In a recent poll, a majority of Americans surveyed said they
wanted health care reform to include some kind of public medical
plan that would compete with private insurers to hold down
costs. Somehow, the respondents felt, adding a government-
sponsored option would discipline the marketplace and keep costs
in line. The only way that will happen, however, is if
government reverses course after nearly half a century in which
it has been one of the biggest drivers of health care
expenditures in the country. The public sector already pays half
of all health care bills and has been subject to political
manipulation, pressure groups and outright patronage in managing
its portion of the health care system so expensively. One
indication of just how much of a culprit government has been in
the rapid expansion of U.S. health care costs is a 2005 National
Bureau of Economic Research study by economists Laurence
Kotlikoff and Christian Hagist which examined the growth in
public sector-care spending since 1970 in 10 indus