Today, Blumenthal works to improve the health of his patients, and more globally, the health care of the nation, through teaching, treating patients and performing research. The government called him to serve as part of the informal group, he says, as an interested observer in the process.

"I'm chief of the unit here that does health policy and I have some involvement with a group that's been reacting to, or trying to reach to the Clinton health care plan," he says. "That's a completely unofficial role, for which I'm not compensated. It involves a lot of trips to Washington and a lot of briefings and we're at the point right now of making our report to the task force on what our views were."

Blumenthal's views on why there is so much pressure now for the government for reform tend to back the theory that while Americans may be able to overlook certain issues, solutions pique the public's interest only when its wallets and purses are threatened.

"I think that society now is probably most concerned about cost containment, which is the most important political emphasis, and impetus behind health care reform," says Blumenthal. "I don't think Clinton would not be nearly as interested in health care reform if health care were not 14 percent of the GNP, or if the Medicare or Medicaid budget weren't going through the roof."

Blumenthal cities Clinton's language and the context in which most discussion of the issue arises.

"If you listen to how he talks about health care, if your listen to his State of the Union, you can say where health care first came up was in talking about the budget, and controlling the deficit," says Blumenthal.

But Clinton's reason for using this kind of language, says Blumenthal, is the fact that this constitutes the majority of concerns nationwide on the issue.

"I think in that, he reflects the views of most businesses and probably most people who are insured, whose concern is not that they can't get insurance, but they can't afford it once they have it," he says. "I don't think they are nearly as concerned about other people's access or about deficits in quality."

But he praises the new administration's energy.

"The improvement of health care quality is a very fertile field now," Blumenthal says. "There's a lot of good experimentation and good research going on, and a lot of innovation."

As an insider, can Blumenthal pick the odds on Congress passing the commission's plan?

"I'd give it slightly better than 50-50 in this Congress," he says, "and 80-20 before the next presidential election."