Health care reform hangs in the balance. Its fate rests with a handful of "centrist" senators — senators who claim to be mainly worried about whether the proposed legislation is fiscally responsible.

Paul Krugman

But if they’re really concerned with fiscal responsibility, they shouldn’t be worried about what would happen if health reform passes. They should, instead, be worried about what would happen if it doesn’t pass. For America can’t get control of its budget without controlling health care costs — and this is our last, best chance to deal with these costs in a rational way.

Some background: Long-term fiscal projections for the United States paint a grim picture. Unless there are major policy changes,...