Oh dear. After President Obama’s news conference on health care/health insurance reform, I am more confused than ever about whether it will — or should — pass this year.

I buy the argument that health care is tied directly to the economic health of the United States. One of every six dollars generated in America goes for health care, yet 47 million people have no insurance and many who do don’t have enough coverage in case of serious illness or injury. Too often pre-existing conditions are not covered.

I agree the status quo is not working and that medical bills are driving far too many personal bankruptcies and job losses — General Motors toppled in part because of high health policy premiums. Medicaid and Medicare, which pay for many of our poor and elderly, are headed toward disaster because they are so costly.

I’m appalled at the political gamesmanship on Capitol Hill as real people suffer (and die).

I don’t understand why Obama isn’t more aggressive about what we need and how we should pay for it. If Congress acts this year, there will undoubtedly be a mandate that everybody has to buy insurance, with the poor being subsidized. Yet he has come late to the table on this.

He has talked about bringing down the upward-spiraling cost of health care. But he insists nobody has to sacrifice, and that there won’t be rationing, which is almost certainly going to happen.

Obama is honest enough to say he understands our skepticism. The last administration pushed Congress to pass a huge Medicare prescription bill we couldn’t pay for, leading to huge deficits. The government’s interference in issues is often scandalous, bureaucratic and inept.

The president has opened the door to higher taxes on people who earn over a million dollars a year by limiting such deductions as charitable giving. Republicans and Blue Dog (fiscally conservative) Democrats disagree. A lot of charities disagree. And on the face of it, I don’t see how a few thousand millionaires can make the difference in financing a system that so far has failed to include 47 million Americans. (And weren’t higher taxes on the rich supposed to bring down the deficit?)

During the last presidential campaign, there was a lot of talk about taxing employer-provided health benefits. Obama opposed it although he now says he might support it as a way to keep health costs from rising too rapidly. It is unfair to those without health insurance to have their tax dollars subsidize tax-deductible employer-provided health insurance. But taxing job-delivered insurance would be a new tax on the already struggling middle class, which Obama said he won’t accept.

The president wants to end the proverbial waste, fraud and abuse in the health care industry. That would be great — duplicative tests, unnecessary pills and X-rays and superfluous surgeries cost us all enormous sums. And such respected institutions as the Cleveland Clinic, Kaiser Permanente and the Mayo Clinic have shown that millions of dollars can be saved through efficiency.

On the other hand, one doctor’s waste is another’s life-saving medical test. Who decides? An independent board that decides what will be covered in an absence of politics? How novel!

But the real trouble is that as a nation we’ve run out of time. Every day 14,000 more people lose their health insurance. Obama, although too laid-back about it, is right to argue the status quo is unsustainable. Some form of health care reform has to be tackled and passed this year or, politically, it will die.

As legislators head home for the August recess, they will be taking the temperature on health care reform from their constituents. The problem will be that many voters, satisfied enough with their own insurance, are wary about change. In Obama’s words, they favor the devil they know over the devil they don’t know. He has to be more forceful and forthcoming about what he wants.

This autumn will be crucial. If Congress kicks the can down the road and fails to come up with bipartisan solutions, that road may lead to bankruptcy.

(Scripps Howard columnist Ann McFeatters has covered the White House and national politics since 1986. E-mail amcfeatters(at)nationalpress.com.)