Is health care reform on the horizon? I posed this question last month to Business Week Editor-in-Chief Stephen Adler in the context of business cost pressures and growing unemployment. Here’s how I live tweeted his answer at the time:

On health care, Adler wonders whether Obama can take this on, or move incrementally instead to make small improvements.

 

I didn’t agree with his assessment then, but I understood the reasoning. After all, the health care industry is big business, and those who’ve made a lot of money on the current system aren’t going to go gently into a brave new world. In the last month, however, I’ve become increasingly convinced that we might be seeing the perfect storm for wholesale reform.

1. Big business wants reform now. Health care costs are killing big companies, and they’re pushing for lower prices, better quality, and cost transparency. (Small businesses, in many cases, have already been priced out of providing health care benefits, forcing their employees into the ranks of the self-insured and uninsured in America.) Wal Mart’s $4 prescription program isn’t just smart marketing, it’s smart business.

2. As more people lose their jobs, the numbers of uninsured people will grow. This means new strains on already-strained state and local public health systems, and more people walking around unable to access the preventive care that offers an early warning system and saves big bucks down the road.

3. The uninsured won’t be among the ranks of the disenfranchised this time. The current economic displacement is hitting all regions of the country and all income levels.

A lot of people have been looking at different elements of the health care system and how to lower costs while driving better outcomes for patients. And more are putting their stakes down every day. The Institute of Medicine just yesterday released a list of 20 key indicators of the nation’s health and health care. Business Week has a fascinating piece in the current issue that explores the question: Why can’t health care be run like the retail sector?

The Bush administration committed $700 billion to bail out Wall Street, and the Obama team will likely request at least this much for its economic stimulus package. This means that for the first time in a long time we’ll be testing new ideas on a massive scale and finding out what works and what doesn’t. How can health care reform not be part of the mix?

I’ve lived and worked in Washington long enough to know that there are no perfect solutions. But we’ve got to try something new.