THE BLOG
03/30/2009 05:12 am ET Updated May 25, 2011

Next Big Change Up: Health Care Reform

While the work on stabilizing the banking system, passing the Obama budget, and working on the other big issues the president has prioritized will all continue steadily along in the coming months, it is clear that health care reform is the next big debate on the President's mind. The first big signal of this was the way he deftly, and rightly, turned the fiscal responsibility summit into mainly a discussion on health care reform, and then announced on the spot that there would be a health care summit next week. Then, in his speech to the nation Tuesday night, he made a push for fundamental reform this year. And finally this week, his budget includes a $634 billion "down payment" on the money needed for health reform. Clearly the president is gearing up for a big battle.

As one of the earliest members of the Clinton White House health care team, I am very encouraged by the early strategic signs coming from President Obama. As I discuss in my book, The Progressive Revolution: How the Best in America Came to Be, we made some big mistakes in the Clinton drive for health care reform that doomed our chances for victory, and President Obama's early decisions suggest that they are learning at least some of the right lessons from that experience. Here are some things I am encouraged about:

1. Obama said we needed to do serious reform this year. In early 1993, President Clinton got convinced by Bob Rubin and other corporate Democrats to delay pushing for health care until 1994, after the first budget fight and after they could push their beloved NAFTA through. President Obama set a great tone in his speech Tuesday night: We're going to go big, and we're going to do it this year.

2. Putting a down payment into the budget. Rubin and his allies also convinced President Clinton that reducing the deficit was more important than health care, and that money for health care should all be done later. It was a huge mistake, making the budget numbers for health care reform politically unpalatable. While President Obama hasn't put in every dollar needed for health reform in this budget, he has sent a budget that does have a significant $634 billion down payment.

3. Leaving the details to Congress. Another major mistake was to take the first year of Clinton's term to write an excruciatingly detailed piece of legislation. The result was that we spent a year being lobbied by every outside group imaginable on every detail of the bill (I personally met with over 1,500 different groups on the bill that year) and then as soon as it got sent to the Hill, that same lobbying process began with Capitol Hill. In the meantime, we lost momentum and passion, and the insurance industry picked us apart by focusing on the tiny details of the bill in their infamous Harry and Louise ads.

Obama is sending clear signals that he is going to leave the details of the legislation up to Congress.

We have a long way to go to pass a serious health reform bill, and the obstacles are big to getting it done. Teddy Roosevelt, FDR, Truman, LBJ, even Nixon all tried before President Clinton's plan went up in flames. But Barack Obama knows how messed up our health care system is, and he knows we need big change. I'm glad he has the guts to take it on, and I'm glad to see his early strategic moves on it are smart ones.

Mike Lux is the author of The Progressive Revolution: How the Best in America Came to Be.