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It Takes Time To Build A Health Care System

Via Mike Allen at Politico, I see that President Obama answered some questions about his plans for health care reform after yesterday's speech to the Business Roundtable.

Not everything is going to be implemented now. … I think there's some people, when we issued the budget they said, "Boy, these Obama people, they're really ambitious--they're taking on health care, they're taking on energy, they're taking on education--don't they know that there's this bank crisis right now, we've got to do one thing at a time." Look, the budget document that we put forward is a 10-year document. … If we don't do the long-term planning, then we end up having more short-term issues again and again and again and again.

So we don't anticipate that every piece of health care is done this year. We think that we've got to get the process and get in place a structure and a framework and a funding approach and work out a lot of these details. But it's going to be implemented over time. We're not going to have instant health IT all next year.  The same is true on the energy front.  Under the cap proposal that we have it wouldn't even start until 2012, where we're going to be out of this recession--or you'll have somebody else speaking to you in 2013.

Just to be clear, this isn't a retreat or change from his Obama's previous stance. He wants to enact legislation in the next year, but, as he suggests in the quote, it will take several years to build the infrastructure for a new health care systems. There are regulations to be crafted, institutions and programs to be established, etc. In addition, one way to hold down the cost of the plan is to ramp up the funding--for the subsidies to people buying insruance and the financing of public insurance programs--over a period of years.

So it will be a few years before any universal health care system is up and running. The key, as Obama says, is putting foundation in place today: Pass the legislation, set aside the funds, and create whatever new institutions are necessary to build the system fully and then run it.

--Jonathan Cohn