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Health Reform's Moment

By Thomas A. Daschle
Friday, March 20, 2009

When I withdrew from consideration to be secretary of health and human services, some pundits said health reform had received a devastating blow. While it would be flattering for me to believe that, it would also be completely wrong.

Those pundits were wrong because of the great team that President Obama has assembled. Kansas Gov. Kathleen Sebelius, the nominee to head the Department of Health and Human Services, and Nancy-Ann Min DeParle, who will head the White House Office of Health Reform, are outstanding leaders. I look forward to helping them in any way I can.

The pundits were wrong because of the president's unwavering commitment to this issue. "Health-care reform cannot wait, it must not wait, and it will not wait another year," he said last month.

They were wrong because of the broad support for health reform in Congress. "Republicans are coming to the understanding that their opposition to universal coverage is misplaced," Sen. Robert Bennett (R-Utah) recently admitted. Sen. Edward Kennedy (D-Mass.) has promised: "We will not fail."

The pundits were wrong because reformers have some new and unlikely allies. "This is a great start," former Republican congressman Billy Tauzin, now president of the leading pharmaceutical lobbying group, said at the recent White House Forum on Health Reform. "You have our commitment to play, to contribute and to help pass health-care reform this year," said Karen Ignagni, chief executive of the major insurance industry lobby.

But the biggest error those pundits made was in thinking that the debate over health-care reform would be decided by who occupies certain positions in Washington. It won't. It will be decided by the American people. And at the Forum on Health Reform, those voices were finally heard.

In a report that was handed to President Obama, more than 30,000 Americans who volunteered to participate in local health-care discussions affirmed in their own words (available at http://www.HealthReform.gov) what we've been seeing in polls and public meetings for a long time: The American people want major health-care reform now.

Parts of the report are heartbreaking. There is the woman from Belle Isle, Fla., who had to put off immunizations for her 1-year-old daughter. And the man from Boulder, Colo., who fell off a roof in September but didn't go to the hospital because he couldn't pay the bills he knew would follow. There are dozens of stories about how Americans deal with the gaps in our health-care system: taking on second jobs, putting off retirement, taking only half of their medicine to make their prescriptions last longer.

But Americans' great determination is also on display. There are strong views about how to increase the fairness, quality and reach of health care. At a discussion I attended in Dublin, Ind., I asked a fire chief to sum up our conversation. He could have been summing up the report: "We have to figure out a way to address these problems together."

There are still a few holdouts. On cable news, for instance, you can hear echoes of the old scare lines about wait lists and rationing. An ad by a group called Conservatives for Patients' Rights warns of a system where "bureaucrats decide the treatments you receive, the drugs you take, even the doctors you see."

These critics are betting that the tactics they used to defeat the Clinton health plan will work again. As Bay Buchanan told the New York Times last month, " 'Socialized medicine' was a great argument for us."

Maybe it was. But it isn't anymore. In the early 1990s, these attacks succeeded because they resonated with Americans' doubts about whether major reform was necessary. Today, those doubts have dissipated.

Since 2000, health premiums have doubled, the number of uninsured has climbed by a million people each year, and our performance compared with the rest of the world has declined. With health-care costs dragging down our economy, blowing up our deficit and forcing thousands of families out of their homes, Americans are losing patience with arguments like "we can't make any changes or something really bad will happen."

It was flattering to hear people say that I was somehow essential to health reform. But I always knew that wasn't true. Yes, it is disappointing that I will not be inside the administration, pushing for health reform. But that doesn't mean I won't be pushing for it. The people who will decide whether reform happens are the ones in that report. They're in our firehouses and community centers and living rooms. They're also the people who decide elections. That's why smart politicians should listen to these voices, not to the worn-out slogans and scare lines of old Washington debates. These Americans are telling us we can't wait any longer: The time for health-care reform is now.

The writer, a Democrat, served as a senator from South Dakota from 1987 to 2005.

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