There are increasingly disturbing signs that Obamacare is foundering. The big worry is whether it will take our economy down with it.

Health care represents about 18 percent of our Gross Domestic Product and we mess with it at our peril. If Obamacare proves to be dysfunctional or its cargo of costs start shifting out of control we could be in real trouble — perhaps beyond the reach of help from low interest rates or credit-spurred consumer spending.

The history of Obamacare, officially the Affordable Care Act, is an important factor. There was momentum behind this legislation that went beyond its loathsome politics; a force for change powered by the recognition that we could not go on as we had been because our health care system was economically unsustainable.

Public recognition of the need for change is probably why the irresponsible way that the economically important, yet largely unread, Affordable Care Act was straight-armed through Congress did not galvanize public opinion and transform it into political action.

Our health care system remains unsustainable, but it is not clear what impact Obamacare will have on this, especially in light of recent upward revisions to its costs.

The worries about Obamacare reach beyond politics, touching those who support the new system and those who oppose it. Even one of the authors of the legislation has expressed concerns, if you can call designating it “a train wreck” expressing concerns.

Neither side really wants it to fail. Supporters still have faith in its ability to bring health care insurance to all Americans, and those who oppose it worry that if it fails it will destroy our existing health care system in the process.

Despite the insomnia-grade worries on both sides, the public’s anxieties still seem unfocused and unable to overcome political inertia. That may turn out to be a good thing, though, for it opens a window of opportunity.

The current political structure of Congress encourages futility. And this would mean that an effort by one party to examine and analyze the costs, operation and benefits of Obamacare would be headed off at the impasse. We would get headlines, party-line votes and eventually come up empty, not just of action but also of useful information.

The bipartisan worries about costs, coverage, delays and unanticipated glitches might be powerful enough to prompt a steely-eyed look at where the system stands and where we are headed. What is needed is a solid economic analysis of the costs and impact of three options: moving ahead; turning back or putting everything on hold while we catch our breath.

This type of analysis should have been done before the Affordable Care Act became law, of course, but done is done. We must move on because we have only this one last chance to decide what is best for Americans’ health care. The new system and the old system will not work in parallel, the way we install and test new computer systems. It will replace the old system.

The non-partisan analysis should not be limited to direct, measurable costs, although that, of course, is the primary goal. Equally important is an honest evaluation, as best we can produce one, of the structural changes that Obamacare will bring.

The impact on the medical professions, for example, is likely to be substantial and we need a hard look on what the likely outcome of this new system will be on physicians, nurses and technicians and their roles in medical practice. Since doctors are key players in both the existing and new systems, we also need to look especially at supply-demand effects on physicians and their training before we take a wrecking ball to the existing system structure.

Most importantly, we are sorely in need of a review of the basic economics of how the costs of adding coverage for over 30 million people to the system will be absorbed.

We also must come up with a working model that examines the income and cash flow of hospitals, which are dominant structures in the existing health care system and will continue that role in the new. We will be asking them to bear a severe burden of institutional change as they adjust to a system where initial patient services, by system design, will be shifted away from emergency rooms to physicians’ offices.

To get the kind of honest analysis and evaluation that Obamacare needs, there has to be a dramatic decline in posturing by Congress and the president. While that seems like a fantasy at this time, the more worried both sides become the more likely it is that Congress puts this system and its deadlines on ice until we can do the analysis.

James McCusker is a Bothell economist, educator and consultant. He also writes a monthly column for the Herald Business Journal.