by Peter J. Fotos

Many Americans would like to believe the health care debate is over, but in reality it is only beginning.

The political left is rolling out $125 million over the next five years for a public propaganda effort in support of President Barack Obama’s new health care regime. Here is what we already know:

• The head of the Congressional Budget Office says the new law will not alleviate pressure on the federal budget.

• The chief actuary at the Centers for Medicare & Medicaid Services says premiums and overall costs will continue to rise at an alarming rate.

• Major American businesses are contemplating eliminating employee coverage.

• The cost of paying physicians participating in Medicare will be one-third more than expected.

Perhaps this is what House Speaker Nancy Pelosi was referring to when she said we need to pass this bill to find out what’s in it. But for all we have learned since the law was signed, there is still more to come in the years ahead, thanks in large part to Pelosi and Obama themselves.

When he began this process, the president faced a decision: whether to expend his political capital to achieve an ideal liberal program or take more modest steps that might attract bipartisan support. It appears the president could not make up his mind. He claimed to favor bipartisanship but rejected any meaningful discussion of the major policy issues. He claimed to favor a public option but was unwilling to insist on it.

Ultimately, Obama and the Democrats chose to adopt a half measure program, an incoherent amalgam of multiple legislative pieces, which taken as whole only delays the inevitable: a debate over whether to move definitively toward single-payer or market based health care. He cannot have it both ways.

A recent Rasmussen poll says 33 percent of voters favor the creation of a single-payer, government- run system, while 54 percent oppose it. Fully 63 percent of respondents favor repealing Obamacare.

The political left is dissatisfied with the bill, realizing it was more about achieving a political victory than the massive policy shift they desired. The political right intensely wants Congress to start over from scratch.

You would be hard-pressed to find anyone in this country who believes our health care system worked without any faults or problems before Obamacare passed. The president’s real failing is that he never gave the nation a reason to believe his plan would improve things. Instead he told campfire horror stories about evil health insurance companies, tales often fundamentally disconnected from reality. Now he has a program with his name on it, which right and left alike will blame for the health care problems of the next decade.

The reality is that all stakeholders are to blame for high health care costs--not just insurance companies but also doctors, bureaucrats, and hospitals, with government mandates and payment schemes bearing a large part of the responsibility for the system’s problems.

A government takeover is not the answer. The solution is individual empowerment in which patients control their own health care dollars. This will allow people to establish the real value of health care in their lives and require providers to deliver it efficiently lest they lose customers, as would any other business.

Obama’s legislation, by contrast, was about increasing government control while essentially maintaining the current blended public-private system. Countless studies – including government ones – show his plan will do nothing to brighten our dreary fiscal future. Entitlements will consume more and more of our federal budget while Medicare already has an unfunded liability of $38 trillion. Medicaid will continue drowning state budgets at the expense of education and transportation funding.

Something has to give. It will come in the form of another massive debate about health care policy between people with very different principles but strong and fervent beliefs about the right thing to do – unlike the current president.

Peter J. Fotos (pfotos@heartland. org) is director of government relations for The Heartland Institute in Chicago and former health policy advisor to U.S. Senator Jim DeMint of South Carolina.