One thing everyone can agree on: there is no perfect health care reform legislation. Every idea has flaws. Every proposal presents problems. This is the reality, but it should not be an excuse for doing nothing. Because the status quo is flawed and problematic, too. And the longer it takes to address the fundamental problems of the current system, the worse the cure will be.

This is a point President Barack Obama made in his press conference on July 22nd. Calling the status quo a “back-breaking alternative plan” he positioned the situation accurately. What’s being debated in Washington is not just the risks and benefits of change, but the cost of doing nothing.

Steven Pearlstein made the same point in his Washington Post business column. “Among the range of options for health-care reform, there’s one that is sure to raise your taxes, increase your out-of-pocket medical expenses, swell the federal deficit, leave more Americans without insurance and guarantee that wages will remain stagnant,” he writes. “That’s the option of doing nothing ….”

It is becoming increasingly difficult to argue for the status quo, yet that’s what the “no reform” advocates are doing. They ignore the financial reality that, unless changes are made, the current system will increase government deficits and shackle business expansion. Eventually changes will be made. The longer the tough decisions concerning what changes to make are put off, the more onerous the eventual changes are likely to be – single payer anyone?

This is not to say that proposals currently on the table are better than the current system. Some would definitely make matters worse. What it argues for is giving those seeking comprehensive and responsible reform to do their work. As Mr. Pearlstein points out, the broad outlines of reform are swirling around Washington: shifting reimbursement from fee-for-service to quality, requiring carriers to sell and consumers to buy coverage, preventive care, and accelerating the adoption of medical technology. I’d add to the list the likelihood that calls for a public plan will morph into acceptance of health insurance co-operatives, owned by its members. This is the direction in which I hope the health care reform debate will move. But what matters is keeping it moving.

Because the status quo is an alternative that may be reassuring to some now, but is likely to result in far worse reforms i the future.