Health care: The 80% Solution

    Rep. John Dingell, who's been pushing health-care reform for over 50 years, says that Democrats need Republican help to complete the effort.

    By Jia-Lynn Yang

    During his speech to Congress this week, President Obama singled out Rep. John Dingell (D-Mich.) for continuing the work of his late father, also a congressman, to overhaul the health care system.

    The younger Dingell was only 16 when his father introduced the first national health insurance bill in 1943. Dingell, Jr. succeeded his father in 1955 and has continued introducing the same bill at the beginning of each Congressional session. The 83-year-old Democrat from Dearborn, Mich., is now the longest serving member of the House.

    He spoke to Fortune about Obama's speech and what shape health reform may ultimately take more than six decades after his father's initial effort.

    What did you think of President Obama's speech?

    I think he did an absolutely superb job. It was clear and easily understandable, complete, and delivered most eloquently. It will have a tremendous impact on the country.

    How did you feel hearing your father mentioned?

    I'm very proud he mentioned my dad. Dad worked on this a long time. The story behind it is, Dad was one of the philosophers behind the New Deal. I used to hear "social justice" a lot when I was a kid. And that was a [phrase] that really meant something to people and it's kind of sad you don't hear it now.

    Dad got his interest in health care when he was fired for union activity in 1914. He was a son of immigrants who was sent off to Colorado to die of tuberculosis. He's all alone, and he doesn't have any health insurance except for what the union gives him. So he became a real convert to address that problem for people, because he saw people every spring dying of diphtheria, meningitis, mumps, measles, pneumonia.

    Like your father you've been a big supporter of single-payer insurance. What do you think of health care reform that doesn't follow the single-payer model?

    I'm a peculiar fellow. I like to make progress. If I had my druthers I'd write a single payer bill like the British or the French or the Germans or the Japanese. These are not all pure single payers, but those countries not only pay less for health, they cover everybody.

    We're going broke on health care, we're spending about twice what every other country does, and we're not getting the results that frankly our people need, want, and deserve. So something has to be done. If we can get a decent package that addresses those problems, and can include in that a decent program that will give a public option, I think I'd be happy.

    So you support the public option?

    People say, why do you need the public option? The insurance regulators are not able to regulate insurance companies except regarding their solvency. But they can't do anything else, and the only way you can do this right is to give [insurance companies] competition. That's why we need the public option.

    How much do the Democrats need Republicans on board to pass this bill?

    I think the country needs the Republicans on board. I've always believed the best legislation is passed in the middle. With something like health care, we'd benefit by having the two parties working together.

    As you observed, the President held out his hand to the Republicans [Wednesday] night, and this is one of the great pieces of legislation of this century, certainly this decade. Having said that, if the Republicans don't join us in a program of health care reform, unfortunately we'll have to do it without them.

    How close is Congress to agreement?

    If you listened to the president [Wednesday] night, we're about 80% agreed on what's going in the bill. The problem that you run into here is, is that 80% going to give you a workable bill, or do you need something outside of 80% to get a workable bill?

    My view is it takes more to make a program of national health insurance for all our people. Someone once asked the head of Macy's (M, Fortune 500), how do you do on advertising? How much advertising is good, and how much is wasted? He said, we waste about half. The other guys said, well, why don't you cut it in half, and he said, I can't figure out which half to cut.

    That's sort of where we are. We don't know what we get with 80%. We don't know which 80% is going to cover everything we need to make this thing work.