PERSPECTIVE FROM THE 19^TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as a Congressional press secretary in Washington, D.C., an Oregon state government manager in Salem and Portland, press secretary for Oregon’s last Republican governor (Vic Atiyeh), and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.

Every time I read about health care single payer proposals, such as from socialist candidate for president Bernie Sanders, I cannot help but think of this TV advertising line:

“I want it all and I want it now.”

The ad is for some goofy offering – Grubub on-line that will make food deliveries to your house.

Sanders wants to make the same kind of delivery. You can have all the health care you want and you can have it now.

At least that’s true until you look at the details of what Sanders and others are proposing. For one thing, no one want so talk about the cost of the “have it all and have it now” proposition, which goes into the billions, if not trillions, of dollars and would require huge tax increases.

That doesn’t bother Sanders and his ilk because they love spending other people’s money.

The Wall Street Journal (WSJ) put it this way this week in a headline on an editorial:

The Burdens of BernieCare

Congress’s budget gnomes tip-toe around single-payer’s reality

The editorial went on:

“Bernie Sanders sells Medicare for All as a simple idea: ‘You will have a card which has Medicare on it, you’ll go to any doctor that you want, you’ll go to any hospital that you want.’ So, the Congressional Budget Office (CBO) provided a public service last week by describing, albeit in thick and cautious bureaucratese, what it would really take to float BernieCare.

“Democrats asked CBO to lay out some parameters of how to set up single-payer, hoping to elude analysis of any one bill in Congress. The latter would carry political accountability—and a price tag. Instead CBO walks through ‘key design components and considerations’ in a report that aims to bore and deploys the word ‘could 209 times.

According to the WSJ, the CBO report acknowledges, for example, that a transition that includes moving 160 million people from employer-sponsored coverage to single payer would be “complicated, challenging, and potentially disruptive” to health care and the economy.

“Further,” WSJ continues, “the Sanders Medicare for All bill would ban private coverage that competes with government. CBO notes dryly that single-payer proposals often prohibit private insurance because ‘some high-income people might prefer to purchase substitutive insurance that offered more generous benefits or greater access to providers.’

“And you can’t go to any doctor you want if government isn’t paying providers what services really cost. The point of Medicare for All is to cut reimbursement rates to Medicare levels, which government can now set so low only because private commercial reimbursement rates are so much higher. Cutting reimbursement rates would ‘probably reduce the amount of care supplied and could also reduce the quality of care,’ CBO says.”

The CBO does not wade into the details of what all this would cost, though it admits “government spending on health care would increase substantially.”

Honest private estimates suggest it would take at least a doubling of individual and corporate taxes to fund Medicare for All. Proponents say the country will save money through lower administrative costs, which CBO says may materialize. But the real savings would have to come from where the money is: Cutting payments to doctors and restricting care.

Another way to describe Sanders’ apparent motivation is that he wants voters to believe he is offering a free lunch. You’ll get what you want and you’ll get it now – so, he says, vote for me.

But voters should know Sanders is promising miracles when what he’ll deliver is poorer care for everyone.

My fervent and continuing wish is that people of goodwill and good intent on both sides of the political aisle – yes, there are a few left – would get together, figuratively, around a round table and hammer out health care public policy from the middle.

Is there room for improvement in what is now offered? Absolutely. From the left — spend all you have and more. From the right, throw up roadblocks to any new proposal. Neither will do the trick.

What we need is a commitment to find the smart middle, which is, to be sure, well nigh impossible in the current environment.

Too bad!