Playing chicken: Health care costs vs. Single payer

Turn to page A6 in today's Wall Street Journal "Overhauling Health Care" and I bet you'll come to the same conclusion as me: there's no place to hide from health care costs.Democrats Turn Up the Heat on Insurance Industry announces a proposal to levy $100 billion in new fees on health insurers. Who will ultimately pay for that, if not the companies and individuals that purchase health care?Businesses Worry About New Burdens describes concerns companies have about health reform bills moving through Congress. Even those that support reform and employer mandates are worried that there isn't sufficient attention being paid to cost reduction. They should be worried.Squeeze for Some in Middle Class describes "this funny dilemma where [middle class people] can't afford health care, but they have to pay a fine." Subsidies may be available for individuals earning up to $43,000 per year and families making as much as $88,000, but since health insurance premiums (never mind out of pocket expenses) for a family of four in my area are about $15,000 per year and rising fast, that's a big burden even for people with incomes that are substantially higher. Of course everyone who pays taxes or works is already paying into Medicare through FICA and through general taxation and deficit spending.I don't agree with 'Exchanges' Factor Deserves Attention, which says the issue isn't so much whether or not there's a public plan, but how health insurance exchanges work. Actually I'm more and more convinced that the big issue is whether there's a public plan or not. The reason is that if we move to near-universal coverage --which seems to be happening-- but fail to address costs --which also seems to be the case-- the existence of a public plan will make it easier to switch to a single payer system.Although it seems we're very far from single payer right now, I predict it will be part of mainstream discussion by the next general election cycle if we stay on the current trajectory.