Despite all the scary, silly talk of “socialism” in the presidential campaign, President-elect Barack Obama and his Democratic Congress will not move to nationalize the health insurance industry after he is sworn into office on Jan. 20. However, he is likely to launch the most serious effort to reform the way health care is insured in this country since First Lady Hillary Clinton's ill-fated drive under her husband's administration.

Back then, the Clinton initiative was undermined by an industry-funded ad blitz featuring the fictional “Harry and Louise,” expressing alarm over how the government was going to tell them which doctors they could and couldn't see.

The mood toward health care reform is quite different these days–not surprising, since 47 million don't have any coverage. Indeed, the Harry and Louise characters were miraculously reborn as reform advocates in an ad campaign launched by a consortium of groups, including the National Federation of Independent Business and the American Hospital Association.

We have a pretty good idea what President-elect Obama wants to do. He promised to establish a National Health Insurance Exchange offering “a range of private insurance options,” including “a new public plan based on benefits available to members of Congress.”

If he has his way, he also would prevent insurers from rejecting applicants due to preexisting conditions, provide a tax credit for small businesses that buy coverage for employees, and subsidize individuals who cannot afford the prevailing premiums.

Under his plan, parents would have to provide coverage for their children, but no adult would be mandated to buy insurance.

The big question, however, is how the president-elect will finance his ambitious health care initiative. He spoke vaguely during the campaign about doing away with paperwork to save billions, as well as levying a tax surcharge (Sen. John McCain called it a “fine”) against large employers that don't offer insurance.

Even in a strong economy, the funding challenge would be formidable. But with the country mired in a financial crisis and a deepening recession, the White House will have an even tougher time tackling an expensive issue like health care reform.

However, I doubt President-elect Obama will allow himself to be merely a crisis manager, if not reduced to a caretaker role, spending all his time cleaning up the mess left behind by his predecessor. He was elected on a platform of change, and he will be expected to deliver on some bold initiatives. It doesn't get any bolder than health care reform.

In addition, rather than be deterred by the ominous fiscal hurdles looming before us, he is likely to argue that if the U.S. government can cough up $700 billion overnight to bail out elite financial institutions, Congress can certainly find enough cash to make sure everyone at least has access to affordable health insurance.

I also have a feeling that a well-disciplined Obama administration will avoid the mistakes made by Hillary Clinton, whose efforts were derailed by micromanagement, policymaking secrecy and a failure to involve key members of Congress. Having come out of the Senate, the president-elect is likely to work hand-in-hand with lawmakers to generate wide support for his bill.

Why should this be of any interest to property-casualty readers? Well, with employee benefits generating a growing percentage of agency revenue, especially in a soft p-c market, our agent audience has a lot riding on the outcome of this debate.

It certainly would boost agency bottom lines if small-businesses and individuals could afford to buy health insurance coverage from them.

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Will Obama Pull Off Health Reform?

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