“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.

Ordinary Americans are rightly suspicious of this exercise in collective ego gratification, which has gripped Obama and many of his congressional allies. Even when the goals are worthy — as they are here — the temptation to exaggerate, simplify and sugarcoat often proves irresistible. Baucus’ promotion of his handiwork is a case in point…

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.