The buildup in Washington for health care reform over the past few months reminds me of the Neil Simon play Proposals.

Much of the first act revolves around the characters anticipating the arrival of a man at a Poconos lake cottage. His description grows increasingly alarming—and hilarious.

By the time he steps onto the stage at the end of Act I, the audience feels as if it knows him before he utters his first word of dialogue.

Many of the characters in the health care reform drama have been engaged in happy talk so far. Both parties and a long roster of interest groups seem to agree on the need to extend coverage, enhance quality and lower costs simultaneously.

An actual bill has not yet emerged. But Sen. Max Baucus, D-Montana and chairman of the Senate Finance Committee, told reporters at a National Press Club briefing Friday, April 24, that the outlines for legislation have already been sketched.

He was referring to a white paper he released in November titled “A Call to Action.” You can find the full document on the committee Web site at finance.senate.gov

The paper is based on several hearings held by the panel in 2008. This year, the health care pace has quickened. The Senate Finance Committee and Health, Education, Pensions and Labor Committee have been holding talks for months with representatives from the health care, business and policy communities.

Baucus conveys a sense of urgency. Now is the only time for the next several years to undertake this effort: A new president and new Congress are in place, and no one faces an election for more than 18 months.

“We have a tremendous opportunity to very significantly reform our health care system to make it work a lot better for virtually every American,” he said. “I’ve never attempted something so challenging. I relish it. It’s a lot of fun.”

The schedule will be lightning fast by Washington standards. Baucus said a bill will be on the Senate floor by July. The House likely will proceed at the same clip.

Baucus and other reform leaders are reassuring large businesses that want to continue to offer health care benefits to attract and retain employees.

“We’re not going to change the way self-insured companies handle health care for their employees,” Baucus said. “Any person who has health insurance can keep it.”

President Barack Obama favors that approach. “He wants to build on the employer-based system,” Nancy-Ann DeParle, director of the White House Office of Health Reform, said at an April 15 press briefing at the Kaiser Family Foundation in Washington.

But here’s where things will get difficult. It will cost an enormous amount of money to cover the approximately 47 million Americans who lack health insurance.

At a House Education and Labor subcommittee hearing on Thursday, April 23, Rep. Rob Andrews, D-New Jersey, estimated that the tab would be $150 billion to $200 billion annually.

Obama’s proposals to repeal tax breaks for the top 5 percent of earners and phase out subsidies for a private-sector Medicare program would cover about 40 percent of the bill, according to Andrews.

“This is where the rubber really meets the road is paying for insurance for uninsured people,” Andrews said.

He then pressed representatives of business groups on how they would fund the gap. A lawyer, Andrews pursues a Q&A in a tough but friendly manner, as if it were a deposition.

He hinted that a pay-or-play proposal will have to be included in health care reform in order to cover the costs.

But that idea sets corporate teeth on edge. Michael Langan, a principal at Towers Perrin HR Services in Valhalla, New York, told Andrews not to take heart in the fact that Massachusetts companies by and large have not dropped their coverage following the pay-or-play mandate imposed by the state as part of its health care reform plan.

He said the minimum coverage level was set so low that virtually every business avoided penalties. But as costs increase for a state, they will be passed on to businesses.

“The bar will only be raised over time to the point where it will erode employers’ resolve to offer their own plans,” Langan said.

Translating pay-or-play into legislative language will put a premium on nuance.

“What does ‘play’ mean? You have to come up with a package that equals ‘x,’ ” said Randel Johnson, vice president of labor, immigration and employee benefits at the U.S. Chamber of Commerce. “And who’s going to define that ‘x’?”

When Congress gets down to those details, health care reform happy talk may turn into grumbling. We can only hope that the final product is more successful than Proposals, which closed after 77 performances on Broadway.

A two-week congressional recess hasn’t cooled the embers of the political fire generated by a bill that would make it easier for workers to organize.

While they’re at home, senators and members of Congress have been the targets of a grass-roots campaign by the AFL-CIO promoting the Employee Free Choice Act. The union says the outreach involves thousands of workers in 350 events in at least 10 states.

Meanwhile, the U.S. Chamber of Commerce has launched a $1 million television ad campaign in five states designed to denounce the bill and persuade wavering senators to oppose it.

