The rushed, secretive way that a bill this destructive and unpopular isbeing forced on the country shows that "reform" has devolved into theraw exercise of political power for the single purpose of permanentlyexpanding the American entitlement state. An increasing roll of leadersin health care and business are looking on aghast at a bill that is solarge and convoluted that no one can truly understand it, as FinanceChairman Max Baucus admitted on the floor last week. The only goal isto ram it into law while the political window is still open, and cleanup the mess later.

• Health costs. From the outset, the White House'score claim was that reform would reduce health costs for individualsand businesses, and they're sticking to that story. "Anyone who saysotherwise simply hasn't read the bills," Mr. Obama said over theweekend. This is so utterly disingenuous that we doubt the Presidentreally believes it.
The best and most rigorous cost analysis was recently released bythe insurer WellPoint, which mined its actuarial data in variousregional markets to model the Senate bill. WellPoint found that ahealthy 25-year-old in Milwaukee buying coverage on the individualmarket will see his costs rise by 178%. A small business based inRichmond with eight employees in average health will see a 23%increase. Insurance costs for a 40-year-old family with two kids livingin Indianapolis will pay 106% more. And on and on.

These increases are solely the result of ObamaCare—above and farbeyond the status quo—because its strict restrictions on underwritingand risk-pooling would distort insurance markets. All but a handful ofstates have rejected regulations like "community rating" because theyencourage younger and healthier buyers to wait until they needexpensive care, increasing costs for everyone. Benefits and pricingwill now be determined by politics.
As for the White House's line about cutting costs by eliminatingsupposed "waste," even Victor Fuchs, an eminent economist generallysupportive of ObamaCare, warned last week that these political theoriesare overly simplistic. "The oft-heard promise 'we will find out whatworks and what does not' scarcely does justice to the complexity ofmedical practice," the Stanford professor wrote.

Steep declines in choice and quality. This is all of apiece with the hubris of an Administration that thinks it cansubstitute government planning for market forces in determining wherethe $33 trillion the U.S. will spend on medicine over the next decadeshould go.This centralized system means aboveall fewer choices; what works for the political class must work foreveryone. With formerly private insurers converted into publicutilities, for instance, they'll inevitably be banned from sellingproducts like health savings accounts that encourage morecost-conscious decisions.
Unnoticed by the press corps, theCongressional Budget Office argued recently that the Senate bill wouldso "substantially reduce flexibility in terms of the types, prices, andnumber of private sellers of health insurance" that companies likeWellPoint might need to "be considered part of the federal budget."

With so large a chunk of the economy and medical practice itself inWashington's hands, quality will decline. Ultimately, "our capacity toinnovate and develop new therapies would suffer most of all," asHarvard Medical School Dean Jeffrey Flier recently wrote in our pages.Take the $2 billion annual tax—rising to $3 billion in 2018—that willbe leveled against medical device makers, among the most innovativeU.S. industries. Democrats believe that more advanced healthtechnologies like MRI machines and drug-coated stents are driving coststoo high, though patients and their physicians might disagree.
"The Senate isn't hearing those of us who are closest to the patientand work in the system every day," Brent Eastman, the chairman of theAmerican College of Surgeons, said in a statement for his organizationand 18 other speciality societies opposing ObamaCare.

For no other reason than ideological animus, doctor-owned hospitalswill face harsh new limits on their growth and who they're allowed totreat. Physician Hospitals of America says that ObamaCare will "destroyover 200 of America's best and safest hospitals."

• Blowing up the federal fisc. Even though Medicare'sunfunded liabilities are already about 2.6 times larger than the entireU.S. economy in 2008, Democrats are crowing that ObamaCare will cost"only" $871 billion over the next decade while fantastically reducingthe deficit by $132 billion, according to CBO.
Yet some 98% of the total cost comes after 2014—remind us why there must absolutely be a vote this week—andmost of the taxes start in 2010. That includes the payroll tax increasefor individuals earning more than $200,000 that rose to 0.9 from 0.5percentage points in Mr. Reid's final machinations. Job creation, herewe come.

• Political intimidation. The experts who have pointed outsuch complications have been ignored or dismissed as "ideologues" bythe White House. Those parts of the health-care industry that couldn'tbe bribed outright, like Big Pharma, were coerced into acceding to thisagenda. The White House was able to, er, persuade the likes of the AMAand the hospital lobbies because the federal government will control55% of total U.S. health spending under ObamaCare, according to theAdministration's own Medicare actuaries.

The tragedy is that Mr. Obama inherited a consensus that thehealth-care status quo needs serious reform, and a popular Presidentmight have crafted a durable compromise that blended the best ideasfrom both parties. A more honest and more thoughtful approach mighthave even done some good. But as Mr. Obama suggested, the Democraticold guard sees this plan as the culmination of 20th-century liberalism.
So instead we have this vast expansion of federal control. Never inour memory has so unpopular a bill been on the verge of passingCongress, never has social and economic legislation of this magnitudebeen forced through on a purely partisan vote, and never has a partyexhibited more sheer political willfulness that is reckless even forWashington or had more warning about the consequences of its actions.

These 60 Democrats are creating a future of epic increases in spending,taxes and command-and-control regulation, in which bureaucracy trumpsinnovation and transfer payments are more important than privateinvestment and individual decisions. In short, the Obama Democrats havechosen change nobody believes in—outside of themselves—and when itpasses America will be paying for it for decades to come.