The big decisions on health care reform are happening right now. Congress is "mixing the concrete" of the health care reform bill, as the economist Robert Reich puts it on his blog, "And after it's poured and hardens, universal health care will be with us for years to come in whatever form it now takes."

But who's doing the mixing? Robert Reich, who served as Secretary of Labor in the Clinton administration, tells Bill Moyers on the JOURNAL that the fight to shape health care reform is the biggest test to date for President Obama. Powerful lobbies have lined up to oppose what is being called "the public option," a key element of the president's plan.

The public option, according to Reich, is a government-run non-profit insurance pool, that, by virtue of its size and bargaining power, could control costs and offer people who are either uncovered by, or unhappy with private insurers an affordable alternative path to health care. Medicare is an example of a public option, notes Reich, with one important caveat — the Medicare drug benefit bill passed during the Bush administration expressly forbids Medicare from using its size to negotiate for lower costs, an important key to keeping prices down.

>Explore the plans being considered by Congress (Kaiser Family Foundation)

In 2003, Reich was awarded the prestigious Vaclav Havel Foundation Prize, by the former Czech president, for his pioneering work in economic and social thought. In 2005, his play, PUBLIC EXPOSURE, broke box office records at its world premiere on Cape Cod.

As the nation's 22nd Secretary of Labor, Reich implemented the Family and Medical Leave Act, led a national fight against sweatshops in the U.S. and illegal child labor around the world, headed the administration's successful effort to raise the minimum wage, secured worker's pensions, and launched job-training programs, one-stop career centers, and school-to-work initiatives. Under his leadership, the Department of Labor won more than 30 awards for innovation. A 1996 poll of cabinet experts conducted by the Hearst newspapers rated him the most effective cabinet secretary during the Clinton administration.

Reich has been a member of the faculties of Harvard's John F. Kennedy School of Government and of Brandeis University. He received his B.A. from Dartmouth College, his M.A. from Oxford University, where he was a Rhodes Scholar, and his J.D. from Yale Law School.