Two months ago, health-care reform looked as if it could be almost easy for the 2008 Legislature -- deceptively so.
A pair of study panels, working in tandem, had produced strikingly similar recommendations that appeared to have enough bipartisan support to become law. The proposals steered clear of philosophical extremes, in favor of enough regulation to help consumers be smarter health-care shoppers and enough incentives to make the medical system deliver better, more cost-effective care. Cost savings from those measures were to be used in part to make health insurance affordable for more Minnesotans, and thereby drive costs lower still.
Those aren't revolutionary ideas. But analysts say they're sufficient to deliver a 20 percent health-care cost savings -- not just to government, but also to the private sector -- by 2015. No other measure on the docket this year promises as much near-term business stimulus.
That promise, combined with the certainty that costs will keep climbing if the state does not act, attracted broad initial backing. But criticism has persisted from the left, which prefers government-run health insurance for all, and from the right, which favors much less government involvement in every aspect of health care.
Last week, it appeared that the latter group had gotten to Republican Gov. Tim Pawlenty. His expressed concerns about a Senate bill modeled after his own panel's proposals looked like a potentially fatal blow to the effort to reign in health-care costs and improve Minnesota's health -- not only for this session, but likely for the rest of Pawlenty's term.
But by week's end, the reform effort was exhibiting encouraging resiliency. Pawlenty was calling his concerns "fixable." The Senate bill was modified to address some critics' objections, and won a bipartisan preliminary vote, 41-22.
The House version, a work in progress, got a news-conference boost from a coalition that included a General Mills vice president, a labor leader, a seniors organization, a nonprofit health-care CEO, and the physician who ran for lieutenant governor on the Independence Party ticket in 2006, Maureen Reed.
Allowing so much consensus to come to naught would be a lawmaking failure Minnesotans would rue for years. It no longer looks easy to achieve major reform this session -- but it still looks imperative.
Reaching an agreement will require a number of concessions. These two stood out last week:
• Pawlenty should back away from tapping the Health Care Access Fund to balance the state budget. That fund was built with a 2 percent tax on health-care services, enacted in 1992 on a promise that it would be used to help the working poor buy health insurance and thereby reduce total health-care costs. Raiding that fund will shrink the reform package's cost-savings potential and will be a deal-breaker with the DFL-controlled Legislature.
• DFLers should back away from what amounts to a new premium tax, to be used to expand insurance coverage as other costs fall. It would make health insurance more expensive for small employers at a time when the state should be encouraging more employers to insure their employees. Dropping that idea will make it easier for business organizations to support the reform package -- and it needs all the business friends it can get.