Richard S. Foster is the chief actuary for Medicare. Congressional Democrats, who friended him in 2004 when he raised questions about the Bush Administration may be frantically unfriending him today. His recent analysis of the new health care law could have been reduced to one word: “DUH.”

Mr. Foster has found that the overall growth of health care spending won’t slow because of the expansion of insurance and services to 34 million people. But when President Obama signed the bill last month, he promised that it would “bring down health care costs for families and businesses and governments.” You mean you can’t actually cover more people for less cost? This is shocking! Someone should alert the media!

Foster’s report, which he sent to Congress last Thursday, said that, “Overall national health expenditures under the health reform act would increase by a total of $311 billion.” Worse, the report estimates that in 2019, when all of the provisions have taken effect, there will still be 23 million people uninsured.

How could this be true? The Congressional Budget Office scoring of the bill was dramatically different. CBO only dealt with federal spending and revenues, while the actuarial view included national spending of all types. From that vantage point, Mr. Foster is concerned that potential lower premiums and co-pays for Medicare beneficiaries might not be realized if concurrent Medicare cuts drive some hospitals into the red and “possibly jeopardize access to care for beneficiaries.”

White House Office of Health Reform director Nancy-Ann DeParle says that fear is “unfounded.” Really?

Check out more blog entries from David Saltzman.