Dr. Jeffrey S. Flier is the dean of Harvard Medical Schoo. As such, he resides in the tallest Ivory Tower, within the most impenetrable Ivory Keep, surrounded by the deepest Ivory Moat. So when he writes, in the Wall Street Journal‘s editorial page, that what you see is not what you get with the left’s currently proposed health care reform, he knows what he’s talking about.

Flier notes the lessons of the Massachusetts health care reform, which he notes has insurance-expanding measures similar to those in the bill under consideration. MassCare, he warns, expanded insurance (although not quite to everyone) but increased spending to the point that in the near future Massachusetts will have to find ways to cut spending drastically.

This example, he warns, should be taken to heart, because we can expect a similar outcome for Obamacare:

Selling an uncertain and potentially unwelcome outcome such as this to the public would be a challenging task. It is easier to assert, confidently but disingenuously, that decreased costs and enhanced quality would result from the current legislation.

So the majority of our representatives may congratulate themselves on reducing the number of uninsured, while quietly understanding this can only be the first step of a multiyear process to more drastically change the organization and funding of health care in America. I have met many people for whom this strategy is conscious and explicit.

We should not be making public policy in such a crucial area by keeping the electorate ignorant of the actual road ahead.

Thanks for the honesty, Dr. Flier. It’s good to know that, while too discreet to let it slip in public, liberal proponents know that Obamacare is only half the goal: first get everyone insured, and then worry about paying for it.

There are plenty of ways to control costs or manage the budget overruns once everyone’s on the rolls. But you have to imagine that the option Flier’s interlocutors have in mind is single payer.