Yesterday, the non-partisan Congressional Budget Office released its long-awaited analysis of a single-payer health care system for the United States. (here) The CBO is the official score-keeper of any major proposed federal legislation and typically estimates the cost impact of the bill.

Both the U.S. House and Senate now have single-payer bills in committees. Because of the growing discussion of a single-payer system in the U.S., the CBO pro-actively reported on the subject without analyzing a specific bill.

The 30 page report contains a lot of “coulds” and “woulds” while essentially listing the possibilities for each impact of a nationalized health care delivery system. For example, the CBO anticipates that financing could come from federal, state, and local governments, or some combination of the three. There is no actual estimate of the overall cost or the amount of new taxes required.

Likewise, the report lists the different potential scenarios for impact on patients and providers without drawing specific conclusions. It does conclude that certain additions, such as long-term care, would have a definite cost impact on the country.

It is almost certain that a single-payer bill will not become law with the current Republican-controlled U.S. Senate and the White House. If proposed legislation does work its way out of committee, however, the CBO has an obligation to estimate the impact of the various parts of the bill. Americans have a right to understand the increase taxes, the change in their health care access, and the burden of nationalizing one fifth of the U.S. economy. Eventually, the CBO will need to get specific.