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Larry, I think that you have largely deuitngsishid our two positions on health care. By and large, both Medicare and Medicaid are too complicated, both politically and economically, to unwind. I suspect that reforms can be made at the edges and more major changes could be implemented in both programs if those using and about to use (at least for Medicare) were grandfathered.What I don’t understand is why, after realizing the huge problems associated with Medicare and Medicaid (toss in Social Security too), people want to create a health care program for the remaining residents of the U.S. that will soon become just like the others.One of the key problems with our health care system is that consumers have little or no incentive to control costs. Moreover, controlling costs at the personal level sure makes more sense than having government agencies control them. I had surgery on my left eye this summer. I have insurance through my wife (a career federal employee). I asked my optometrist (a preferred provider) for a surgeon who was also a preferred provider. The doctor has performed more than 20,000 surgeries and everything worked out. I behaved in a manner that obtained quality results with cost savings to the system and to me.Obama’s plan doesn’t provide these personal cost saving incentives. He’s a redistributionist and wants to create more dependency. FDR had it right give people benefits and they will vote for you. When most people didn’t make it to 70, FDR’s plan worked. But it doesn’t any more. By and large, people need to be responsible for themselves. Risk sharing through insurance makes sense. but if we want economic growth, we cannot tax our way into paying for redistributionist plans.We need a plan that provides incentives for the insured to select cost effective and high-quality health care.

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