(Written by Bob Rosenblatt, who covered the reform debates for the Los Angeles Times.)

No matter who wins the White House and control of Congress in November, health reform legislation will likely be a front-burner issue for both the House and Senate in 2009. The debates about reform and the behind-the-scenes meetings of 1993 and 1994 produced a wealth of knowledge on what should be done differently the next time Congress and the White House take up this issue.

A new Alliance issue brief, funded by the Robert Wood Johnson Foundation, recounts nine lessons learned as recalled by veterans from both sides of the aisle and from the administration. To download, click here or go to http://www.allhealth.org/publications/Uninsured/Health_Reform_Debate_of_1993-94_81.pdf

The lessons:

1. Strike while the iron is hot -- in the first year after an election. That's when attention is focused on the message voters were sending, and before lawmakers have to worry about the next election.
2. Go for the easiest procedural path. Putting your ideas into a budget reconciliation bill means avoiding the chance of a Senate filibuster.
3. Involve Congress from the very beginning. If you expect legislators to vote for your bill, they need to be involved in shaping it.
4. Raising taxes is tough, but NOT raising taxes can also carry a price. The administration's health plan of 1993-94 was more than a thousand pages long in an attempt to redirect existing dollars rather than raise taxes.
5. Don't try to put everything into one bill. The Massachusetts health reform experience proves that you can leave some details for later.
6. Be willing to deal. Health reform could possibly have passed in 1994 if proponents had been more willing to compromise.
7. Expect pushback. Major health reform means change, and many people resist change, especially if their own income stream is threatened.
8. If you're from Venus, listen to the people from Mars. Meaningful health reform is not just about covering the uninsured, nor it it just about reining in costs. It's about both.
9. It won't happen if it's not a priority. For major reform to have a chance, many leaders must put it near the top -- or at the top -- of their priority list.

These lessons come from two Alliance briefings on the topic in December 2007 and January 2008, also funded by the Robert Wood Johnson Foundation. To download webcasts, transcripts, podcasts and resource materials from those briefings, go to www.allhealth.org/briefing_detail.asp?bi=118 and www.allhealth.org/briefing_detail.asp?bi=119