WASHINGTON -- From the White House to Capitol Hill, it seems that just about everyone in the nation's capital is in favor of health-care reform, but nobody wants to shoulder the burden of paying for it.  President Barack Obama is not about to wade too deeply into that debate.  During a prime-time news conference Wednesday devoted almost entirely to health-care reform, Obama harped on the reasons for reforming health care immediately (skyrocketing costs) and the disastrous effects of not changing the system (an unsustainable federal deficit).  But what was absent from the president's remarks--and what's stalling the debate in Congress--is an admission of who's going to pay for reform. According to Obama, roughly two-thirds of the savings in the health-care overhaul, expected to cost about $1 trillion over the next 10 years, will come from cutting waste in current government medical programs. But what about the remaining third? (For the full text of the president's speech, click here.)  The president admits that reform will require patients and hospitals "to be more discriminating consumers." His preferred method of raising revenue is to limit itemized deductions for the wealthiest Americans, but that idea hasn't made it into any of the proposals that have emerged so far on Capitol Hill.  "I continue to think my idea's the best one," said Obama, adding that he's "not foreclosing" on any other suggestions.  So far, the primary "other suggestion" has been a surtax on Americans with annual adjusted gross incomes of more than $350,000. Business groups, fiscally conservative "Blue Dog" Democrats in the House, some Democratic senators and all Republicans have balked at the idea, which is a central element of a recently introduced bill in the House of Representatives. (See "ObamaCare: Who Gets Hit And How Hard")  That's a big problem for the president because until other proposals to pay for health-care reform materialize, ObamaCare is essentially synonymous with the House bill. And it's fairly clear to just about everyone with a stake in the debate that the House bill-at least in it's current form--will not become the law of the land.  Meanwhile on Capitol Hill, efforts to pass a health-care bill seem stalled indefinitely. Senate Minority Leader Mitch McConnell, R-Ky., says he "can't find a single member who is not for trying to improve America's health-care system." Yet, the Senate Finance Committee has not been able to reach an agreement to pay for reform.  The House bill, which has cleared several hurdles so far, is stuck at the committee level because Blue Dogs want to make sure that the legislation is fiscally responsible, deficit neutral and that it includes several other key elements, such as not harming small businesses. Blue Dog Rep. Baron Hill, D-Ind., says there's "progress, albeit slowly, on trying to get a bill that we can vote out of committee."  Obama had been pressuring both chambers to pass legislation before their scheduled August recess, but with that looking increasingly unlikely, he seems to have backed off such a firm deadline.  "I do think it's important to get this right," he said Wednesday night. "I'm not going to sign a bill that I don't think will work."  That should be easy. No one in Congress has been able to produce a bill that will work.
Who will foot the bill for a reform of the system? Answering that question will resolve the debate.