When Bill Frist was Senate Majority Leader, he did not advance the cause of comprehensive, bipartisan health reform and will be remembered for his role in the Schiavo case (although he did take heat for working with Democrats to expand federally-funded stem cell research). Mostly he pushed for malpractice reform (in a very partisan model) and for small business purchasing pools (also from a GOP perspective).  If there were compromises to be had under his watch, he didn't have them.

Better late than never.

We've watched Frist over the past few months. As we've noted, he has backed a fairly expansive approach to prevention and population health, and recently endorsed the individual mandate (which was a centrist Republican idea before it became a Democratic idea). Now he tells Karen Tumulty of TIME that he'd vote for the Democratic health care reform bill in Congress -- even if there's a lot in it he isn't crazy about. (He later told ABC News Radio that he doesn't like the Baucus bill as currently drafted, according to the Politico.) 

"I would end up voting for it," he told TIME. "As leader, I would take heat for it. ... That's what leadership is all about."

Some of what he criticized in the health reform proposals in the Democratic Congress isn't the usual party line stuff either -- he wants the bill to do both more to "bend the curve" and fundamentally realign incentives for doctors and hospitals. He also worries that the final version of the bill might only cover an additional 20 million Americans, falling short of the goal of universal coverage.

He also brings up a good point -- something we've begun talking about among ourselves but haven't written about much yet. Implementation is hard. And Republicans will have three to four more years to continue attacking the hard parts before people begin to reap the benefits. Karen writes:

The first few years are likely to be rough, he predicts. States will be struggling to set up new marketplaces for insurance coverage, their Medicaid rolls will grow, taxes will go up, and consumers will not yet see the benefits. "The Republicans will go wild," using the start-up difficulties as a tool for fundraising and for making their case in the next election, Frist says. "In the Congress, nobody's thinking about that." His advice for the Obama Administration: "Stay nimble," and be prepared to make adjustments as difficulties arise.

Frist might be more nimble as a transplant-surgeon-turned-policy-wonk than he was as a politician, but it doesn't hurt to have a prominent Republican physician/politician on the side of reform (does Senator Snowe read blogs?) particularly as the political debate gets ever more strident.