I have been a practicing physician for the last 23 years. I have witnessed many changes in technology, politics and insurance over that time.

Throughout my career my only goal has been to worry about the proper delivery of care to patients in need. Now we are faced with a national standoff that is not about the delivery of health care but about the delivery of political promises and the creation of a social entitlement long dreamed of by the Democratic Party and other progressive interests in our country.

The plan is not really about health care for the patient; it is about channeling tax dollars to the special interests aligned together in the creation of the health-care reform bill. Insurance companies stand to gain millions of new policyholders from the dismantling of the Medicare Advantage plans. Drug companies have supported the plan because they have assurances that their charges will not be slashed and more insurance guarantees will become available to cover their drugs. The unions, especially, have much to gain by shifting costs for medical care to the public sector and, more important, by enlarging the union rolls with many thousands of new members from among the new government workers to be hired to implement the plan. All of this will occur at the expense of quality health care delivery if we do nothing to stop it.

The real question at this point is whether President Obama and the Democratic-run Congress can somehow convince the American public that the health reform bill has magically transformed itself into something other than what it was when originally passed by the House and the Senate. The talking points about the bills center on how the cost of health insurance will continue to rise if reform is not passed. They stress that the insurance companies continue to take advantage of struggling families by gouging them for higher premiums. They imply that the vote will be for the current bills or “nothing.” The unending mantra is that the Republicans are continually holding back the progress of the legislation.

All of this comes from a Congress and a president who have controlled the majorities of both houses and controlled the procedure , debate and entire process (almost entirely in secret) of the legislation for one whole year and have been unable to pass the bills on to Mr. Obama. This has occurred primarily because of infighting within the Democratic Party and the keen awareness by the American public that the claims made about the reform bill regarding its purpose and creation are untrue.

The goal of the health reform bill has always been a federal takeover of the health delivery system in America in order to create a new and permanent entitlement for the American. This would be done in order to redistribute wealth by increasing taxes to be paid in subsidies for millions of new health insurance policies and to be paid in salaries for many thousands of new bureaucratic positions within the government. This will control and consume a full one-sixth of our economy and will come with obligations of government oversight and control of utilization of care.

There is no question that the cost to our nation for the plan before Congress will be tremendously larger than the cost of premium increases derided by the president. Mr. Obama also shares in the blame for the very cost increases he is criticizing since the “spend our way into prosperity” plan pushed by the administration has not resulted in saving or creating the jobs that are so badly needed by our country. These job losses have resulted in foreclosures, bankruptcies and the loss of medical insurance by millions of Americans.

Insurance works, of course, by spreading the cost of needed services across a large “risk pool” in order to provide those services at an affordable rate to the few subscribers who actually use them. As the “risk pool” is reduced by job losses, the remaining members of the pool must share ever larger fractions of the total cost thereby increasing premiums.

While I certainly don’t intend to imply that this has been in any way a “plan” by the administration to help pass the bills, I do think it is a bit disingenuous of the president to focus on such cost increases as a reason to have the federal government proceed with a tremendous enlargement of services in order to rectify the problem that he has helped create. It leaves me at least with little confidence that the same people who have helped cause the problem will be able to efficiently fix it, especially given the famous innovation and flexibility of our government.

I fear that the president and Congress have no desire to try to fix the real problems we currently face with jobs, our struggling economy, the Social Security system, Medicare, or Fannie Mae and Freddie Mac until they are able to push through their health reform bill. because these problems can only be fixed by fiscal restraint. And who in their right mind would argue for the creation of a huge new federal entitlement program costing one-sixth of our economy when they are talking about fiscal restraint?