I’ve been writing about politics and public policy since 1985 and the current health care reform sequence is the most complicated issue of my career. So what I’m attempting to do with this column is to work through the many elements that have brought us to the point where the U.S. House has passed a plan and the action now shifts to the U.S. Senate.

My own personal experiences as a father, husband and small business owner drew me to the conclusion some eight years ago that the current health care system is broken. As I’ve written before, I have a preexisting medical condition and found myself virtually uninsurable as a sole proprietor. A COBRA plan I was on cost my business close to $50,000 over a three-year period. My greatest fear is that a catastrophic illness in my family could bankrupt us.

I have many friends and family in health-related industry. I am watching a good friend battling a rare and serious form of brain cancer (glioblastoma) and have a front row seat to this personal crisis. His significant other is a nurse in the VA system. One good friend is a retired insurer. Another runs a Fort Wayne nursing home; his wife works in hospice care. One is an emergency room nurse in Martinsville. His wife works for a medical device maker. Another is a radiologist. My brother-in-law works for St. Vincent. I have talked extensively with my family physician and my dermatologist. At least half of these people are Republicans or lean that way. All agree: The system is broken.

Shortly after I began writing my political column, I watched President Reagan and Health and Human Services Secretary Doc Bowen achieve limited health reforms that were quickly undone by the special interests during the first Bush presidency. I watched the Clintons try and fail to overhaul the system.

Then came Barack Obama. I covered close to 20 of the 49 campaign events he had in Indiana and two as president. At every one, Obama described the need to reform health care. This may be the best chance in my lifetime to create a 21st Century health care system. This is the hand we’ve been dealt and it comes in the most extraordinary set of circumstances — Wall Street meltdown, auto collapse, energy crisis and the Great Recession of 2009 — that took shape over the previous eight to 16 years during the Clinton and second Bush presidencies.

Certainly, the bill that passed the House last Saturday night is deeply flawed. I fear that Senate Majority Leader Harry Reid made a bad choice to embrace the “public option” that may very well be politically untenable.

I thought U.S. Rep. Joe Donnelly summed it up appropriately in South Bend on Tuesday: The United States is a rich country and yet so many go without affordable health care. “That is not what this country should be about,” he said. “Health care is a basic human right.”

I also listened to Gov. Mitch Daniels on C-SPAN last Sunday, calling the House plan “ruinously expensive.” Asked for his solution, Daniels explained, “You would give the tax break … instead of corporations and institutions, you would give it directly to the American people and then free up competition for them to shop and buy for themselves and control it themselves.”

Asked about covering the uninsured, Daniels said, “In our state government, half the employees have consumerized health care. It’s a personal account that they manage and if they should run through it, they would be covered beyond that. They have complete peace of mind.

“I really hope national policy would head in this direction instead of further down the trail of the problems that brought this to pass in America. We have a health care system that pays doctors and providers not how well they do, just how much they do. We make people feel health care is free at the first dollar, so we tend to over consume. We put a lot of defensive medicine in the system with a real ridiculous malpractice system.”

All good points. After listening to Daniels it just fuels the other perspective I’ve come to: The congressional Republicans ducked this historic opportunity. The status quo shouldn’t be an option at this point in history.

What should the Senate do? I hope they address preexisting conditions, cap catastrophic expenses for families, allow insurers to cross state lines, and institute cost-saving mechanisms, protocols and outcomes that have proven successful at the Mayo Clinic and in the Hawaiian care system. Medical malpractice costs should be addressed. I liked Sen. Olympia Snowe’s idea of a “trigger” for a public option if insurance reforms don’t occur.

Brian Howey publishes at www.howeypolitics.com