I don’t want to get unduly excited about this. I’ve absorbed too many disappointments since the Democrats won control of the U.S. Congress. Still, it looks as if health care reform might be coming to America after all. Maybe not in one step. But gradually.

My optimism comes from news that those sleazy Senate “moderates” have lined up behind a proposal to expand Medicare in exchange for abandoning a government-run option. Even Joe Lieberman is for it because he had suggested expanding Medicare back when he pretended to be a Democrat. Not even two-faced Joe has the brass to oppose something he once proposed.

From what I’ve heard, the latest proposal would let people 55 years old join Medicare. There’s a lot more to it than that; the bill is a thousand pages or more. Most of the “reforms” look like window dressing to me. For example, what’s the point of decreeing that insurance companies must accept customers with “pre-existing conditions” if you don’t set a limit on the premiums the companies can charge those customers? And the “public option” in the bill has been watered down to the point where it probably won’t do anything to curb the health care profiteers’ rate increases.

The health insurance companies, which own so many members of Congress, have vehemently opposed any attempt to restrict their price gouging. Even with the government agreeing to force all Americans to buy health insurance and promising to subsidize customers who can’t pay, the companies balked. Sure, that would give the private insurers some 30 million new customers – at taxpayers’ expense – but they aren’t interested if they would have to face competition from a government-run agency.

However, if Congress lets 55-year-olds join Medicare, that would be a lot more appealing. After all, people over 55 are more likely to get sick, and who wants that kind of customer? Let Uncle Sam look after them! With the younger, healthier customers forced by law to buy private health insurance, the prospects for a profitable operation would look a lot better. So I bet the health insurance companies are telling their political pawns to back off and let this proposal go through.

In the short run, of course, there could be a lot of pain for some Americans. Driven by greed, the health insurance companies are likely to hike premiums and reduce care. Life could get pretty tough for Americans under 55 who make a middle-class income. But my guess is that such a state of affairs wouldn’t last long. Public outrage would reach the point where the politicians would have to go back to the drawing board and expand Medicare again.

So, it looks as if a single-payer health care system may be in America’s future after all. Keep your fingers crossed. (But don’t hold your breath.)