Learning from failures of 1994

Rep. Frank Pallone Jr. (D-N.J.)
April 23, 2009

In 1994, when we last tried to reform our nation′s healthcare system, I was still a fairly new member of Congress serving out my third term in the House. Fast forward 15 years and I think it′s a useful exercise to ask myself, "What has changed?"

My colleagues and I from the 1994 battle are still here. We are a little bit older, but we are also a little bit wiser about how to approach health reform. We have the benefit of having a second chance and we have no intention of making the same mistakes that were made during the last go-around on health reform.

For example, in the House, the three committees that have jurisdiction over health issues (Energy and Commerce, Ways and Means, and Education and Labor) are working together in a unified fashion to develop a single proposal based on the key principles outlined by President Obama.

This is a stark contrast from 1994 when the three committees were handed a legislative proposal from above in which they had little or no input and went to work on separate paths.

There are also many new players who will be integral in enacting healthcare reform legislation. Most importantly, we have a dynamic new president who has made healthcare reform one of the pillars of his legislative agenda that will put our nation and America′s hardworking families on the road to economic recovery.

President Obama recognizes that time is not on our side when it comes to this debate. The longer we debate this issue, the longer healthcare costs continue to spiral out of control and the longer American families have to wait for to access affordable and quality health care coverage. That is why he has called for comprehensive health reform to be enacted by the end of this year.

Even though it was early in his first term, President Clinton′s health reform plan came too late. President Clinton had already spent significant political capital on some of his other priorities, like the North American Free Trade Agreement, which made it all the more difficult to get healthcare reform across the finish line.  Keeping health reform front-and-center, as President Obama continues to do, will improve our chances for success.

Another major difference between today and the 1994 debate is how various stakeholders are positioning themselves now. I can barely keep track of all the alliances that have formed among groups that were pitted against one another 15 years ago.

Industry representatives such as America′s Health Insurance Plans (AHIP) and PhRMA have teamed up with consumer groups like Families USA and AARP. Similarly, groups representing employers′ interests have joined forces with unions. I applaud these groups for working together to come to an agreement on the principles for health reform. While this is a good first step, the truly hard part is about to come.

As with any controversial issue, the devil will be in the details, and commitments to achieving health reform will be tested as those of us drafting health reform legislation begin to put pen to paper.

As this process unfolds, it is imperative that those involved in this debate recognize that in order for health reform to succeed it will require shared responsibility and sacrifices. The time to say that you are simply willing to come to the table has come and gone. We need people who are willing to take their seats and stay firmly planted as we hammer out these details, especially on the most controversial aspects of health reform.

For example, much of the recent debate has focused on whether or not Congress should allow a public health insurance plan to compete against private insurers. People are already drawing lines in the sand and preparing to walk away when it comes to this issue. This is unfortunate and makes little sense considering it represents a clear compromise between those on the right who want competition only among private plans and those on the left who might prefer a sole public option or even a single-payer system.

A public health insurance plan is not the slippery slope that opponents of health reform make it out to be. It is not government-run healthcare. Nor will it lead to the end of private insurance. A public health insurance plan that competes on a level playing field with private insurance companies is a uniquely American solution that will promote choice, improve coverage and help lower healthcare costs.  

There are many other details that will need to be flushed out that require tough choices on the part of patients, providers, insurers, manufacturers and members of Congress. I′m hopeful that we all have learned from our previous mistakes and can come together to finally reform our nation′s healthcare system. We simply can′t afford to let history repeat itself.  



Pallone is a member of the House Energy and Commerce Committee.