Just talked to a spokesman for Rep. Pete Stark (D-CA), a powerful subcommittee chief in House Ways and Means, who wanted to make the congressman's stance on health care reform crystal clear. Although a report last month suggested that Stark believes a major health care bill could wait until early next year, his spokesman reiterated that the congressman is ready for a reform push before the 2010 midterm elections intrude on the political scene.

"Comprehensive health reform is a complicated, important effort," Stark clarified in a statement. "It will take time to do it right, but we ought to finish in 2009 if at all possible."

To Sen. Ron Wyden (D-OR), health care reform is the great "unrequited love" of progressives. "It goes back to Harry Truman," he told me during a sit-down interview today. "Every 15 years or so, there's an effort to fix health care. Every time, progressives have said, 'This is the moment, my dream of universal health care will be achieved!' ... Something goes wrong, and it goes by the boards."

His realistic assessment of health care's progress during the past half-century made his prediction for 2009 all the more remarkable: Wyden believes there is "a real path to 65 to 70 votes" in the Senate for a health bill that gives all Americans access to "good-quality, affordable coverage".

In fact, he added, major health reform could receive a vote in Congress by the summer. So is it really time for progressives to start believing in love again? Or should we heed Rep. Pete Stark (D-CA), another influential lawmaker on health care, when he says health care should wait until next year?

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Sen. Ron Wyden (D-OR) knows how to build health care coalitions. From his seat on the Senate Finance Committee, he has watched the major health debates of the past decade -- from the 1994 Clinton flame-out onwards -- play out from the front row. His Healthy Americans Act helped lay the groundwork for Barack Obama's post-partisan movement on health reform by getting conservatives, progressives, and corporate interests together on a proposal to break the mold of traditional insurance. So he's got a pretty authoritative take on the health care proposals that are headed for inclusion in the stimulus bill.

"If there can be two good wins on health care early," he told me during a sit-down interview in his office today, "on SCHIP and COBRA for the uninsured, it's a bit of a down payment in terms of broader reform. It can build on that -- on Democrats and Republicans finding common ground."

Wyden added that reforming health information technology, allowing all Americans to have an electronic medical record within five years, is also on track to be part of the stimulus, for one simple reason: "It's a job creator."

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Buried in today's New York Times piece on Tom Daschle's confirmation hearing before the Senate health committee is a possible revelation on his plans for passing health care reform this year.

Daschle, tapped by Barack Obama to head the health and human services department, had hinted as far back as June that he would consider using the "reconciliation" process as a way to fast-track broad health reforms. Reconciliation is a procedural tool, presaged in annual congressional budgets, that allows deficit-reducing legislation to be taken up in the Senate with no ability to filibuster and limited ability to amend -- an anti-democratic proposition in theory, but a weapon often used by Republicans during their years in the majority.

Reconciliation could be a boost to Democrats as they anticipate Republican pushback to a new public health insurance option as part of the Obama team's plan. But Daschle told senators yesterday that he would not use reconciliation to secure passage of health care reform, per the Times:

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The Boston Globe reports that the Obama team is being careful to take a very different approach to health care reform than Bill and Hillary Clinton did in 1993 and 1994, mainly avoiding one big mistake: The Clintons' virtual exclusion of Congress from policy deliberation.

Instead, the new White House is going to lay out parameters of what they want done, and then let Congressional leaders do the actual work of writing a bill that is acceptable to the members. A key player in this will be Tom Daschle, who served in the Senate during the failure of the Clintons' bill in 1994, and will now work with his former colleagues in Congress in his new role as Secretary of Health and Human Services.

"Congress did not want to be told what to do," said Sen. Max Baucus (D-MT), who is planning to take a key role in the upcoming health efforts. "They're very cognizant of that and they don't want to make the same mistake."

This is kind of big. Health care advocates hoping that Barack Obama will fast-track health care reform had been waiting for a crucial sign: A public indication from the new Obama administration that they view health care reform as crucial to fixing the economy, a key talking point of reformers.

Today they got that sign.

In the Obama team's first public statements on health care since the election, top Obama health adviser Tom Daschle gave a speech today in which he hit exactly that note, describing health care reform as a "top priority" in rescuing the economy.

"There is no question that the economic health of this country is directly related to our ability to reform our health-care system," Daschle said.

Daschle cited the fact that high health care costs are preventing U.S. businesses from staying competitive and creating jobs. "That's what makes this so urgent and so much a part of the economic recovery process," Daschle said. "I believe that for the first time in American history, health-care reform will be done."

