With 60% of bankruptcies in America today due to health care costs, and with 75% of those bankruptcies involving people who have health insurance, it's clear our system is broken and needs fixing now, both for ourselves and for our economy.

Artificial deadlines may not matter, but timing and speed will matter a lot. Our polling shows strong public support for action on health reform despite the recession (because people are defining health now as an economic problem). But it also shows that many of the old vulnerabilities to Harry and Louise type attacks are still there and could erode support for most of the major elements of health reform now being discussed. After there is legislation on the table with details about how health reform will work and how it will be financed, proponents of action in the Congress should move as fast as possible to put health reform legislation on the president's desk, because a protracted debate could sap momentum and support.

In legislation as in life, it makes sense to strike while the iron is hot. The health reform iron is hot right now. It would be a mistake to let it cool.

Deadlines can be helpful. They represent a benchmark for Congress to work toward and are a clear alternative to battling over health care reform without an end in sight.

However Congress has a tendency to meet deadlines with quick fixes rather than meeting the needs of the people in the time allowed. Not only are these band-aid fixes ineffective, they leave the real problems for someone else to fix down the road.

For example, look at the physician reimbursement formula to Medicare from 2008. Under a statutory deadline many doctors could no longer afford to see Medicare patients because the physician reimbursement formula had expired. It wasn’t until a month later, after Congress returned from recess that our legislators came to an agreement – albeit temporary. Over the course of this past year, physicians received a .5 percent increase in Medicare reimbursements, followed by a 1.1 percent increase this year. But in 2010, it’ll be back to the drawing board. And how long might some Medicare patients have to wait this time – two, four or even six months for politicians to create another temporary “fix” for the program? These stopgap measures do little to develop a health care policy based on positive outcomes for patients.

In order to achieve real comprehensive health care reform, efforts must be bipartisan. Health care is too important an issue to be denigrated into a match of dueling talking points on Capitol Hill and cable news. In order to achieve real reform, we must have a legitimate discussion and debate that centers around patients and how best to provide the quality health care they deserve. Republicans have some good ideas, as do Democrats. But focusing solely on how much reform is going to cost will only lead to more delays. Congress needs to use the cost of reform as a driver to improve the quality of the nation’s health system, not a barrier. If they can get beyond using health care as a political football we can have health care policy that is patient focused and accessible to everyone.

All too often deadlines have become arbitrary moments in time at the expense of patients and tax payers. But when used as motivational tools to spark real action, deadlines can provide a timeline, incentives and benchmarks for processes and successes. The most important thing is that Congress get it right this time, not with quick fixes but with real health care reform.

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I think waiting for health care legislation will get everyone in the right frame of mind.

After reform is enacted, we almost certainly will be waiting longer for our own health care.

Waiting in Boston is twice as long as in any other city and ER visits for nonemergency care are the same today as they were three years ago [here is the link].

Massachusetts is beginning to look like Canada.

Timeliness is critical to health care reform. We learned this in 1993-1994 when President Clinton's health care reform effort was delayed: It was initiated with his speech in September 1993 and the submission of his proposal in November 1993. By that time, the President had spent a significant amount of his political capital on votes applicable to NAFTA and balancing the budget as well as his "don't ask, don't tell" administrative solution for gays in the military.

Although President Obama entered office with greater political capital because he received a majority of the presidential vote (unlike President Clinton's 43 percent plurality), no President's political capital is infinite or permanent. The President's political leadership is essential to health care reform, and that leadership needs to be asserted when -- as now -- his political capital is substantial. Moreover, once we get into 2010, the congressional election season will begin and the opportunities for bipartisanship become much harder.

Additionally, there is now something close to an aura of inevitability that meaningful health care reform will happen. That aura of inevitability is most helpful in motivating health care interest groups, members of Congress, and opinion leaders to play a cooperative role in the debate. It is important that this aura of inevitability does not slip -- and timeliness is important to its retention.

From my discussions with the staff on all five committees, it seems likely that the self-imposed schedule of July floor action can and will be met. To be sure, there remain difficult issues that are still being worked out, but all five committee chairmen -- and the President -- know that adherence to the schedule is important. As Senator Baucus has repeatedly said, we cannot let the perfect be the enemy of the very good -- and, with that attitude prevalent among our nation's leaders, it seems likely that key decisions will soon be made to enable the process to move along on schedule.

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As President Obama has repeatedly stated, health reform is not a luxury that can be postponed, but a necessity that cannot wait. It is important to take bold steps now. Health care spending per capita in the United States is more than twice that of other industrialized countries, with no commensurate return in access, health outcomes, or value. Our inefficient health system places an enormous and growing burden on American families and businesses, weakening our nation's economy, and has put federal and state governments on an unsustainable fiscal path.

The new Administration and Congress have already made progress toward a reformed health system that puts people front and center. Reauthorization of the Children's Health Insurance Program and passage of the American Recovery and Reinvestment Act were important initial steps that expanded coverage to some our nation’s most vulnerable populations, invested in information technology and comparative effectiveness research to improve quality and efficiency, and laid the groundwork for more fundamental change. President Obama's budget blueprint, which set aside $634 billion for health reform over 10 years, demonstrated a meaningful commitment to passing health reform legislation this year.

