Douglas W. Elmendor is facing the toughest task of his brief tenure as head of the Congressional Budget Office: attaching a price to a monumental overhaul of the nation's healthcare system. So far, the CBO has proven unwilling to assume big savings from popular reforms, such as computerizing medical records and studying the comparative effectiveness of various treatments. The CBO has estimated, for example, that requiring doctors and hospitals to use electronic records would save the government only about $34 billion over the next decade—a small fraction of the overall cost of reform.