The budget deficit has reached $480bn this year, and some experts predict it will rise above $1 trillion by next year, when the cost of the bail-out is included.If others overseas can see the situation, why can't we?
This would represent half of all of federal spending, and put enormous pressure on interest rates and new spending programmes.
Most healthcare analysts believe that even without the deficit "there are no easy paths to financing universal coverage," as Professor Jonathan Oberlander of the University of North Carolina writes.
"All major financing options have serious political liabilities; they risk arousing either public opposition and anti-tax sentiment or stakeholder opposition," he adds.
He argues that neither plan is likely to generate enough cost savings to be self-funding, and that fiscal rules will make it hard to count the expiry of tax cuts as fresh income.
However, the key Democratic Senator in charge of such reform suggests that it would still proceed.
"While some suggest that the current economic situation might thwart efforts to overhaul America's healthcare system, I believe the state of the US economy makes the need for healthcare reform even more urgent," said Democratic Senator Max Baucus, chair of the Senate Finance Committee.
Simple. In America, fixing our health care spending orgy will always be someone else's problem. It's just gotten too big for any one person to get their hands around it. So rather than face fiscal reality and all that that entails, we just keep adding hydrogen to our Healthcare Hindenburg.
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