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Guess who really pays for health care?

By Ed Rollins, CNN Senior Political Contributor
  • Ed Rollins says President Obama should have explained that health bill will cost taxpayers dearly
  • He says health care consumes 17 percent of the nation's economy
  • He says costs are rising at a rapid rate, and consumers are footing the bill
  • Obama's attempt to add some GOP ideas doesn't go nearly far enough, Rollins says

Editor's note: Ed Rollins, a senior political contributor for CNN, is senior presidential fellow at the Kalikow Center for the Study of the American Presidency at Hofstra University. He was White House political director for President Reagan and chairman of the National Republican Congressional Committee.

New York (CNN) -- If President Obama had been forthright last week at the health care summit, he would have opened the meeting by stating: "If you have health coverage, under our reform bills you are going to pay more and get less. If you are one of the 45 million elderly or disabled people on Medicare, you are going to get less. There is no such thing as free medical care. Somebody has to pay! And in the end it is you."

Those are the facts! And as Senate Majority Leader Harry Reid stated to the Republicans : "'re entitled to your opinion, but not your own facts."

However, the facts, as the president has found out, are not exactly a compelling message to persuade a reluctant Congress and public to overhaul nearly one-fifth of the nation's economy.

Adding 31 million people (45 million now don't have coverage) to the health care system will cost the taxpayers trillions over time. Many of that uninsured group can't afford health insurance, and if this legislation passes, the government will create an entitlement program to subsidize them. In the end, like the entitlement programs that have gone before them, they will far exceed any cost estimates on the table today.

Just to remind you, Mr. President and members of Congress, the taxpayers have a right to know the full fiscal consequences of this legislation. The United States is spending this year nearly $2.5 trillion on health care. That is 17.3 percent of the U.S. economy and it's rising at a rapid rate. We spent $134 billion more in the past year than in the year before.

To put $2.5 trillion into perspective, that is more money than the federal government received in taxes and revenues this year. The problem is nobody knows (and especially the Congress) what a trillion dollars really means.

A trillion is a million million. Still means nothing to most of us. If you spent a million dollars a day since the birth of Jesus Christ, it wouldn't even equal a trillion. If you stacked up a trillion dollars in dollar bills, it would reach 68,000 miles into the sky, about a third of the way from the Earth to the moon. Those numbers are too big for any of us.

Somebody has to pay for the most expensive health care in the world. Many experts would argue it is also the very best health coverage in the world.

Health care today is paid for by three entities. The government (federal, state and local) pays more than 50 percent of the costs. That is us, the taxpayers.

The insurance companies pay about one-third of the costs. That again is us.

We pay the premiums and the insurance company pools the risk, and distributes our monies back for the medical services. They obviously add an overhead cost as does any business, but it's still our money being paid out.

The third payer is again us. Out-of-pocket reimbursements or additional fees come directly out of our pocket and paycheck.

Health care has changed as dramatically as anything in our society in the last half century. First, we are living longer. In 2007, American men could expect to live 3.5 years longer and women 1.6 years longer than in 1990.

We are long past the days when you walked into a doctor's office and the doctor -- armed only with a stethoscope, blood pressure monitor and a thermometer -- listened to our symptoms and made a diagnosis. Maybe in a rare case an X-ray was called for. We paid our bill and went to the drugstore and got our prescription. There were no MRI's, no heart diagnostic tests, no CT scans or any of the wonder drugs that have extended our lives and in many cases made the quality better.

It's not that people aren't seeing doctors. In the last several years, more than 1.2 billion annual visits to a physician's office have taken place, averaging more than three a year per person.

Certainly, some efforts must be made to provide some insurance reform -- but that also means malpractice insurance reform. Some massive efforts need to be made to curb Medicare and insurance fraud. And efforts must be made to create more competition among insurance companies across state lines.

The president's attempt to add some of the better suggestions from the Republicans addressing these issues is not going to add any support from that side of the aisle. They are minor changes that are positive but don't tackle the fundamental cost issues or address the new entitlements and mandates that Republicans object to most.

Reducing costs in most cases means reducing services. Who doesn't want an MRI for their child injured in a car wreck? Who doesn't want tests done on a spouse or parent who has chest or abdominal pain? But if Reid and Pelosi shove this legislation through Congress against public opinion, they and their party will pay a price.

Yet the price Democrats will pay at the polls in November won't be nearly as big a price as our kids and grandkids will pay when the bill comes through years hence. If you're going to have reform, make the system better. Take your time and do it right.

The opinions expressed in this commentary are solely those of Ed Rollins.