Health care reform efforts in Congress continue to make news, but too little of the news focuses on reducing the cost of health care in the United States. The contentious debates are over employer mandates, subsidies for insurance coverage, limits to choice, abortion funding and coverage for illegal aliens.

Last weekend, the House of Representatives passed, by a narrow 220-215 margin, a 2,000-page health care reform measure that falls short of imposing real cost controls. In fact, the House bill fraudulently shifted $250 billion in additional Medicare payments to doctors out of the health care bill.

From the beginning, President Barack Obama said his goals for health care reform were not only providing universal coverage and ending denial of coverage for pre-existing conditions, but also cost control. He has spoken many times about "bending the cost curve" of health care and has stressed that the current cost structure of the U.S. health care system is unsustainable.

The nearby chart illustrates the reality that only a few in Congress seem to recognize. The United States spends a much larger percentage of its gross domestic product and far more per-capita than any other nation on health care. And the health care outcomes in the U.S., meaning the health of the nation, is generally worse than that found in most other advanced countries.

Though Obama and many reform advocates behind the House vote might have good intentions, the political reality in Washington has led the White House to make secret deals with politically powerful special interests in exchange for their support for health care reform. Deals have been cut with the health insurance industry and the drug makers to limit the cost-saving measures aimed at their industries. Lobbyists representing hospitals, doctors and medical device makers also have cut deals to limit the savings sought in their operations.

The reason for the deals is that just about every dollar of cost savings is a dollar of someone's profit.

Reform advocates in Congress and in the White House now say the most significant cost savings will come from Medicare.

Based on past experience, those promises cannot be believed. Congress is reluctant to impose cost savings that will reduce profits for some special-interest groups, as the recent "doc fix" story revealed when Congress voted to override Medicare cost savings mandated in a 1997 law.

A recent New York Times article dealing with an innovative cost-saving approach to medicine practiced at a Salt Lake City hospital noted that the American health care system is more expensive than any other country's and the outcomes only are marginally better. The article notes, "Any bill that Congress passes this year is unlikely to fix these (cost) problems. The lobbying groups for drug companies, device makers, insurers, doctors and hospitals have succeeded, so far, in keeping big, systemic changes out of the bills."

When taxpayers hear that the nonpartisan Congressional Budget Office "scores" a health care bill as actually reducing the deficit, it must be noted that the CBO does its best to estimate future costs of legislation, but it also has accepted congressional promises of future savings. This is a big shortcoming for CBO estimates, given that cost-saving promises in health care reform bills are vague and subject to future cancellation or modification.

With the recent passage of a House version of health care reform, attention now shifts to the Senate, where it is expected that more attention will be paid to cost reduction.

But the deals that the White House has cut to garner the political support of the health insurers, drug makers and American Medical Association suggest a partial sellout in which these special interests have traded political support for promises to protect profits. Real health care reform, and real cost control, would not likely have the support of health insurers, drug makers, hospitals and doctors groups, because it would trim their profits, bringing them in line with similar organizations in other countries.

Despite being lobbied to support the House bill by Obama, White House Chief of Staff Rahm Emanuel and two Cabinet secretaries, Rep. Jason Altmire, D-4th., was among the Democrats voting against the massive health care reform bill, misnamed as the Affordable Health Care for America Act.

Rep. Kathy Dahlkemper, D-3rd, voted for the House measure, claiming it controls the growth in health care costs.

Altmire and a few other Demo-crats are lonely voices expressing concerns over costs and the failure to truly reform health care delivery in America to bring it in line with other advanced nations of the world.

As attention shifts to the Senate, Americans should press their representatives in Congress to return to Obama's original goal, to bend the cost curve so that growing health care spending does not bankrupt the country.

The current bills in Congress barely nudge the cost curve, largely because of the promises made to protect profits of health insurers, drug companies, device makers, hospitals and doctors.