"If Reform Fails", a recent NY Times editorial, states that the status quo is immoral, impractical and unsustainable. What can we expect now that the House approved "Health Overhaul, Sending Landmark Bill to Obama"?  No proposition I have seen identifies, in a practical way what does or does not work for patients and those practicing on the front lines of medicine. Blame the patient?  Regarding the slippery slope of adverse lifestyle choices some of us make, you've gotta live in someone else's shoes before you cast stones. 
Blame the doctor?  Blame the lawyers?  Blame the politicians?

It's not surprising that the public is confused about how to control health care costs; I've been around a while and see another shell game coming--cost sharing with patients/employees- inappropriate; inadequate funding to care for the poor, soaking paying patients for the deficit in hospital budgets they cause, cost-shifting to doctors as in paying for care over time when we have no longitudinal data, docs referring (err dumping) and testing and treating with reckless abandon and without accountability (or protection from not doing so). Patients mercurially shift their allegiances - inefficient. The ER substituting for the medical home; while outrageously overcharging, it's discontinuity at its worst. In doctors' offices and in hospitals and other similar settings, nurses' aids and support staff are spending a quarter of their time documenting, charting and filling out forms. The politics are quixotic--"Who's gonna pay for it?" they ask. 

In Paul Krugman's [healthcare economist] "Health Reform Myths," we learn we already are paying for it; there's both direct and indirect costs when patients don't get the care they need.  I agree that,"Realistically, health reform is likely to do much better at controlling costs than any of the official projections suggest."  We all will pay if we do not improve quality, cost and access.  We will pay even more so if we do nothing to determine what works and then realign the incentives. The worst part is that there's virtually no Peter Drucker type of measurement and management in any proposal for healthcare reform.  

Watch as we test the "oft-heard liberal claim that the legislation will actually save even more money than current estimates suggest. The Congressional Budget Office scores, they argue, don’t account for the bill’s investments in comparative effectiveness research and delivery system reform, or the impact of a federal board charged with weeding out unnecessary Medicare payments."  [From "Show Time for Health Care" by Ross Douthat]