Rep. Henry Waxman predicts that President Obama will sign a health care reform bill this year, including a public competitor to private insurance, based on voters' mandate in the 2008 election.
"The system we have is not a system and it's not sustainable, and we need to put one in place that will have ways to hold down those costs and make sure that every American has access to affordable, decent, quality health care," the chairman of the House Energy and Commerce Committee said in a conversation with Atlantic Media Co. Political Director Ronald Brownstein on Wednesday at a National Journal Group Policy Breakfast. "That's one of the reasons that the president was elected and the Democrats were elected: to accomplish this goal."
The California Democrat has already seen another major bill move through his chamber: the climate change legislation that passed the House last month. Now he's anxious to see it approved by the Senate, which he hopes will happen by the end of the year, when Obama will attend the United Nations climate change conference in Copenhagen.
"The Senate is a hard place to pass legislation, and we'll see what happens there," Waxman said. He added, "I hope it will pass this year because the president is going to Copenhagen in December, where we have an opportunity to get back on the international track because this is not a problem just for the United States."
Waxman said that environmentalists' major criticism of the bill, the inclusion of offsets for carbon emissions, is mistaken.
"The compromises I think in many ways made the bill better because we wanted a transition period as we squeezed down on the carbon emissions, and from our point of view we were getting the reductions in carbon emissions -- guaranteed reductions," he said. "To do that, we didn't want to have any jolts in the economy."
Waxman would not predict how the bill may change by the time it goes to conference, but he did outline the basics he would require.
"The irreducible core of the bill is that we get to reductions in carbon emissions and we do it not with any magic bullet, but with a combined approach that will achieve the reductions and move the economy forward and allow us to be less dependent on foreign oil for our national security," he said.
Until then, there's health care reform. Waxman acknowledged that accomplishing that goal will require overcoming the challenges that have blocked other presidents and Congresses.
"I told the Democratic caucus the first time I talked on health care, 'this is not easy,'" he said. "If it were easy, we would have done it years ago."
One of those challenges is getting the support of the many stakeholders involved in the health care system, from insurance companies to doctors to patients. But Waxman said the bill will end up benefiting everyone, and as a result stakeholders are more open to compromise now than they were in the 1990s, when health care reform failed.
"Now, most of the stakeholders want what they want, but they realize that something has to be done," he said. "The present status of health care is unsustainable in a lot of different ways, particularly financially."
Another challenge is private insurance companies' concern that employers will move their employees to the public plan, Brownstein noted. Though Waxman acknowledged this issue, he could not provide a specific explanation of how the bill will ensure that citizens will be able to continue in their current health plan if desired.
"We are mindful of that concern, and we're trying to work out specific details to make the system operate," Waxman said. "There definitely has to be oversight."
He added, "We want competition, but we don't want the public plan to win because that would drive out the private insurance competitors. So what we have to figure out is how to keep the public plan on a level playing field."
Waxman said he anticipates that the three House committees involved in the legislation -- Ways and Means, Energy and Commerce, and Education and Labor -- will begin marking up the bill next week after they receive the Congressional Budget Office cost estimates today.