What was Speaker Nancy Pelosi thinking as she reveled in the passage of the House’s health care bill? Does she really imagine that this monstrous legislation will improve the lives of most Americans? Does she expect that creating 111 new government bureaucracies and offices will make it easier for most of us to receive medical treatment? Does she think that sharply raising marginal tax rates for our highest-earning citizens and small businesses will spur productivity and hiring?

No, I imagine that she was thrilled by the taste of victory. Somewhere along the way, this push became all about personalities and contest; the original goal of reining in health care costs was abandoned, and the prize at the end became passage of a landmark bill. Nancy Pelosi envisions herself forever sculpted into liberalism’s Mt. Rushmore.

President Obama also has been caught up in the grandeur of the moment. With his usual modesty, he exhorted his colleagues to “answer the call of history.” He said “When I sign this in the Rose Garden, each and every one of you will be able to look back and say “This was my finest moment in politics.” He has been imagining the photo-op; he probably already has his tie picked out.

“Today’s may be a tough vote, but it was in 1935 when we passed Social Security” said Michigan’s John Dingell. (Was he really in the House in 1935?) That aspiration -- to profoundly change the way our country works -- was what was on the minds of those who voted for this bill. Some who voted “Yea” voiced displeasure with the actual bill, such as Jim Cooper from Tennessee, but held out hope “it will get better in the Senate.” What if it doesn’t? What if, just like Social Security, the emerging health care apparatus ultimately threatens the solvency of the United States?

Many of our fellow citizens have lost interest in the health care debate. They are bored with the endless haggling and distrustful of the conflicting data thrown at them from both sides. They especially dislike sentences like the one I just wrote -- about insolvency. Such threats seem extreme, and echo the endlessly gloomy forecasts about Social Security going bankrupt. People are still getting their Social Security checks, so most have written such projections off as the province of right-wing scare-mongers. The right raises inflammatory issues of rationing and death councils; the left offers up platitudes about universal care and lower insurance costs that are just as implausible.

This ennui is understandable, but we are approaching the point in this debate where decisions will be made and laws will be passed. According to numerous polls, people want lower health care and insurance costs, don’t want higher taxes to cover those not able to afford coverage, and would prefer to have less, not more, government interference in their lives.

With that in mind, every American should read up on this bill. The legislation that passed the house does include higher taxes (more than $460 billion), does not lower costs and allows the government unprecedented control over individual health choices. The principle gimmick used by those projecting a deficit reduction is the assumption that politicians will have the fortitude to sharply cut Medicare spending – by $50 billion in 2015, for instance. That has never happened yet, and it won’t happen in 2015. It does nothing to control out-of-control direct and indirect malpractice costs, it does nothing to promote healthy living or to assure that Americans have “skin in the game.” It upends one sixth of our economy in order to provide insurance for that 10% of our population -- about half of which is young, healthy Americans who have chosen not to have insurance -- that isn’t covered currently. (That is an indisputable figure.)

Whether you are for or against it, this is truly a monumental disruption of our economy. Once enacted, we will never go backwards. There has never been a social program of this scope that has been rescinded. If unhappy, Americans can vote their legislators out of office but, make no mistake, the damage will have been done. It’s like a neighborhood fighting a 60-story skyscraper. You better kill it before the first shovel goes in the ground.

Liz Peek is a financial columnist. She writes frequently for the Fox Forum and Women on the Web.