RALEIGH — With continuing reports about Congress's putting national health reform on hold, it's time to reflect on where we go from here. After more than a decade of being involved in trying to enact specific pieces of legislation through the General Assembly, I know only too well the lobbyist's mantra on how to kill legislation you don't like - delay, delay, delay. Delay buys time for opponents to sharpen and continue their attacks, runs down the clock until the next big recess or election and can tire and dishearten supporters of change.
All three of these problems are now besetting national health reform. And with all the delays, health reform was already in trouble before the Massachusetts election. What if a U.S. senator had gotten ill and wasn't able to attend sessions? That 60-vote supermajority would be gone just as completely.
Despite charges from the right, the reform bill in the Senate is one of the most conservative ways of implementing health reform (that actually covers most Americans) ever proposed. Keeping private insurers and major small business tax credits and cutting the Medicare program to be more effective and efficient - these key parts of the Senate bill are all ideas from the moderate to conservative side of the political spectrum. No scary "socialist" takeover of health care here - just quietly building on the current system.
Perhaps the biggest problem is reflected in the recent community meetings I've been to around North Carolina. Supporters of health reform are angry that legislation they thought was almost complete has stalled, but they also seem resigned to the idea that Democrats are ineffective and unable to get it done. People who've poured their hearts and souls into trying to finally get health reform passed just don't understand why, with Democrats holding a 59-41 Senate majority, an overwhelming House majority and the presidency, that fairly moderate health reforms can't be enacted.
These folks just aren't that excited about taking to the streets to support a reform bill that's more conservative than many would have liked when reform has already passed both the House and Senate.
From butting up against some of the most powerful special interests in the state to get legislation enacted here, I'm familiar with the idea that failure can be followed by another try next month or next year. That's not what has happened with national health reform over the past century, unfortunately. Every 15 years or so, reform comes up on the agenda, politicians from FDR to Richard Nixon make it a priority and we have another national debate.
There are a couple things that are different this time around, however.
First, no other movement for comprehensive health reform has ever passed bills in both the House and the Senate. Politically, we are very, very close to enactment.
Second, the problems of unaffordable coverage for many people and businesses - especially small businesses - have never been in sharper relief. Health insurance has never been more expensive than it is today for individuals, businesses and governments. The growth is unsustainable.
These two reasons alone make me think we have more of a chance than not of getting reform through this year.
Nobody really wins if we don't enact health reform. Businesses and health industry players all understand that. Relentlessly rising health costs mean more and more people are unable to afford health premiums, drugs, hospital treatments and on and on. A shrinking market isn't a healthy one.
Problems caused by the lack of reform - increasing pressure on state and federal budgets, thousands more people losing their livelihoods just because they got sick and more businesses unable to provide health care - are not going away. Proposing ineffective solutions works for only so long before voters demand accountability, regardless of party.
Decisive action and leadership can still save health reform from death by delay. Over the next few weeks, we'll see whether Democrats can get it done.
Adam Searing is project director of the N.C. Justice Center's Health Access Coalition.