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Jeff Goldsmith continued participating actively in the dialog on health reform during the fall and winter of 2009. On October 20, Jeff argued that extending Medicare eligibility to those over age 55 on a voluntary buy-in basis was an excellent alternative to creating a new public plan. See Hiding in Plain Sight: Using Medicare to Solve the Public Option Conundrum On October 21, he commented on Congress's unwillingness to tighten the fraud and abuse laws as a way to pay for health reform (see 'Atul Gofigure').

On December 1, he explored the fiscal risks created by Congress' inability to restrain health costs in The Leaning Tower of Jello: Why No-one Believes Health Reform will be Deficit Neutral. And on December 11, he followed up by analyzing a pivotal Congressional Budget Office report on the behavior of the private health insurance market, again arguing that the costs of health reform are dramatically understated, in There be Dragons: The Fiscal Risks of Premium Subsidies under Health Reform. Read these provocative blog postings

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