Hillarysworld

Outraged that you'll be paying nearly two-thirds more than you do now? Ready to demand repeal of the reform law passed early this year?

Think again. The estimate, from the actuarial department at the Centers for Medicare and Medicaid Services, actually amounts to a kind of tacit endorsement of the measure. That's because the new law would have virtually no effect on the upward trajectory of health care spending, while bringing insurance coverage to an additional 32.5 million people and ending the worst insurance company abuses.

Put another way, the controversial reform measure has enough cost controls to deliver protections to more Americans for roughly the same money as would have been spent otherwise. What it doesn't have is enough controls to prevent health care from growing at unsustainable rates much higher than inflation. That's not a reason to repeal health reform, but it is reason to revisit it.

Health care spending continues to surge in part because, once deductibles and co-payments are satisfied, patients and providers are largely free to play with insurers' money. This creates incentives to overprescribe, overtest and overtreat — and to develop high-priced new drugs and other products that are only marginally better than existing ones. There is a lack of any real push toward efficiency. The price for all of this is passed along in the form of higher premiums and soaring outlays for government benefits.

" Bending the cost curve on health care is hard to do," President Obama conceded at Friday's news conference, something he downplayed while selling his plan to a skeptical public and Congress. Ideally, the two parties would join to do the heavy lifting, yet an honest discussion of what more needs to be done on health care costs is lacking from the current partisan debate.