A lot has changed since the failed Clinton reform attempts of 1993-1994. Today, there is little disagreement in Washington that the American health care system is in a crisis.  Medical costs are climbing and increasing health insurance premiums are harming the financial security of families and the economic viability of companies.  Tolerance for the large number of uninsured in the country is near an end. Hospitals and physicians are struggling with increasing numbers of uninsured patients, and small businesses are hoping for help with the continually rising costs and the financial burdens of providing health care coverage for their employees.

There is not only wide agreement among policy makers that there is a problem with the health care system, but there is also growing consensus on what potential solutions might look like. The interest groups and academics who waged battles against the Clinton plan in 1993 are now finding common ground. Although enacting comprehensive health care reform in 2009 will likely include vigorous and heated debates among lawmakers and key stakeholders, their willingness to work together to find common ground and to acknowledge the need for immediate health care reform is certainly promising.

In the early 1990’s, the opponents of health reform were better funded and more organized than advocates. They didn’t like the Clinton plan, and they spent a lot of time and money driving home the message that the American public shouldn’t like it either.  In the end, they were successful. This time, advocates of reform are ready. Even Harry and Louise, the public face of the anti-health care ad campaign from 1993 and 1994, have returned to deliver a much different message.

And the debate continues…