"A big f**king deal"

President Obama has won a major political battle (we'll see later who wins the war). He has succeeded where Bill Clinton failed back in 1993. The victory means we will have the largest expansion of social services in the US since 1965, essentially the biggest so far in my lifetime.

As VP Joe Biden so eloquently put it: "This is a big f**king deal."

As a result, some 32 million Americans (the number was over 40 million during the 2008 election hype) will be joining the ranks of the medically insured. Many, if not most, of these are health insurance companies dreams - young adults who were healthy enough to freely opt not to have insurance. Now they will be forced to pay and that pool of new money, along with $940 billion in federal fiat dollars, will likely make heathcare more profitable in the short-term.

Here's a nifty timeline of what should unfold over the next several years of reform.

The passage of the health reform bill is all about making sure more people get involved in basically the same chaotic healthcare provider we've always had. More people participating in essentially the same thing. That is called "reform." Most healthcare stocks were up on the news of the bill's passage. Wonder why?

And, as I have posted before, what about the costs of all this expansion in health coverage? Where does this bill address the cost of a trip to the emergency room or routine exams like mammograms and colonoscopies? It is difficult to find where this bill will affect the fundamentals that drive the cost of healthcare. And if we don't drive the costs down, isn't the taxpayer eventually going to have to pay for the higher costs?

Proponents argue there are plenty of cost controls in the legislation. I suppose this is possible. There are certainly complex arguments on both sides of the issue. But, taming the hungry monster just as we put more money in the mix doesn't strike me as an easy - or even realistic - task. The truth is the bill itself never addresses the sources that drive up health costs in this country.

As readers know by now, I have always been more concerned with the costs of this welfare-state expansion than with the matter of the uninsured. The vast majority of Americans are not excluded from our heathcare system. Certainly, our physicians are inefficient, the pharmaceutical companies and attorneys and insurance costs and the health habits of the American people (just to cite some primary factors) have combined to form a chaotic system that is bankrupting the country anyway. But, saddling the American taxpayer with more of the burden without a clearly defined approach to the cost of physician visits, tests, and routine procedures seems risky business.

Nothing in this bill tames the beast. Costs are of secondary concern. Even today there is very little about costs in the news. What little there is seems mostly regionalized. There are a few stories here and there. Unfortunately, much of the concern comes in the form of neocon political rhetoric instead of solid fiscal debate.

Most of the news is about how the bill will affect business, or how it will be implemented, or how it will impact charities, or how it wasn't a bi-partisan effort (like Medicaid and Medicare were), or even if it is constitutional. All this energy is wasted, in my opinion, because the reform is here and now we must pay for it...forever.

Now, that is a huge freakin' deal. Probably more than anyone realizes.