That last line is thrilling advocates and unions who are vowing a major push for reform. In a statement, SEIU hailed Daschle for "confirming the commitment of the new administration" to reform, which the union said was "great news."

To be sure, all the good feelings are easy to have right now, before the gristly business of agreeing on how to pull off reform gets under way. But for now, reform advocates have heard what they were hoping to hear.

"We're absolutely thrilled that Daschle took the opportunity to emphasize how important it is to fix health care in order to fix the economy," Jacki Schechner, a spokesperson for Health Care for America Now, a major umbrella group of reform advocates, unions, and providers, told us.

Here's yet another encouraging piece of news on the health care front.

I'm told that dozens of the heaviest hitters from the health care reform world met for a private retreat in Virginia last week and spent two days girding for a major battle with the insurance industry, hashing out specific messaging, discussing organizing goals and planning a major fundraising drive to blanket the airwaves with ads next year.

At the retreat -- which was organized by Health Care For America Now, the major umbrella group of unions, reform advocates and providers -- the group agreed that they were aiming to start next year with at least $25 million for ads and field organizing, with the hope of raising many millions more.

Notably, the group, which is operating from the assumption that Barack Obama will act fast on reform, honed a message built around what they called "deficit investment." That's a more public relations-friendly term than "deficit spending," and the slogan is meant to encapsulate the case that health care reform is central to rescuing the economy, a primary talking point of health care reformers.

One other interesting tidbit: Attendees talked about the need to counter some of the conciliatory, disarming talk coming from the insurance industry right now, such as its recent declaration that they would support making insurance available to all applicants, in exchange for a mandate.

"We know the insurance industry is toxic," Jacki Schechner, a spokesperson for the group, told me. "We know they're all about their bottom line. We're seeing them for what we are, and we're getting ready to take them on."

The meeting is significant because it shows that the various interest groups vying for reform are far more clear-eyed about the magnitude of the war ahead -- and are organizing and strategizing far earlier -- than such players did in the run-up to the battle over Hillarycare in the early 1990s.

Here's still more great news for those who are hoping that Barack Obama will act quickly and decisively on health care reform: The guy who's widely expected to be Obama's chief budget official says that such reform is central to repairing the economic mess.

Peter Orszag, the apparent front-runner for the post of head of the Office of Management an Budget, is currently the head of the Congressional Budget Office. And he says health care costs are a problem that's directly linked to our economic woes.

"Although it may not seem immediately relevant given our current difficulties," Orszag says in a post on his blog, "it will be crucial to address the nation's looming fiscal gap -- which is driven primarily by rising health care costs -- as the economy eventually recovers from this current downturn."

Read his whole post to get his full argument, but here's why this is key. As Ezra Klein notes, the budget chief is in a key position with regard to health care, because he's one of the president's top advisers and helps set the administration's fiscal priorities. And the guy expected to get the job says that rather than displacing health care reform as a priority, the financial mess puts health care front and center as a problem.

Health care reform advocates have privately indicated to me that one thing they're all watching for very closely is a sign that the Obama administration views things in these terms -- that they see reform as central to fixing the economy over the long term. Now they've got such a sign.

There's still more good news this morning suggesting that health care reform is creeping closer to reality:

The health insurance industry said Wednesday that it would support a health care overhaul requiring insurers to accept all customers, regardless of illness or disability. But in return, the industry said, Congress should require all Americans to have coverage.

The proposals, put forward by the insurers' two main trade associations, have the potential to reshape and advance the debate over universal health insurance just as President-elect Barack Obama prepares to take office.

In separate actions, the two trade groups, America's Health Insurance Plans and the Blue Cross and Blue Shield Association, announced their support for guaranteed coverage for people with pre-existing medical conditions, in conjunction with an enforceable mandate for individual coverage.

As Steve Benen says, this is important news given the industry's role in killing Hillarycare, and suggests more political momentum for reform heading into 2009.

One other interesting dynamic at play that has reform advocates cheery is that a wide variety of the other interest groups that also moved to sink Hillarycare want reform to succeed this time, for a whole bunch of different reasons.

Late Update: More must-reading on the issue from Ezra Klein and Jonathan Cohn.

After an earlier round of hand-wringing about whether President-elect Obama would push off health care reform out of fear of its economic and political costs, some experts and advocates in the field are increasingly optimistic that the incoming president will in fact act decisively and ambitiously to pursue reform in his first year.

