underlying problems, is this smoke and mirrors or political expedience at the very least? first of all, ezra is right. most of the taxes that will pay for this bill don t kick in until four years down the road. so that s just not true. but the problem, as both of them have noted, is it really doesn t bring down costs. that s largely due to the deals made up up front, with the phrma, hospitals and ama, that frees all of the health care costs in place as well as the dependence on the employer insurance system. and that is going to prevent our ability for the next ten years to really deal with health care costs. it s going to pour concrete into the present system. and really keep us from being able to make health care affordable. the german system, health care costs are roughly half of what they are here. and they have better quality of care. we can t do that. we spend a huge amount of money, our percentage of our gdp on health care frlt and if we go and sort of lock in all of these dea