Will people wonder “what took so long?”

Assuming that the Senate’s health reform bill goes forward, as expected, on Christmas Eve, by year’s end, both the House and the Senate will have passed their own versions of health reform. A joint House-Senate conference will need to iron out the differences early in 2010.

Are these bills perfect? By any standard, the answer is a resounding no. Many opponents, of course, have loudly made it known that they believe that health reform should never see the light of day. Who can forget the summertime town hall signs saying “keep your government hands off my Medicare?” Now, even supporters are having their doubts over whether these bills go far enough and are worthy of support. Health reform supporters have to be wondering: Is half a loaf better than no loaf at all? Or are we better off starting over?

Senator Ted Kennedy is no longer with us but health reform, as his widow, Victoria Reggie Kennedy reminded us recently in Washington Post op-ed piece, was the cause of his life. As Kennedy pointed out, if health reform were easy, it would’ve been done long ago. Many presidents and Congressional leaders have tried but, until now, all have failed. Starting back with President Theodore Roosevelt and his Bull Moose Party in 1912, and, more recently, with Presidents Truman, Nixon, and Clinton, there have been many attempts to reform our health system but never have they come this close to becoming law.

As his widow points out, the senator “predicted that as the Senate got closer to a vote, compromises would be necessary, coalitions would falter and many ardent supporters of reform would want to walk away. He hoped that they wouldn't do so. He knew from experience…that this kind of opportunity to enact health-care reform wouldn't arise again for a generation.”

Personally, I like the analogy by Senator Tom Harkin (D-IA) comparing these bills to a starter home. Under this thinking, “this is not a mansion…it’s a starter home, with a solid foundation, a strong roof, and room for expansion.“ Putting a framework in place is key, according to this view, and there will be time for tinkering with it later. You have to wonder, though, whether upgrading the starter home will be any easier down the road. If health reform is signed into law, this might be it, for quite some time.

Senator Ted Kennedy often said: “when it’s finally done, the people will wonder what took so long.” I continually hear opponents wonder “why are they rushing this through?” I guess 98 years isn’t long enough for them. Many supporters already wonder why this didn’t happen long ago. Maybe someday, everyone will feel that same way.