Unless the unexpected happens, we're about to get some major changes in health care.
The main effect of these changes will be to add millions of people to Medicaid and to give subsidies to others to buy private health insurance. In a nutshell, after this bill goes into effect -- some four years from now, many fewer people will be uninsured.
This part is pretty good. The U.S. should not be the only major industrial nation without health care for millions of poor citizens. People should not die, lose their homes or go into bankruptcy for getting illness and injury treated.
I have long believed this. More than 35 years ago, when I was a junior speech writer for Mr. Nixon in the White House, I wrote the message that sent up to Congress a proposal for the feds to buy health insurance for all of the indigent and lower middle class in the country. Mr. Nixon believed in it and so did I, then and now.
But how are we going to pay for what we are about to get? Mr. Obama plans to place a heavy tax on so called "Cadillac" private health care plans, to tax them as if they were income, in effect. There could also be a new tax on very high income Americans in the cards. This makes sense.
But the plan is to also cut reimbursements to doctors for their work on Medicare patients and to strictly regulate insurers.
I don't like these parts. Why should doctors, already often wildly overworked and not at all well paid compared with bankers or rock stars or athletes, get their pay cut?
And why are we beating on the insurance companies? They are not raiders from another planet. They are American companies, owned by other Americans' pension funds and retirement accounts. They often screw up, but then so does everyone everywhere. If they are going to be required to cover pre-existing conditions, premiums for healthy people will soar. Is that fair?
Well, anyway. It is a brave new world now. Uncle Sam is bigger than ever and there's no going back. America, just roll up your sleeves. This won't hurt a bit.