Why wait for 2009?
Health insurance coverage is already a major issue in the 2008 White House contests. The Democratic front-runners -- former Sen. John Edwards (D-N.C.), Sen. Barack Obama (D-Ill.) and Sen. Hillary Rodham Clinton (D-N.Y.) -- all embrace forms of universal coverage.
But there is no real reason to defer action on affordable health insurance until 2009, when there is a new president in the White House.
Though four Democratic senators are running for president -- Obama, Clinton, Sen. Chris Dodd (D-Conn.) and Sen. Joe Biden (D-Conn.) -- the Democrats control the Congress now. Blockbuster legislation revamping the way health insurance is provided is going to take time to complete even with all parties pulling together.
Edwards already has unveiled his health plan. Clinton and Obama will bring out their detailed proposals when it suits their strategic timing.
But why not get started? Business-labor coalitions have been created in the past months to find common ground, throwing together, among other strange bedfellows, the Service Employees International Union, Safeway and Wal-Mart.
There's already innovative legislation that could provide the framework -- the Healthy Americans Act introduced last December by Sen. Ron Wyden (D-Oregon), a member of the Finance Committee with jurisdiction over health care.
"Senators don't get election certificates that allow them to sit around and wait for two years," Wyden told me. "So I think there is a very important six- or seven-month window in which to get real traction in this Congress and that is essentially what I am pointing for.''
One of Wyden's central proposals is ending the system that now exists where most people get their health insurance through their employers.
Framing health care reform as a pro-business benefit -- cutting employers loose from running health care plans for workers -- is a way to make sure there is support from corporate America.
Pushed by global competition, the discussion in 2007 is already massively refocused on providing a new American-style health system where everybody has access to insurance at least as good as a member of Congress can get. "Employer-based coverage is just melting like a popsicle on the summer sidewalk," Wyden said.
Wyden has a different approach. Workers would get payments from their bosses to buy health insurance in a private marketplace that would be mandated to absorb everyone. There would be subsidies for some. But there is going to be "a transition to a system where people are going to have to purchase it on their own."
The Wyden plan calls for more prevention and personal responsibility. "I think the challenge is going to be to come up with sensible health policies that promote personal responsibility in a realistic kind of way." To encourage parents to take part in wellness activities to benefit their kids, Wyden's plan would offer a discount on the premium of participating parents.
Said Wyden, "It is not as if the only person who feels strongly about it is somebody who is running for president. I think a lot of senators are saying 'I'd much rather move in a bipartisan way now and show voters in the fall of 2008 that we can deliver rather than wait around to 2009.' "
Wyden has an innovative health plan. There's no reason, with so much common ground, to let presidential politics put off starting the work.