This week will mark the one-year anniversary of the Obama Administration’s start to reform America’s health care system, and while Democrats are urging a resolution, Republican continue to see a long road ahead.

In his weekly address, President Barack Obama said in light of last week’s White House Health Summit, there are still disagreements between the two parties, but that “no final bill will include everything that everyone wants.

“That’s what compromise is,” Obama said. “The tens of millions of men and women who cannot afford their health insurance cannot wait another generation for us to act. Small businesses cannot wait. Americans with pre-existing conditions cannot wait. State and federal budgets cannot sustain these rising costs.”

The president added, “It is time for us to come together. It is time for us to act…So let’s get this done.”

That sense of urgency was echoed House Speaker Nancy Pelosi, appearing on ABC’s “This Week” Feb. 28, who said the time to move forward is now as Americans are struggling with the economy and providing health care coverage for themselves and their children. She pointed out that it was March 5, 2009, when the Obama Administration started gathering input on reform measures.

“Time’s up, yes,” Pelosi said. “If your family has a pre-existing condition or if you are denied coverage or if you have a rescission, if your insurance has been withdrawn just as you’re about to need a procedure, you know that it’s long overdue. And what’s the point of talking about it any longer?”

Pelosi said that following last week’s summit, “We’re ready for the next step, which is to write legislative language, and then go from there.”

Reconciliation is ‘political kamikaze’

But not everyone is ready for that next step, or is clear on what that step would be.

Lamar Alexander

Appearing on the same program, Sen. Lamar Alexander (R-Tenn.), who gave his party’s opening statement at the summit, called Obama’s plan “not a good bill.” He added, “If he’ll put his bill aside and renounce jamming the bill through, we can go to work on this the way we normally do in the United States Senate, which is in a bipartisan way.”

Alexander, like others in his party, are staunch opponents to passing health reform through the budget reconciliation process, requiring only 51 votes in the U.S. Senate to pass some reform measures, rather than 60 votes to pass a health reform bill as is. Using that approach Democrats could pass the bill without any Republican votes.

Alexander said while the process has been used in the past, it has never been used for “anything of this size and magnitude and complexity.

“It would really be the end of the United States Senate as a protector of minority rights, as a place where you have to get consensus, instead of just a partisan majority, and it would be a political kamikaze mission for the Democratic Party if they jam this through after the American people have been saying, look, we’re trying to tell you in every way we know how, in elections, in surveys, in town hall meetings, we don’t want this bill,” he said.

Alexander found agreement on the reconciliation process from a Democrat, Sen. Kent Conrad of North Dakota, who chairs the Senate Budget Committee. On CBS’ “Face the Nation,” Conrad had his doubts about how health reform could become a reality in this way.

“I think I understand how reconciliation works and how it can’t work,” he said. “The major package of health care reform cannot move through the reconciliation process. It will not work.”

Time to begin again

What will work, according to several Republicans, is starting over with health care reform after nearly a year of discussions.

Appearing on “Face the Nation,” Sen. Tom Coburn (R-Okla.) said the current stalemate could be broken one way: starting over from scratch.

“I think it could change if we start it over and we actually worked and treated the disease that is plaguing American health care,” he said. “The disease is cost. And until we put in the incentives to change the dynamics – the market dynamics, the fraud dynamics, the defensive medicine, that’s $250 billion a year in defensive medicine costs. What we need is not more government; we need more market-oriented, patient-centered health care rather than government-centered health care.”

His sentiments were echoed by Rep. Marsha Blackburn (R-Tenn.), who said it is time “to look at starting again and addressing what the American people want to address.

“They want to make certain that we take a focus on cost containment and do some work there, that we look at across-state-line purchasing, look at what you could pull out of the cost of health care if you address medical liability reform,” she said. “What they [Democrats] want to do is let…the federal government have the overshadow of all of this and make the decisions of what the states can do. What we’re saying is we don’t need more government in health care, we need to free people up and let them get outside of this and make decisions.”