Dave Durenberger: Health care reform should wait until 2011

"Change you can believe in" was much more than an election theme. It was an aspiration on the part of millions for a new kind of political leadership for America. It is a hope that President Obama can lead us to some significant changes in public policy. Health care is among the most important of these. Americans believe their health care system costs too much and produces too little and they want someone to change it.

For the last six months the president has made clear his commitment to improving access to and the quality of our health care by reducing its cost. He hasn't laid out a specific plan for achieving that goal, leaving that to the Congress. Members of both the Senate and the House have worked hard to develop legislative plans to achieve the president's goal. Even the health care industry appears at long last to be cooperating in change.

But it is already clear that the president's stated goals cannot be met by this Congress. President Obama must face this reality quite soon. In health care reform, getting it right might just be more important than getting it done.

Obama must consider postponing health reform legislation to 2011.

Taxing the rich, as proposed in the House, is not the answer. Republicans and enough Democrats in Congress already know that, so it won't happen. Reforming the way we spend federal tax dollars is one way to reward high quality systems. But the Democratic majorities just announced their opposition to changing the tax treatment of employer-paid health insurance. Just as they did in 1994, large labor unions have persuaded Democrats to oppose this long-needed reform.

The two big public insurance programs -- Medicare and Medicaid -- could be reformed to allow the El Paso medical community to reap some of the benefit of low-cost, high-quality changes in care delivery as an incentive for reducing the amount of high-cost care in McAllen. But the medical industry and, therefore, too many members of Congress oppose payment reform that distinguishes based on medical practice variation. It is difficult to break through the "more-is-better" philosophy that has been part of our American medical mindset for much too long. And efforts by policymakers to do so are greeted by taunts like "government-run health care."

The quick support of the Democratic legislation by large national medical industries means only one thing to a reformer like me: They believe Obama needs health reform at any price, and they can trade endorsement for the right to negotiate industry-favorable changes later in the conference committee process. The response to the Congressional Budget Office's wise warning about adding to costs will simply mean pushing costly coverage expansion and some cost-saving measures out toward the 10th budget year. Then, as the time approaches, the industries will demand "give backs" in policies that cost them money.

Congress is divided. The political parties are divided. The medical industry is divided. The American people are poorly informed. Both the nation and Obama have more at stake right now in restoring our national and international security and self-confidence than they do in the passage of health reform legislation.

By reason of the serious efforts made in both houses of Congress thus far, much has been learned. Leaders and followers are much better informed. The urgency of reform will be as strong or stronger next year or in two years than it is today. Hopefully, our economic capacity as a nation to take on the megabillion-dollar consequences of this change will be as well.

Dave Durenberger is a former Republican U.S. senator from Minnesota and chair of the National Institute of Health Policy.