President Barack Obama did it. He got the health care reform package that he had invested so much of his political negotiating skills during his first year leading the country as our president.

For a relatively inexperienced politician this was a third major victory that has surprised many of the political pundits in this country.

Even if you did not vote for him, or if you did vote for him and wish you had not, you should give Obama credit for his three major successes.

First, he came into the national political spotlight for his outstanding address at the Democratic National Convention, July 27, 2004. I believe that speech so eloquently delivered helped put him on the stage of national politics.

The second major success was the way he organized his political campaign for the presidency, first against the ultimate Washington insider, Hillary Clinton, and then against the genuine Vietnam War veteran and national hero, Sen. John McCain, the Republican candidate.

If you look at the way Obama organized the young people and others who had not been active in politics, you should give credit to the organizing skills and success in selling the "Yes We Can" slogan that brought Obama into the White House.

The third success is the most recent victory in getting enough support from members of his own party to pass the health care bill in Congress.

But this third victory came at a major cost, I think.

First of all, Congress and the president cannot possibly replace the basic economic law of supply and demand as it applies to health care in every part of our country.

I feel sorry for the plight of those 30 million or more citizens without health care insurance. When they get sick, or involved in a traumatic accident, they head to the emergency room of the nearest hospital.

Now with the new law, all citizens will be forced to purchase health insurance from a company of their choice (not the federal government).

Those who are too poor to afford health insurance may be assisted by the government in ways that should extend the health care to all those 30 million presently without insurance, other than free or lower cost emergency treatment.

I think the law of supply and demand will come into play. I can assume that the newly covered 30 million citizens will have more testing, more preventative treatment, more detailed medical treatment than under the current take traumas to the closest ER for treatment the cost of which is covered by the government.

I should admit that my knowledge comes from the briefly described news media reports on the contents of 2,000 pages of the law that few of us have actually read (including me).

I think the humanitarian purpose of extending the health care system to all citizens is a noble cause. But I wonder just how this will work in actual practice?

Thirty million new patients will demand more doctors, hospitals, clinics. As the demand increases and the supply of facilities and medical personnel does not grow at the same pace, the cost is certain to go up.

Forcing all citizens to purchase insurance seems to me to play right into the hands of insurance companies. How much leeway does the citizen have in bargaining with an insurance company when the person has no choice as to whether or not to buy insurance?

Finally, I worry about the overall cost of the program. I have been a student of politics in our country since I was 13 years old and had a meeting with our congressional representative to talk about the best schooling to prepare me for a position in the government in D.C. or overseas.

I am positive that the number of governmental projects that are accomplished way under budget are far less than those projects that have gone way over budget.

If health care reform comes to cost trillions of dollars way over budget, our country could be ruined. If I am wrong and we actually save trillions of dollars, then Obama will have streets, malls, schools all named after the president who brought unexpected and dramatic change to the American political landscape.

Time will judge Obama, and all the rest of us, as to the way we met the challenge of streamlining and making more fair the way we conduct our medical services to all citizens and the costs that must be paid, however we decide to continue.

Tom Nichols is a retired college professor who lives in Gainesville. His column appears regularly on Mondays and on gainesvilletimes.com.