During the health-care debates, Scott Gottlieb, physician, American Enterprise Institute fellow, and partner in an investment firm, became one of my favorite analysts. Gottlieb always seemed able to penetrate the mysteries of the humongous health-care bill and offer clear insights. He’s done it again. And in an article in the New York Post Gottlieb explains why the mantra if-you-like-your-health-care-policy-you-can-keep-it doesn’t mean what you thought.

Slightly more than half the current health-care plans are going to find that their current policies are going to have to be replaced. The reason? A combination of vague language and the power granted to Secretary of Health and Human Services Kathleen Sebelius and other key agency officials in 160 new agencies to interpret that vague language and create the new national health-care system. Gottlieb notes:

[Sebelius] is starting off by applying new regs to health plans offered by large employers — even though these costly rules were supposedly only going to apply to plans sold in the state insurance “exchanges” that don’t get created until 2014. This twist is spelled out in an 83-page draft of a new regulation that leaked late last week.

Bottom line: Sebelius means to dictate what your insurance plan must look like almost from day one, no matter how you get your coverage.

Indeed, the draft regs envision more than half of all policies having to change within three years — an unmistakable break with President’s Obama’s oft-repeated promise, “If people like their insurance, they will be able to keep it.”

The regulations, as interpreted by Sebelius, could force consumers to buy one of four kinds of policies-all the policies are quite similar, with differences revolving around trade-offs of higher co-payments for lower premiums. Supporters of the legislation claimed that only health plans sold in “exchanges” would be affected. But Sebelius is applying them to the kinds of plans employers offer. This means that, unless you are filthy-rich, you will almost certainly end up in a single government-designed insurance plan.

Gottlieb explains something else about the application of the legislation that might at first sound like insider wonk-baseball. But it’s important. There were, according to Gottlieb, two schools of thought on health-insurance reform in the administration: the White House economists, who favored a degree of competition in federally managed insurance “exchanges” and a group that might be dubbed the HHS wonks, who tended to favor a one-size-fits-all. The law itself didn’t decide, but it gave discretionary powers to HHS wonks.

But that is not the only reason the wonks may win. Gottlieb notes:

Unfortunately, those more moderate White House economists are now leaving the administration, including the rumored departure of widely admired businessman and health-care expert Robert Kocher.

Washington insiders refer to this HHS team as “true believers” — a group of earnest, left-leaning activists who’ve long favored a single nationalized health plan. They are massaging the law’s vagueness to give themselves the tight federal control over health care that will bring their vision into practice.

The more that is revealed of the nation’s new health-care system, the more ardently I hope it can be replaced. If opponents don’t lose their nerve, I firmly believe they have a chance, especially as the public learns more and more about how it will impinge on their lives.