Peter Suderman at Reason exposes it:

Since the New Deal, American entitlements have consistently grown faster than projected in size, scope, and cost. Like unwanted houseguests, they cost money you don't have, and they can't be kicked out. Reform and repeal efforts are about as successful as kindergarten experiments with do-it-yourself haircuts. Indeed, the health care bill's very structure is a testament to this fact. Much of it is funded with changes designed to eliminate waste in Medicare and Medicaid—changes that could, or at least ought, to have been used to reform those programs, both of which are unsustainable. Yet the only way these changes were politically viable was if they were made in order to fund an all-new benefit.