Behind closed doors all over Washington, serious people are working hard to design a major overhaul of the U.S. health care system. We should wish them well, but their chances of success are slim. Since yet another complete failure would be catastrophic, some attention should be given now to policies that are politically palatable, and would begin the evolution to a new and better health system.
Three measures will start this process. Two—improved health information technology, and investment in research that would study the comparative effectiveness of various forms of health care—have already been put in motion. The third—a national health insurance exchange—has a bipartisan heritage and can appeal to both liberals and conservatives.