These experts point to several very recent rapid-fire developments to justify their hopes, first among them the announcement today that Obama has tapped Tom Daschle as secretary of Health and Human Services.

Richard Kirsch, the national campaign manager for Health Care for America Now, a leading umbrella group of health care advocates, unions and providers, points out that Daschle has repeatedly talked about the imperative of acting fast on health care reform lest Obama's mandate be spent in other areas.

"Daschle has talked for awhile about the need to do this early," Kirsch tells me, recounting that Daschle stressed this in a meeting with him as long as a year ago. Kirsch adds that there are mounting signs that the Obama team "understands that because of the enormity of doing health care, because it's the hardest thing to do, they need their mandate the most for it."

Dem Rep. Pete Stark, a longtime advocate for universal health care, hit a similarly sunny note in a statement today.

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The folks who know what they're talking about when discussing health care say that the choice of Tom Daschle to head Health and Human Services is hugely significant in two ways.

First, it's a sign that Obama will pursue real, meaningful, ambitious reform; and second, it shows that he's determined to avoid the mistakes that doomed Hillarycare in the 1990s.

Here's Ezra Klein:

This is huge news, and the clearest evidence yet that Obama means to pursue comprehensive health reform. You don't tap the former Senate Majority Leader to run your health care bureaucracy. That's not his skill set. You tap him to get your health care plan through Congress. You tap him because he understands the parliamentary tricks and has a deep knowledge of the ideologies and incentives of the relevant players. You tap him because you understand that health care reform runs through the Senate...

Daschle signals that the Obama administration view health care as a political problem. The key to success is votes. And Daschle is a guy whose last job was lining up votes.

And here's Jonathan Cohn:

Daschle has also thought long and hard about the failures of the 1994 reform effort -- and how to avoid them. He was actually the first person I heard mention the possibility of using the budget reconciliation process this time around. (Under reconciliation rules, it takes only 50 votes to pass something, since there are no filibusters.)...

Like Senator Max Baucus, who has also raised this possibility, Daschle was careful to say that reconciliation should be a fallback option -- something to use only if bipartisan progress became impossible because Republicans were reprising their role from 1994 and refusing to compromise. But he also noted that it was an option Democrats had to keep on the table, in order to make cooperation more likely.

Also, you'd think the Daschle pick should quiet all the pundit speculation that Obama won't be able to afford the cost or political capital to act quickly and decisively on reform. Daschle wouldn't have taken the gig if he didn't think it was a major priority for the new administration.

For more on Daschle's views of health care, see interviews with him here and here.

Here's some very good news for those who are hoping that Obama moves quickly and ambitiously on health-care reform:

President-elect Barack Obama's incoming White House chief of staff challenged chief executives and other business leaders Tuesday night to join the new administration in a push for universal health care, saying incremental increases in coverage won't be acceptable.

"When it gets rough out there, a lot of business leaders get out of the car and say, 'We're OK with minor reform.' I'm challenging you today, we're going to have to do big, serious things," Rahm Emanuel said, speaking to The Wall Street Journal's CEO Council, a conference convened to elicit corporate opinion on the challenges facing the new president.

Rahm also promised that the new administration would "throw long and deep" on major issues, health care being only one. While the devil will of course be in the details, the fact that Rahm himself is setting the bar very high for the incoming administration's expected health care reform efforts is welcome.

Late Update: Ben Smith has video of Rahm's speech.

If Hillary doesn't want -- or doesn't get -- the Secretary of State gig, she appears to have another high-profile option open to her that involves a topic with which she has some passing familiarity:

Sen. Hillary Rodham Clinton (D-N.Y), considered a prominent contender to become secretary of State in the Obama administration, was offered an alternative Tuesday -- to be a senior member of the Senate team aiming to overhaul the nation's healthcare system.

Sen. Edward M. Kennedy (D-Mass.), who has announced plans to craft sweeping healthcare legislation next year, asked the former presidential contender to head a working group focused on insurance coverage.

Politico reports that this not precisely what Hillary had hoped for on the health insurance front, but it would be a prominent post nonetheless.

Health care, of course, was the domestic issue where Hillary's differences with Barack Obama were most pronounced. But with questions swirling about how prominent a role Kennedy will play in driving reform on Capitol Hill, given his own health, Hillary seems like a logical back-up figure.

Pundits may be predicting that Barack Obama won't take up health care in his first year, but someone who actually knows what he's talking about on the issue says Obama will push hard to get it done right out of the gate.

