Rebecca Adams has a nice piece in CQ Politics on how we get from the "Happy Talk" stage of health reform to action. She explains what the various interest groups are doing, how they've changed since 1993-94, and what attempts are being made early in the game to craft compromises, thrash out problems and avoid misunderstandings. So far, there's still a lot of disagreement about issues like mandates or a public plan to compete with private insurance plans.

This time, many of the erstwhile opponents of national health care plans, such as insurers and employer groups, say they're open to a health care overhaul—and are jockeying to gain a foothold in early negotiations over health care legislation, which President-elect Obama already has flagged as a major domestic policy priority. Industry lobbyists are meeting weekly with officials from groups that supported prior reform efforts and Capitol Hill staff to work through their many differences and thrash out workable compromises.

But industry players know that no end of potential conflicts lie in wait. "We're in the happy-talk phase of health care reform," said G. William Hoagland, who served as an aide under former Senate Majority Leader Bill Frist, R-Tenn., and who now works as vice president for public policy at the health insurer Cigna. "We're all in agreement that everyone should have insurance, that we should control costs, that the quality of health care should be improved. After you get that out of the way and get into specifics, then that's when things get bogged down."

But the fact that so many people are talking and reaching out is encouraging. It didn't happen in the 1990s, at least not enough and not in time.