Climbing the Hill on Health Care

By Tom Daschle, Wall Street Journal - September 3, 2009

The memories linger. The mass at the Basilica of Our Lady of Perpetual Help in Boston celebrating Ted Kennedy's life was a powerful and uniting moment. Prominent Republicans and Democrats embraced as they shared stories of times with Teddy. Ted Kennedy Jr. delivered a moving eulogy of his father.

He talked of losing a leg at the age of 12 and of wondering if he would ever be normal again. He talked about the snowy day, after returning from the hospital, when his father invited him to go sledding. As they approached the steep, snow-packed hill, Ted Jr. fell on the ice. "I can't do this. I will never be able to climb up this hill," he remembers saying.

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His father would have none of it. He lifted his son and said, "I know you can do it. There is nothing that you can't do. We're going to climb that hill together, even if it takes us all day."

They made it up the hill and Ted Jr. learned a valuable lesson—that what seems impossible can often be done with hard work and determination.

There were many members of Congress in the basilica that day. I hope they were listening. During the month of August and even before Kennedy's funeral, I heard many of those members talk about national health reform and say, "We just can't do this. It is simply too hard."

That is what we have heard for 70 years from Republicans and Democrats alike. And as we stand, once again, at the bottom of the hill, the challenge is daunting. It means ensuring meaningful insurance coverage for all Americans while changing the health paradigm from illness to wellness and from volume to value.

Beyond the caustic and confrontational town-hall meetings, millions of Americans are now coming to realize that the status quo is not acceptable.

There is no doubt about the consequences of failure. Failure to address insurance coverage for all will mean that the numbers of uninsured in America will climb to more than 60 million people in 10 years from nearly 46 million now. Failure to address ever-escalating health costs means that a typical family will see its annual cost of health insurance rise to $25,000 by 2025 from about $12,000 now. Failure to fix problems with quality in our health-care system is an absolute guarantee that we will remain dead last among all industrialized countries when it comes to outcomes. Failure has another price, too. It could cost us our global leadership.

If we lack the ability to successfully address the urgent problems of health care in our country, the American people and the rest of the world will rightly question our ability to tackle other challenges, domestic and global. And needless to say, given the dominance of my party in the White House and in Congress, Democrats will be to blame.

By far the best path to success is to continue to pursue a traditional, bipartisan solution. I have great admiration for former Senate Majority Leaders Bob Dole and Howard Baker who, earlier this year, demonstrated remarkable strength and leadership in working with me through the auspices of the Bipartisan Policy Center to propose a compromise on comprehensive health-care reform. That compromise—which included focusing on preventive care, controlling costs, creating health-care exchanges, and other ideas—can be a blueprint for progress on health reform in Congress this fall.

However, should Republican intransigence continue, Democrats cannot simply stop. They cannot ignore the human suffering as well as their fiscal responsibility to act. They must focus on the budgetary implications of health reform and use the Senate rules of budget reconciliation to allow a health-care bill move with majority support. The choice between complete legislative failure and majority rule should not pose a dilemma for any Democratic senator.

Republicans who cry foul have only themselves to blame. First, they walked away from the table even though they had many opportunities to participate in White House meetings and in House and Senate committees over the past eight months—and eight years.

Second, they set an ample number of precedents over the past decade in using their majorities then to pass their agenda using the same reconciliation rules in the Senate.

Democrats should be clear about their purpose. The goal of meaningful health reform should be to expand coverage, reduce projected costs, improve health-system quality, and enhance health-care options for all Americans.

We should be clear that doing it right does not mean doing it fast. While the legislative framework must be enacted in a comprehensive manner given the intricate interrelationship between each of the stated goals, the policy implementation must be done cautiously over time. For some elements, even an implementation time frame of years is not too long.

I have no doubt that the naysayers will continue to argue that the job is too hard and the hill is too high. We have heard it for decades and we will hear it some more.

But as Ted Kennedy told his 12-year-old son as he stood before another hill, "You can do anything if you try hard enough." My friend Ted was right then and he was right to press us to move up the hill on health-care reform.

Mr. Daschle is a former senator from South Dakota and former U.S. Senate majority leader. He is currently a special policy adviser at Alston & Bird.

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