Teddy Kennedy just made a visit to Capitol Hill, where MSNBC picked him up live, and Kennedy, whose Health Committee is right in the center of discussions between all the various health care factions, predicted that Obama would act fast.

"Barack has indicated that this would be a prime issue, and I believe that it will be," Kennedy said when asked if he would introduce a universal health care bill. "The president-elect that this is gonna be a priority and I certainly hope it will...I think we've got a good start on it."

Asked if he would like to see Obama sign a bill in his first year, Kennedy answered: "Well, yes. He's stated that."

One lingering question has been how prominent and forceful a role in driving health care reform Kennedy will play, given his illness, and whether other major figures in Congress would emerge as public faces on the issue. Health care experts say Max Baucus' decision to release a health care plan has upped the pressure on Kennedy's operation to produce high-profile results.

Late Update: Here's video...

Here's an interesting tidbit from the health care wars: Health care advocates are bolstering their case for the political viability of health care reform by aggressively showcasing newly-elected House Dems who say their victories turned largely on health care as a campaign issue.

One of the most potent of health care lobbying organizations -- Health Care for America Now, a coalition of pro-reform advocates and influential unions -- rolled out four incoming members of Congress to make just that case in a conference call with reporters today.

"Health care was a huge issue in my race," Member-elect Debbie Halvorson of Illinois said on the call. She added that the political viability of health care reform was such that "I think this will be the year we get it done."

"On the local level, voters spoke loudly and clearly when they elected candidates who are committed to delivering quality, affordable health care for all," added Richard Kirsch, Health Care for America Now's national campaign manager.

I don't know what kind of traction this particular call will get, if any, but I wanted to flag this emerging argument. One big question is whether the Obama team will conclude it might require too much political muscle to get started on health care reform right away, as some pundits are predicting. The idea that health care reform is a political net plus, and the 2008 election proves it, is the emerging talking point in response.

Correction: Our source is now telling us that he thinks he misrepresented what happened in the meeting when he spoke to us. He conferred with several others who were in the meeting and says he's now convinced that the idea that was floated wasn't wrapping health care reform into a stimulus package; rather, he says, the conversation touched on the benefits of discussing health care reform as an economic stimulus. So the Kennedy staffers, he says, didn't signal interest in including health care in a stimulus package, as he originally thought. He -- and we -- regret the error.

This is interesting: I'm told that Dem Senate staffers involved in planning health care reform are starting to mull an interesting solution: Paying for reform as part of the big economic stimulus package that the lame-duck Congress is debating.

In a private meeting this afternoon between staffers on Ted Kennedy's Health Committee and major health care reform advocates, the idea was brought up and taken seriously by the staffers, according to a person who was present.

The discussions are preliminary and the details are murky. But the fact that this idea is now bubbling up on the Senate staff level is significant, because it's one that has mostly been confined to academic circles and is only just starting to nudge out into the public eye. It's an idea that would likely command strong support from advocates.

The focus of the meeting was not this topic -- it was convened so advocates could push the Kennedy operation to hew to the principles of Obama's plan as it mulls health care solutions -- but the staffers took the idea very seriously, the participant says.

The staffers even suggested that the advocates -- a who's who of influentials from the labor and lobbying community -- go out and try to sell the idea preliminarily to the public.

"The Kennedy staff really liked the idea," the participant says. "They said, `Go out and make that popular.'"

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It's common enough for interest groups to wring their hands about an incoming president's priorities. But this is an important story.

There seems to be genuine worry among some health care advocates and opinion leaders that Barack Obama won't move swiftly enough on health care reform, potentially squandering a chance to use his mandate in service of this long-sought goal.

Health care reform advocates are saying that they worry Obama's enthusiasm for health care reform may wane as he confronts other looming challenges. Some senior Dems in Congress are predicting the same, as are some opinion makers.

"If you`re looking for a bold move early on on an issue like health care and immigration, I`ll say no," Chicago reporter Lynn Sweet said the other day on Hardball.

That has prompted no shortage of worry that Obama could duplicate the missteps of Bill Clinton, who failed to act on health care for too long, with disastrous results.

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The American Federation of State, County and Municipal Employees keeps up the economic assault in the swing states, blitzing a dozen battlegrounds with two new hard-hitting mailers tying McCain to George W. Bush on the economy and lambasting McCain's health care plan.

