PRESIDENT-ELECT Barack Obama has demonstrated that reform of America's health-care system is one area of change that his administration will attack promptly.
Three factors argued against it, but we're glad Mr. Obama seems intent on working past them.
The first is that the health-care field is a rat's nest of entrenched, entitled interests, making money from the way things are, stoutly resisting changes that might cut into this profitable arrangement.
The second is the disastrous experience of the previous Democratic president, Bill Clinton. Mr. Clinton threw what he thought was his first team - his wife, Hillary Clinton - into health-care reform early in his first term. Both emerged from the effort bloodied and unsuccessful. Some fault the way the Clintons went at it. Others recognize that America's health care is controlled by an interlocking set of American institutions - hospitals, doctors, insurers - that like things the way they are. See their breathtaking profits and expanding piece of the American economy as evidence of this fact.
The third is that, obviously, Mr. Obama will have other pressing priorities when he (finally) takes office on Jan. 20. The state of the economy is first. Second will be getting his nominees confirmed by a Senate stiffed for years by President Bush and now ready to assert its prerogatives in considering Mr. Obama's nominees. Third will be foreign policy issues, starting with Iraq and Afghanistan.
In that context, to take on health-care reform will require courage and confidence. Mr. Obama nonetheless has signaled his intention to tackle it. He has nominated Tom Daschle as his secretary of Health and Human Services and head of the new White House Office of Health Reform. Mr. Daschle is the former senator from South Dakota who was majority leader and, more recently, a close adviser to Mr. Obama during the campaign. Most important of all, he knows the Congress very well from 26 years in the House and the Senate.
His only problem is one he will encounter in the Senate confirmation process. For years, his wife has been a prominent and powerful Washington lobbyist. Mr. Obama had promised the American public a respite from such entanglements, and Mr. Daschle should be asked for assurance that his wife will not profit from his role in Mr. Obama's reform effort.
There is no question but that American health care needs work badly - to increase access, to improve its quality and to see that it doesn't impoverish its consumers. Hats off to Mr. Obama for his willingness to pick up that bristling porcupine.