that will not happen

excellent article in the NYT (excerpt):

With health reform's fate suddenly in doubt, Mr. Obama lost much of his ability to arm-twist the political left into accepting an idea it hated: reducing the federal government's huge subsidies for high-cost insurance plans by taxing those plans. Labor leaders have warned that the tax would hurt workers. That isn't impossible, though research has shown that the highest-cost plans offer no better care than merely good plans. Mainly, the subsidies appear to benefit drug makers, hospitals and insurers. But to keep House liberals in the fold, the White House delayed the tax until 2018.

Conservative Blue Dog Democrats did not leap to the tax's defense because they're not sure about it, either. Many need union support in the midterm elections. Many are also struggling with the classic dilemma on health spending. They genuinely would like to control costs. They just don't like a lot of the specific ideas for cutting spending or raising taxes. Like all of us, they want to lose weight without eating less or exercising more.

This is why the Blue Dogs have never gotten behind a package of measures that would hold down costs.

The same is true of centrist Republicans like Olympia Snowe, George Voinovich and Mr. Brown. And conservative activists have done nothing to demand that Republicans support cost control. Indeed, the activists have tried to punish fiscally conservative Republicans.

Senator Robert Bennett, a Utah Republican, helped write a bill to give people more choice of insurance plans, creating more competition, and to reduce government subsidies for insurance. But he made the mistake of working with Democrats on the proposal (which went nowhere). Today, Mr. Bennett is at risk of losing the Republican nomination to a candidate backed by the Tea Party.

What we're left with, then, is this:

A bill that would spend about $950 billion over 10 years to help the uninsured and small-business employees buy insurance. Initially, the bill relies on accounting gimmicks to cover these costs. Most important, the insurance expansion does not start until 2014, holding down the 10-year cost. The taxes and Medicare and Medicaid cuts in the bill are then big enough to pay for the bill.

Over time, however, the cost savings are likely to rise more quickly than the spending, more than making up for the gimmicks.

The Medicare oversight board will crack down on unnecessary tests. Medicare pilot programs will grow. The insurance exchanges will spur competition. In the second decade, the Congressional Budget Office projects the bill would cut about $1 trillion from the deficit.

Critics have said, correctly, that this prediction might not come true. If the budget office took account of the uncertainty and the gimmicks, the $1 trillion savings estimate might well shrink. But to suggest that the most likely outcome is only marginal cost savings, or even cost increases, requires a selective reading of the evidence.

Over its history, the Congressional Budget Office has tended to the effect of cost-reduction efforts in Medicare. As doctors and hospitals adjust to new rules, they figure out how to be more efficient than economists expected. And Congress, in most previous cases, has not overturned legislation that phases in changes -- like the 2018 start date for the high-cost insurance tax. Looking at the whole picture, The Financial Times has said that the bill, "though flawed, is in fact a great step forward."

.......But that's unavoidable. We all wish that Congress could summon the wisdom to come up with a politically popular plan that would sharply cut costs. Waiting for that day to arrive, though, doesn't seem very conservative.

http://finance.yahoo.com/insurance/article/109034/health-cares-obstacle-no-will-to-cut