After a year of debate, protests, rallies pro and con, endless committee meetings, television ads, political calculations and presidential speeches, the House of Representatives is on the verge of passing major health care reform. Finally.

And yet the final stumbling block is not recalcitrant Republicans who don’t want major reform and don’t want to give President Obama a major legislative victory. No, the final hurdle involves Democratic House members struggling to vote for the Senate-passed health care bill. Some progressive Democrats don’t think the bill has enough reform, including a government option for people without insurance. Abortion opponents don’t think the Senate language is restrictive enough in barring the government from paying for a woman’s abortion. And so-called Blue Dog or conservative Democrats think the bill will be too costly.

These House members, who include Minnesotans Collin Peterson, a Blue-Dog against the bill, and Jim Oberstar, an abortion opponent leaning towards a yes vote, need to put aside their differences and get behind the reform bill. We will not have another good chance to make a major change in our health care system for years if Congress does not act.

And the consequences for standing pat are quite serious. A recent report in the New York Times, quoting economists, health care experts and business people, paints a dire picture if nothing is done to extend coverage and attempt to control health care costs.

Even the 85 percent of the population who are covered by insurance will see their premiums double over 10 years, according to the report. The number of uninsured, now at an estimated 49 million, will increase to as many as 69 million in the next decade. The cost to businesses and the government will be unsustainable. And, most alarming of all for a nation that should care about all its people, 275,000 people will die prematurely over the next decade because they didn’t have health coverage.

The health care bill the House will vote on is not perfect. It does not have bipartisan support, but not for lack of trying. For all their bluster about starting over, the Republicans’ proposals, according to most estimates, would insure an additional three million people vs. 30 million in the Democratic plan. You cannot adequately spread the risk and provide affordable coverage by adding so few people to the insurance pool.

For anyone who has ever lost a job, health care reform will mean he or she won’t have to go without coverage. For people with pre-existing conditions from heart disease to diabetes, health care reform means they can get affordable insurance for them and their families. For middle class families and independent business people, reform means a chance to purchase insurance through exchanges. For millions of uninsured in the only industrialized country that doesn’t have some form of universal coverage, help is on the way. And for a nation that spends more per capita on health care than any country for the 37th best results, reform means an attempt at cost containment and more effective delivery. The Congressional Budget Office has said the reform bill will lower the deficit.

I don’t often agree with many Republican positions on health care or other issues, but I have to admire their political will and savvy. Can you imagine large numbers of Republicans opposing a president of their own party on his most important domestic legislation? No, they would back their president, just as they have backed Gov. Tim Pawlenty in Minnesota.

There are some signs of movement among Democrats. Rep. Dale Kildee, anti-abortion congressman from Michigan, has announced he will vote for health care reform.

“I now find myself disagreeing with some of the people and groups I have spent a lifetime working with,” he said. “I have listened carefully to both sides, sought counsel from my priest, advice from family, friends and constituents, and I have read the Senate abortion language more than a dozen times.”

 Perhaps Congressman Oberstar can find solace in those words.

And Rep. Dennis Kucinich, one of the House’s leading progressives, has put aside his concern with the Senate bill’s lack of a government option, to support the bill. “In the past week it’s become clear that the vote on the final health bill will be very close,” Kucinich said. “I take this vote with the utmost seriousness. I’m quite aware of the historic fight, which has lasted the last century.”

Despite all the rhetoric about “government takeover of health care” and “socialized medicine” that you hear from our own Rep. Michele Bachmann and others, the fact is that the final health care bill is a rather moderate document. Most experts say it has many of the same features that Republicans proposed following the defeat of President Clinton’s health care proposals of the early 1990s.

I heard one of those experts speak recently  at a University of St. Thomas lunch. He has studied health care policy for years. He said that while he might have done some things differently, the bill about to be voted on in the House should be passed because it extends coverage and attempts to control health care costs and the time is now. The speaker was former Republican Sen. David Durenberger, head of the National Institute of Health Policy at St. Thomas. I wish Congressman Peterson and other reluctant Democrats had heard the talk.


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