An AFSCME official sends over the mailers, the first of which hammers McCain for his "fundamentals" gaffe and claims that Bush-McCain policies are "killing the middle class" (click on the images to enlarge)...

"You have a right to know about John McCain's economic record," the mailer reads, reflecting internal union polling that shows low-information swing-state voters lack a strong sense of McCain's ideology and proposals on the economy.

Meanwhile, a second mailer hits McCain's proposal to tax health care benefits, the central target of efforts to paint McCain as the risky and even frightening choice on this crucial pocketbook issue. Also note the word "Republican" in big and garish green letters...

The Obama campaign is opening up a major new offensive against McCain on health care that includes a forceful speech today denouncing McCain's plan as "radical," as well as a blitz of ads like this new one:

The ad hammers McCain's proposed tax of health benefits as a "trillion dollar tax" and the "largest middle class tax hike ever," an effort to turn McCain's frequent claim that Obama would hike middle class taxes on its head.

With the push on health care, which has been gearing up for some time now, the Obama team is homing in on a specific pocketbook issue in order to paint McCain as the risky, uncertain, and even frightening choice at a time when public fears are fixed squarely on the economy. Many Dems think that Obama's strongest suit amid all the generalized anxiety is to close out the race with as much specificity as possible as to how precisely he will improve people's lives, and why McCain would make them worse off.

This is starting to get more and more attention today: In an interview with the Dallas Morning News, a health care policy adviser to John McCain appeared to suggest that anyone with access to an emergency room effectively has health insurance.

The adviser, John Goodman, who is not paid by the McCain campaign but is widely quoted as one of the campaign's advisers and an author of McCain's health care policy, offered the following solution to the health care crisis to the paper:

"So I have a solution. And it will cost not one thin dime," Mr. Goodman said. "The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American -- even illegal aliens -- as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.

"So, there you have it. Voila! Problem solved."

The problem with this analysis, according to an expert quoted in the article, is that people without insurance are less likely to seek non-emergency-room care, which ultimately drives up the cost to the health care system.

In the interview, Goodman elaborated by suggesting that the truly uninsured are those who are denied care.

"So instead of producing worthless statistics that people fling around in vacuous editorials and pointless debates, the Census Bureau should produce meaningful numbers, identifying all of the sources of funds people will draw on if they need medical care," Goodman concluded.

More on this in a bit.

Late Update: The McCain campaign is now saying that Goodman is not an adviser. Oddly enough, there were multiple press reports in the past few months identifying him this way that have yet to be corrected.

Late Late Update: Here's a statement from the McCain campaign saying that this guy was an adviser, but no longer...

Mr. Goodman volunteered his advice to the campaign in the past. However, his philosophy on health care -- and especially on the urgency of the problems faced by 45 million uninsured Americans -- are clearly out of step with John McCain. Earlier this summer the campaign informed Mr. Goodman that his advice was not required and requested that he not identify himself as being associated with the campaign in any way, including as a volunteer. John McCain could not disagree more strongly with Mr. Goodman. John McCain believes that addressing the problem of the nation's uninsured is one of our most pressing national priorities. That's why the McCain plan will, for the first time, bring health coverage within the reach of every American.

Here's an advance look at the new ad that Health Care for America Now -- the consortium of progressives, unions, and think tanks that's planning a $40 million ad campaign to call for universal health care -- is planning to unveil today at a noon press conference...

The group, which is being promoted by Elizabeth Edwards, is planning a hugely ambitious campaign that includes more ads like the above, organizers in 52 cities, Op eds in big broadsheets, and even an organizer placed in the districts of every Blue Dog Dem who might be resistant to supporting universal health care. The initial ad buy is $1.5 million.

HuffPo's Sam Stein has a good rundown of the group's plans.

With Hillary under tremendous pressure to draw a sharp contrast with Obama in Wisconsin, where he's leading in the polls in the crucial contest, Hillary has hit the radio waves in the state with a new ad emphasizing that only she has a plan for universal health care.

"With John Edwards out of the campaign, Hillary is now the only candidate for president — Democrat or Republican — who supports universal healthcare," says Congresswoman Tammy Baldwin, who represents the liberal stronghold of Madison. "With Hillary this isn't just talk. This is about solutions."

Note that the campaign seems to have re-edited their "solutions business" catch-phrase, something the campaign had been pushing earlier this week, and are now simply saying that Hillary is the candidate of "solutions," as opposed to "just talk" from Obama.

An mp3 of the ad is available here.

(Via WisPolitics)