If health care reform doesn't work, we're doomed

Here's David Brooks with "Fiscal suicide ahead" on why it's a longshot:

If you read the C.B.O. testimony and talk to enough experts, you come away with a stark conclusion: There are deep structural forces, both in Medicare and the private insurance market, that have driven the explosion in health costs. It is nearly impossible to put together a majority coalition for a bill that challenges those essential structures. Therefore, the leading proposals on Capitol Hill do not directly address the structural problems. They are a collection of worthy but speculative ideas designed to possibly mitigate their effects.

The likely outcome of this year’s health care push is that we will get a medium-size bill that expands coverage to some groups but does relatively little to control costs. In normal conditions, that would be a legislative achievement.

But Obama needs those cuts for his whole strategy to work. Right now, his spending plans are concrete and certain. But his health care savings, which make those spending plans affordable, are distant, amorphous and uncertain. Without serious health cost cuts, this burst of activism will hasten fiscal suicide.

In related news, less than a week after healthcare industry leaders promised big savings, they were saying "not so fast": "Health Care Leaders Say Obama Overstated Their Promise to Control Costs." Maybe it would have been prudent to get the health care savings up front before we spent the money we don't have.