Both are justified fears.
The Congressional Budget Office has produced enough projections and data to legitimize the unexceptable cost.
Proposals such as having Med-PAC technocrats manage Medicare policy. This proposal is billed as ” taking the politics out” of Medicare, meaning the Congress. Who is to say the Med-PAC board will not become crooks? Could they not receive bribes and pay-offs? Freddie Mac and Fannie Mae officers were not elected politicians. Were they not influenced?
Expanding the Federal role will not fix anything, but will make the so-called reform pallatible for a time, a short time.
What will work?
Create competition! The Federal government should exercise a proper role to create competition in the medical fields and then step aside.
But, you might say, much of medical care does not lend itself to competition as you might find in the automobile or furniture business. Much of medical is a natural monopoly. After all many towns only have one hospital. So, you write regulations as best you can and make violations punative.
Much of medical does lend itself to competition. There is a role for the Anti-Trust Division of the Justice Dept. to find creative ways to establish real competition. Should pharmaceutical companies still be merging in this climate. Well, they are merging.
First year enrollment in medical schools is about 18,000. Maybe it should be about 30,000.
There is a proper role for the Federal government, but it is not managing health care.