We have, in this country, a handy if depressing recent history to consult on the subject. Nobody knew or even wildly guessed what the last major medicalcare reform–Medicare and Medicaid–would cost and practically nobody understood or even knew about all of the more important provisions that were in it. This is the first thing you should remember whenever you find yourself in the presence of rhetorical certainty concerning the numbers, and nevermore so than when you hear the telltale word “outyears” as in, “the gap between revenues and costs then narrows in the outyears.” “Outyears,” which is not to be found in any dictionary I own, is a congressional testimony-ese word designating that future time when everybody involved in the legislation will have been safely re-elected and the costs of the program will in fact begin to explode contrary to all the modest projections of what they were going to be.

The reason for these all but inevitable explosions gets you to the next consideration to keep in mind. It is that you are right now looking only at legislative blueprints and graph-paper projections and inspired guesses and wishful premises. Together they amount to a construct of life that takes into account everything but life itself, that is, everything but the way incorrigible, flawed humankind and the institutions it creates behave and have tended to behave for the past several thousand years. Some time ago at a science fair I watched a row of pigeons lined up before a row of machines that dispensed a beakful of corn to them only when they had given it the required (and continually changing) number of taps. It was amazing to me how fast these old birds got on to the system and managed to make it yield up one presumably scrumptious beakful after another. To some this experiment provided evidence that the pigeons could count. I didn’t think so. I thought it was evidence that they could manipulate and outsmart the system. And so, these talented pigeons have ever since seemed to me the perfect metaphor for what happens in this country the instant we have enacted any of that usually long-awaited and much-prayed-for social legislation that marks our time. Someone–or a lot of someones–learns how to outsmart it.

I note morosely in this connection that in the very week the Clintons were announcing their proposed, far-reaching new healthcare system, more than a few old pigeons were coming home to roost in programs that had once seemed all aglow in good purpose and high hopes too. There was a big conviction in the HUD scandal that concerned the widespread misuse of federal housing funds. There were revelations of terrible fraud and theft of federal education grant funds for needy students. This is worst-case stuff, of course, but it is part of what drives up the costs of programs that require or at least presume some integrity and restraint on the part of those who run them and those who seek their benefits. A larger part is not fraudulent at all, merely opportunistic and clever. People can, by and large, be counted on to take the high-end option of what is available to them in any program, or to push to raise costs to cover what it costs them or other-wise redirect the way the thing is supposed, in theory, to work.

And, by “people” I mean every kind of people: this is one truly bipartisan aspect of our public/private life. That brings us to yet another fact worth keeping in mind throughout the medical-care-reform debate now starting: ideology is a totally unreliable guide as to how various individuals and institutions will behave under a new law. So is whatever palaver they were putting out with so much seeming passion during the argument about enacting it. No one figured out better how to flourish under the health-care reforms of the mid-’60s than numerous of those medical, hospital and insurance entities that had denounced them most hysterically as legislation and predicted the ruin of the world in general and themselves in particular. Some of the worst and most shocking ripoffs of the Great Society’s poverty-program funds were perpetrated by none other than people who had been participating in the debate as devoted spokesmen for and advocates of the poor. Be very leery of those in this debate who are speaking in apocalyptic terms “in the name of” just about any group at all.

Be leery too of those who respond to criticism of the proposed legislation or offer miraculous substitutes for it based on one-word tranquilizer concepts. We have developed a compendious vocabulary of glow-words, as I think of them, with which you can exit an argument without quite saying how you would solve the problem that’s just been raised: education-and-treatment, job retraining, rehabilitation, prioritizing, etc. Health care will have its own set of terms that people will invoke without ever bothering to say just how well the proposed one-word solution works or who will administer it or whether there’s either money or knowledge enough to bring it off.

Keeping an eve out for such terms will require some literary skill and so will what I advise as an all-points verb alert. I wish you had been paying attention in class instead of staring out the window when they were explaining the subjunctive mood and the conditional, not to mention the future perfect tense. You are going to get a heavy dose of all these and more–the “ifs,” the “assuming thats,” the “at that point, provided thats,” the “should produce, all things being equals” and the “will have beens.” That is the kind of structure on which both the pros and the antis will be seeking to rest their case. People tend to take these finely wrought and much hedged propositions as assertions of objective truth or hard predictions of what is to come. But they are not. The best advice is to kick away old assumptions and biases for this debate, be skeptical of everyone, including your own side. Above all, believe that all numbers are provisional and that anything that looks easy is almost certainly fake.