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With Health Care Passed, Where Are We Now?

by Scott Bittle

Thursday, March 25th, 2010

Is there anything about health care that hasn't already been said, or that isn't going to be said in the next few months? Maybe not, but a few points are worth repeating.

The health care plan is an enormously important piece of legislation, expanding health coverage to millions more Americans. A Pew survey found half of the public said they had not only followed news reports on health care but had also talked about the bill with friends or family. That's a huge amount of public interest. Yet three-quarters also gave the media fair or poor grades for explaining the details. There are many equally difficult, pressing challenges awaiting us, such as energy and climate, immigration, and our national debt. As a nation, we simply have to do a better job of helping citizens through their learning curve on complex problems.

Our fiscal problems, in particular, can't be solved without engaging the public, because the problems are fundamentally those of choices, priorities and values.The Congressional Budget Office projects that the new health care plan will cut the deficit by $138 billion over the next 10 years, and by another $1 trillion in the decade after that. But a lot of the projection depends on factors that are hard to predict and on what Congress will do in the future.

If the CBO projections are right, we'll be saving $138 billion, but the national debt held by the public will climb from $7.5 trillion to $20.3 trillion by 2020. The furious commentary over the cost of the health care bill tends to gloss over a key point: whether the plan works as advertised or not, the federal budget is still on an unsustainable path. We have lots of options to change that, but all of them require tough choices about what's important to us as a nation. And none of them are going to work unless we start doing a much better job of engaging the public in making those choices.


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