Robert Samuelson writes:

What’s driving the great health debate of 2009 is not a popular clamor for universal insurance. “Many Americans are balking again at the prospect of health care reform,” writes pollster Andrew Kohut of the Pew Research Center. A new Wall Street Journal poll found 41 percent of respondents opposed to President Obama’s proposals and 39 percent in favor (the rest were undecided). The underlying driver is politicians’ psychological quest for glory.

“My colleagues, this is our opportunity to make history,” implored Chairman Max Baucus as the Senate Finance Committee last week opened consideration of his bill. Politicians, in their most self-important moments, see themselves as instruments of national destiny. They yearn to be remembered as the architects and agents of great social and economic transformations. They want to be at the signing ceremony; they want a pen.

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Americans worried about this legislation may not know its details or may even be misinformed. Still, their skepticism is justified. Grandiose rhetoric obscures unflattering reality. The proposals don’t force the major structural changes in the delivery system that might curb uncontrolled health spending, which is the central problem. The bills Congress is now considering might marginally improve Americans’ health but would worsen the federal budget outlook and squeeze other public and private spending. Whatever bragging rights result will quickly erode in the face of the health system’s continuing problems.

Be very afraid.