The Washington Times has a story about Mark Warner addressing one of the biggest unspoken problems in the health care reform debate.

“I wish the president would have started the debate by explaining to the American people that our current health care system is not financially sustainable, for even another decade,” Mr. Warner said. “Driving down health care costs should have been the focus of the debate.”

Warner is completely correct our current system is completely unsustainable and will not survive another decade if it continues in the same manner it has been. The current reform proposals will make some important steps which should help slow the exploding growth rate, but they are too little too late. The problem is that there is not the political will for real cost-cutting reform at this time. Warner himself is as guilty as anyone on that matter. He claims to see the train heading for the cliff, but he has yet to endorse the kind of radical reform necessary to reduce cost.

Has Warner endorsed single payer? Did he come out strongly in support of a public option tied to Medicare rates on the new exchange, which would save the federal government $110 billion? Did he even go a step farther and demand a Medicare-like public option be available to all individuals and business. A move that would drive premiums down and bring in hundreds of billions in taxes because of increased wages? Has he endorsed a single provider rate setting mechanism like Switzerland, Belgium, France, etc., which could cut over 30% of the cost of our health care? Does he support a massive reform of the pharmaceutical industry which would save the nation hundreds of billions by bringing our prices in line with the rest of the world?

Sadly, the answer to all of these questions is no. As much as he claims to be disappointed that Obama is not pushing the issue of cost containment, Warner is equally unwilling to spend the political capital to champion ideas which have a proven track record around the world.

This is the real unspoken issue in the health care reform battle. Smart people, officials like Warner, in very safe seats, see the collapse of our system coming, but are still afraid t champion smart, proven, but never-the-less radical solutions.

What this means is the real reform will not happen for several more years, until the system is just about to or has already collapsed. That is why smart progressive are fighting so hard for what appears to be a small public option. It is not about what the public option will be right away, it is about getting the correct infrastructure in place when things really start coming apart.

Our dysfunctional political system will not allow us to make the large but necessary moves to stop the impending disaster. The best progressives can do is make sure that when the massive skyscraper that is health care system comes down, it is at least a controlled, inward demolition. The public option could be the foundation for a system where the government insures everyone has access to quality affordable care. Without the public option in place, the system could easily collapse into a massive corporate welfare program. A system where private insurance companies are given huge government subsidies to “reduce cost” in the only way they have so far, with massive denial of care.

Reform will not save our current system, because none of the players involved are willing to consider the drastic changes that could save it. That is why Sen. Wyden is fighting for his completely open exchange, Cantwell is promoting her “basic health plan“, Conrad is defending his co-ops, the insruance companies are fighting to kill a public option competitor, and progressives are fighting tooth and nail to get a real national public option. What this health care fight is really about is getting the alternative structure you want ready to replace our current system when it does inventiably breakdown.