Opinion: This Time, Failure Is Not an Option for Health Care Reform

(Nov. 13) -- If the health reform debate of 1993-94 taught this nation anything, it's that there are very real moral, economic and political consequences from failing to fix our health system. This time, health reform will succeed because failure is not an acceptable option.

Sixteen years ago, Democrats -- faced with extreme and misleading rhetoric from Republicans -- failed to govern effectively and couldn't agree how to reform our health system. As a result, voters gave power to Newt Gingrich and Tom DeLay, who had very different priorities.

OPPOSING VIEW: Democrats are learning the wrong lesson from the failure of ClintonCare, says Grace-Marie Turner.

Unfortunately, the national Republican leadership has decided to repeat this strategy, denying that our health care problems demand bold action and hoping to deny a new Democratic president a political victory at any cost to our nation's health. So once again they're talking about a government takeover of health care -- despite the fact that plans being discussed would put a record number of people into private insurance -- about rationing, about higher costs and lower quality.

But today's health reform debate is charting a far different course, and this appeal to the ultraconservative Republican base has created a unique opportunity for Democrats to prove they can govern and reflect the majority of Americans' concerns.

Unlike the Clinton-era effort, Congress, not the president's advisers, is driving the legislative effort, as it must. In addition, four main differences with 1994 explain why reform is still alive despite the concerted efforts of GOP leaders, Glenn Beck and Dick Armey.

• Today, family health insurance costs 20 percent of median family income; it was 8 percent in 1994. As a result, more and more families are hit hard by the shortcomings of our system.
• Health care costs now threaten the ability of U.S. companies to compete internationally. Employers fear unpredictable and ever-rising health care costs.
• Health system stakeholders -- physicians, hospital leaders, nurses, even some insurance and drug industry executives -- all now realize that our system is unsustainable. They loathe being forced to slash costs without the balm of coverage expansion if we fail to pass reasonable reform once again.
• Finally, federal and state officials know that their budgets will be hopelessly busted if we don't rein in health care cost growth. All other priorities -- like education, transportation and communication -- will suffer.

Real leaders also see the true link between reducing Medicare cost growth and reform. They know covering the uninsured is a necessary first step to let providers focus on improving quality and efficiency, which in turn will slow Medicare and systemwide cost trajectories.

This is why repeated use of "rationing" scare tactics is particularly irresponsible. These rhetorical claims by Republicans and others amount to an abdication of their responsibility to engage in an adult conversation about how to get Medicare costs down and our fiscal house in order.

The fact is that any reform package that the vast majority of liberal and conservative Democrats -- and the brave Republicans who are still engaged -- can support will earn the support of the American people.

Indeed, the latest Kaiser Family Foundation poll shows that 63 percent of Americans think the country would be better off with health reform. That's up from 46 percent in August, during the heyday of opponents' misinformation campaigns.

Rhetoric aside, Americans seek the benefits of reform. We want to know we aren't going to be denied health insurance because we are sick. Stakeholders want to manage their institutions into a sustainable future. Employers want to become competitive on a world stage again. And we all want government leaders to work together to solve our nation's greatest problems.

This time around, health reform will succeed. And lawmakers who play a proactive, problem-solving role in the debate will be rewarded at the polls in 2010 and beyond.
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Len Nichols, director of the Health Policy Program at the New America Foundation, was the senior adviser for health policy at the Office of Management and Budget during the Clinton reform efforts of 1993-94.