David Brooks identifies a key problem with the health care reform legislation milling around Congress: it may not save us much money:

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.

There’s worse things than a medium-size bill that mitigates some negative aspects of our health care structure – except, as Brooks reminds us, President Obama is counting on significant savings in health care to pay for the trillions he’s pumping into stimulus projects.

The theory is this: we’ll be able to pay off the debts we’re generating today if we can reduce our health care costs in the future. But what if we don’t reduce those costs? What if we have to pay back our debts AND still handle increasingly high health-related costs? That’s not going to be good for our economy. But it’s the bargain we’re trying to make. And it’s something we need to keep in mind as we debate health care reform.

Politics Will Heath Care Reform Actually Save Us Any Money?