care" in the 1990s. So I expect what we're going to see is health care becoming even more ruinously expensive and much harder to get.

Hey William,

First representative Weiner was being sarcastic and ironic. He had been listening for weeks to Republicans demonizing any form of government involvement in medical or insurance care. So he challenged them to put their money where their mouths were. If government involvement is so horrible then we should do away with the veterans administration and medicare. They are both run by the government.

And that's not how medicare works. You get your medicare card which means you get basic medical care -- physicals, tests, etc. If you want cadillac coverage you buy a supplemental policy which reduces any cost to you even further, and may speed up wait times for various procedures. When my mother had her lung cancer surgery medicare too care of the bulk of the cost, and the supplemental picked up what remained.

The drug coverage that was put in under Bush is a joke because it specifically states in the law that medicare cannot negotiate with the drug companies to reduce costs. Big Pharma is making a killing off this, and seniors are suffering under the so called "donut" hole where suddenly they have to pay full boat for their prescriptions. In Canada, and at the VA hospitals they get to negotiate, and their costs are much, much lower.

Personally, I'm not happy with what's being proposed though it is better than what we have. If this passes insurance companies won't be able to make me an automatic deny. On the other hand I have seen nothing in any of these bills (aside from the public option) that will keep insurance companies from making it too expensive for me to buy coverage.

I also think that it was never illegal to seek alternative health care in Canada. My impression was that money always talks. I will check with Canadian friends to see there was an actual restriction. At any rate, it doesn't exist now.

I want a single payer system. I just spent a week hanging out with my friends from Australia and they _love_ their system. For people earning over a certain amount 2% of your income is dedicated to a health fund, and from that the government pays for health care for everyone. You are issued a card that is simply swiped when you go to the doctor -- no forms, no hassle. This covers basic medical care, and if you want knee surgery your are probably going to end up on waiting list. If you have a crises you get care immediately. You will be cared for in public hospitals where there are no private rooms.

If you can afford it you can add a supplemental policy that enables you to go to private hospitals and get your knee surgery more quickly. The cost to my friend for this additional policy $110 a month.

Is there rationing of care. Yes, to this extent. If you are 88 years old they are not going to give you a new heart. They are going to give that heart to a young person. If you are alcoholic they are not going to give you a new liver.

Even under medicare we have rationed medical care because at some point further treatment is a waste of resources. But my mother loved medicare, and I haven't met a single senior who didn't look forward to the day they had coverage.

Increasing medical costs are scary. But some of those increases are due to the fact that we are all paying for the uninsured who end up in emergency rooms, we are paying for 1.2 Billion dollar bonuses for the head of United Health care. 30 cents of every dollar goes to pay insurance bureacrates who are looking for ways to deny your coverage or end your coverage if you get sick. And we paying for more an more elaborate machines, and forgetting basic preventative care for a citizens. People who have no insurance or are under insured end up costing the system a hell of a lot more money because they wait until they are desperately ill before they seek medical attention -- at an emergency room -- the most expensive place to receive care.

And for another ironic take on the health care debate check out this wonderful article by Jonathan Alter of Newsweek magazine. http://www.newsweek.com/id/209817

Two percent would be pretty bearable. The last figure I saw in the New York Times was that a compromise had been made on giving subsidies to the poor once their insurance costs reached 12% of their income. That's a lot less bearable.

Consider: Two full time wage earners both at the new minimum wage: gross income $29,000 a year. Once they're paying $290 a month, they get help for the extra. $290 a month would be difficult enough for me that I would think about paying the annual penalty instead, and I make more than $29K and have comparatively low expenses. This particular compromise is going to force a bunch of people who are worse off than I am to spend more than they can afford buying health insurance. It looks like a great windfall for the insurance companies, but its actually helping people in need looks a lot more dubious.