President Barack Obama came a long way towards acknowledging the ultimate consequences of his health care plan yesterday. But he still has a long way to go before he comes clean with the American people. First, President Obama acknowledged that, contrary to his repeated earlier promises, his health care plan will force millions of Americans out of their current health care. Obama said: “When I say if you have your plan and you like it, and your doctor has a plan — or you have a doctor and you like your doctor, that you don’t have to change plans, what I’m saying is the government is not going to make you change plans under health reform.”

That is a distinction without a difference. If the government creates financial incentives that cause 119 million Americans to be placed in government care, then they are culpable whether they specifically forced Americans or not. After all, Obama’s cap and trade plan does not force energy companies to raise energy prices, but Obama has, to his credit, admitted: “Under my plan of a cap and trade system, electricity rates would necessarily skyrocket.” Americans deserve this same frankness on health care.

Another huge admission by the President yesterday involved his insistence that any health reform include a public plan. Earlier this month, Obama told the American Medical Association: “What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system.” But yesterday Obama admitted: “I think there can be some legitimate concerns on the part of private insurers that if any public plan is simply being subsidized by taxpayers endlessly that over time they can’t compete with the government just printing money, so there are going to be some I think legitimate debates to be had about how this private plan takes shape.”

It’s good to see the President acknowledging that there is real legitimate concern that a government plan will inevitably lead to single-payer health care. As we have pointed out before, it is impossible for the federal government to play both umpire and competitor in any market, especially health care. Here are just some of the questions that Congress has not yet addressed: Would the public plan be subject to state premium taxes, like private health plans, or state insurance laws, or solvency requirements with the private plans in states with which it is competing? Will public plan officials be subject to the same state and federal tort laws as private firms? How about the same accounting standards as private companies? Could they be sued for breach of contracts?

And most importantly, as the President himself identified, how can this government credibly assure the American people that a public plan will not drive private firms out of business by offering lower premiums, due to their ability to be constantly bailed out by the federal government? This is, after all, the same federal government that in just the past year has bailed out AIG, Citibank, Freddie Mac, Fannie Mae, General Motors, and Chrysler. If all those “private” companies were too big to fail, what intelligent American would believe for a second that the federal government would not hesitate to bail out a money-losing public health plan?

Americans have every reason to be suspicious that the public plan is just the first step on the road to single-payer care. Rep. Jan Schakowsky (D-IL) has explicitly said so. So has Sen. Russ Feingold (D-WI). And in 2003, President Barack Obama told the AFL-CIO: “I happen to be a proponent of a single-payer universal health care program. … And that’s what Jim is talking about when he says everybody in, nobody out. A single-payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately.” Everybody in out, nobody out; that’s Obama’s ultimate goal. And with the public plan, he’s not going to force Americans to get there, he’s just gonna make it impossible for them to choose anything else.

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