The recent pledge from business and industry leaders to eventually reduce the growth in national health care expenditures by 1.5 percentage points annually is another reason to be optimistic--and an important signal that major stakeholders are ready to work together to build a more efficient and sustainable system.

It is crucial that President Obama and the 111th Congress maintain this momentum. Work by the Commonwealth Fund Commission on a High Performance Health System shows that, if enacted this year, comprehensive payment and delivery system reform has the potential to expand affordable coverage to all while slowing the growth in national health expenditures by $3 trillion over 11 years, while bending the health care cost curve from 6.7 percent to 5.5 percent annual growth. Given that we have a historic political opportunity and a clear path toward a high performance health system that works for all Americans, we must take swift action to ensure the health and economic security of this and future generations.

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Last Thursday when talking about health care reform, President Obama said, “If we don’t get it done this year, we’re not going to get it done.” The President correctly realizes health care reform cannot wait and if we do not act quickly our window of opportunity to will close. That is why upon taking office he set a goal of enacting comprehensive health care reform this year.

In the House of Representatives, the three committees of jurisdiction on health care – Energy and Commerce, Ways and Means and Education and Labor – have agreed to work together to produce one health reform bill. As Chairman Emeritus of the Energy and Commerce Committee, I have been tasked to work with Chairmen Waxman, Rangel and Miller to draft the legislation that is based off of the President’s health care reform principles. The House Democratic leadership is supportive of our goals and the President’s timeline, and Speaker Nancy Pelosi has pledged that we will have a health care reform bill on the floor by July 31 of this year.

We are working against the clock, but in some ways that may actually help our cause. The tight timeline has kept us focused and has allowed us to make health care reform our top priority. The American people need us to act quickly. The status quo of our health care system is unacceptable as the crushing costs of health care are bankrupting American families, our businesses, and our government.

The stars have aligned in favor of health care reform in a way that I have never seen. The American people are desperate for it, the President wants it, and Congress wants it. Though it won’t be easy, I am confident that we will meet our timeline. In fact, I am going to absolute work my hardest to ensure that we do.

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I opened discussion of health care reform more than a year ago and have since held over a dozen hearings on the topic. Last November, I released a white paper and in April and May of this year, Senator Grassley and I held roundtable discussions with health care policy and industry experts. Next came detailed policy options focusing on three main subjects: reducing costs and improving quality in the health care delivery system, expanding health care coverage to all Americans, and financing comprehensive health care reform.

With the necessary groundwork in place, we are on a steady path toward mark-up of a comprehensive health reform bill this month. I’m confident we will succeed in the effort to reform our health care system, because we simply can’t afford to fail. Our health care system is in crisis. And it’s not just a crisis for the uninsured. It’s not just about health. It’s about our economy. Americans understand this, President Obama understands this, and Democrats and Republicans in both bodies of Congress understand this. Finally, advocacy groups and even the insurance companies understand this. If there’s one thing we all agree on, it’s that reforming American health care is essential to our social and economic well-being.

In 2007, our economy lost more than $200 billion as a result of the broken health care system. Health care spending currently outpaces economic growth by an average of 2.1 percentage points per year. At this rate, health care spending will double by 2018, to $4.4 trillion per year. That’s one-fifth of our total economy. That’s the cost of doing nothing, and simply put, it’s unsustainable.

Americans’ wages are not keeping pace with the increase in health spending either. Since 2000, the cost of insurance has increased 2.5 times more than wages per year. American families are already burdened with a hidden tax of more than $1,000 a year in additional premiums to cover the cost of uncompensated care. And businesses could see their health care costs double from $429.8 billion to $885.1 billion in the next ten years.

Clearly, health care costs are spinning out of control. That’s why Senator Grassley and I have been working to find the best ways to deliver care more efficiently and to provide high quality care more consistently. We want our health care providers to deliver the best possible care and to do so by coordinating with their patients’ other doctors and providers. We want to invest in medical information technology and make certain that doctors have access to the latest independent research on what treatments work best for which patients. Finally, we want to reduce fraud and waste in Medicare by ensuring proper payment and reimbursement rates. According to the National Health Care Anti-Fraud Association, at least 3 percent of the $2 trillion spent on health care every year—more than $60 billion—is lost to fraud.

Senator Grassley and I are also aiming to reform the individual and small group health insurance markets to end the culture of discrimination against sicker individuals and encourage competition among companies based on price and quality. Also under consideration is an expansion of Medicare and Medicaid to cover the lowest-income Americans and make coverage more affordable by providing tax credits to low income individuals and small businesses.

Indeed, there are some contentious issues for both Republicans and Democrats up for debate, but I believe we are up to the task, and I’ll continue the push toward bipartisan solutions in the coming days and weeks. Our guiding and unifying force is that we can’t afford not to act. Not only do we have a fiscal responsibility to reform our health care system, but also a moral obligation to ensure that every American has access to quality affordable health care for generations to come.

To fix our broken health care system, everyone will have to give and take. Everyone will have to suspend judgment, yield some ground, and work together to find a uniquely American solution to end the health care crisis.

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