National Health Care Reform: Later Than Sooner?

Whether comprehensive health care reform is needed is no longer debated on Capitol Hill. The only question is when it’s coming. I’m among those who have been predicting that the Obama Administration and Congress will move quickly to enact comprehensive health care reform. I’m far from alone in this: incoming Secretary of Health and Human Services Tom Daschle thinks so, too. In fact, so does incoming President Barack Obama. Throw in several leaders in the U.S. Senate, including Senators Ted Kennedy and Max Baucus and you’ve got a growing conventional that universal coverage will be coming sooner or later.

But this consensus is not universal. Representative Pete Stark will have a big say on health care reform as chair of the Health Subcommittee of the Ways and Means Committee. And, according to The Hill, he’s saying Congress is unlikely to be ready for a vote on health care reform until “the end of 2009 or the beginning of 2010.”  The problem, according to Rep. Stark, is that there are simply too many competing priorities, including the economy, to get to comprehensive reform. This doesn’t mean less grand reforms won’t happen early in the new Administration (e.g., expansion of the State Children’s Health Insurance Program (“SCHIP”)), but even those could cause a delay in working through a major reform package, according to Rep. Stark.

Rep. Stark, a California Democrat who has served in Congress for 35 years, encourages a deliberate approach to comprehensive reform. According to The Hill he believes the House “needs to build toward health reform through the regular order. ‘I think you have to give everybody a chance to have a hearing,” including interest groups. Of note, Rep. stark pointed out the need to hear from the American Medical Association, the American Hospital Association and the Pharmaceutical Research and Manufacturers of America. He dismissed the need for the health insurance industry to buy-in to the reforms, however. Predicting they would never support a Democratic health care reform package, Rep. Stark said the industry’s opposition won’t change much. “They’re going to be easy to roll because nobody likes insurance companies.”

Rep. Stark is not the only voice suggesting health care reform will take some time. Senator Charles Schumer, who sits on the Finance Committee, in April told The Hill, “Health care I feel strongly about, but I am not sure that we’re ready for a major national health care plan.”

While there is broad consensus that reform is needed, the debate will grow contentious as details of a plan emerge. Current allies may find themselves on opposite sides when the nitty meets the gritty. Or as Michael Cannon of the Cato Institute put it in USA Today, the interest groups “all want to be at the table because they don’t want to be on the menu. Sooner or later, someone is going to be on the menu. You can’t do comprehensive reform without goring someone’s ox.”

Beneath all the flying metaphors is the realization that achieving comprehensive health care reform won’t be easy. It’s also vitally important. The Obama Administration and Congress should take the time needed to get it right. Because there are no do overs when you’re tinkering with 16 percent of the nation’s economy in the middle of a recession.