As the EFCA cage match gets bloodier, it looks as if another issue might cause a labor-management brawl. And it’s one of the few areas where the two groups have been unusually cooperative in recent years—immigration.

On Tuesday, April 14, the AFL-CIO and Change to Win released five principles for immigration reform. The framework is significant because it symbolizes labor unity on the issue, especially the guest-worker dimension that split the movement in 2007.

This development could add further momentum to what immigration reform supporters hope will be a concerted Obama administration effort to pass a comprehensive bill this year.

One proposal by the labor groups is to establish “an independent commission to assess and manage future [immigration] flows, based on labor market shortages that are determined on the basis of actual need.”

The business community is wary of allocating employment visas through such a commission. Dan Yager, chief policy officer at the HR Policy Association in Washington, told The Wall Street Journal: “I think that’s just a way to avoid having a guest-worker program, and our view is that there is definitely a need for that.”

But in other areas, business and labor are on the same page—such as the need to overhaul the employment verification system and to create a path toward legal residency for the 12 million undocumented workers currently in the United States.

Both sides also should agree that immigrant workers must be treated fairly.

“Having access to a large undocumented workforce has allowed employers to create an underground economy, without the basic protections afforded to U.S. citizens and lawful permanent residents,” the immigration framework states. “An inclusive, practical and swift adjustment of status program will raise labor standards for all workers.”

During a recent trip to the United Arab Emirates, I saw a region that is dependent on foreign labor. Everywhere you turn in Dubai and Abu Dhabi, there’s a building going up. On my first look around, I understood the joke that the crane is the UAE national bird.

The thousands of people toiling on the construction projects are from somewhere else—India, Sri Lanka, Bangladesh or other countries in the region. None of them has UAE citizenship.

That situation could foster abuse. In fact, while I was in the UAE, the British Broadcasting Corp. aired a documentary asserting that guest laborers are exploited.

I didn’t see mistreatment myself. But I did notice the forlorn expressions on workers at a project near the Dubai hotel where I was staying. They were in line for fruit being passed out during a break.

Although having a job in the UAE may be better than unemployment at home, life is a struggle in their adopted country. They are sacrificing so that rich Emiratis—and international tourists—can enjoy gleaming hotels, office buildings, marinas and shopping malls.

For a brief moment, I felt a twinge of moral superiority, convinced that we don’t treat foreign workers this way in the United States.

But then I remembered that some nefarious American employers take advantage of Mexican immigrants. Wealthy suburbanites in the Washington area sometimes fail to pay Guatemalan day laborers—or even give them a ride back to the place where they were picked up in the morning.

While campaigning last fall, President Barack Obama touted his skill at fostering consensus on tough issues. He hasn’t demonstrated that ability in office so far. But perhaps he will find a way to bring labor and management together to ensure that the U.S. meets a higher immigration standard than the rest of the world.

When I got to my hotel today after a tour of Abu Dhabi, I checked my BlackBerry. Yes, even halfway around the world, my world still revolves around Washington—and I have to know what’s going on.

One of the first messages that popped up was an announcement from the U.S. Customs and Immigration Service. USCIS stated it was still accepting H-1B visa applications a week after the April 1 deadline.

As heavy H-1B users predicted, the take-up rate slowed this year thanks to the recession. In previous years, all of the 85,000 visas were snapped up within a couple days of the application deadline.

It’s easy to understand why it’s galling to many members of Congress as well as laid-off programmers that many top U.S. technology companies are still seeking H-1B visas to employ highly skilled immigrants in computer science and other positions.

But my trip this week to the United Arab Emirates has given me a new perspective on the H-1B numbers. U.S. companies want to raise the H-1B cap, but even at 195,000—which it was earlier in the decade—you’re talking about a relative handful of jobs across the entire U.S. economy.

It’s not as if foreign programmers are about to usurp the technology sector. If you want to see an expatriate workforce, come to the UAE. Of the 4.7 million people who live in the seven countries that compose the federation, only about 20 percent are native born, according to Gulf Business magazine.

This fact is immediately evident when you’re here. The construction boom in Dubai, where I was earlier this week, has lured thousands of Indian and South Asian workers to the country. I saw dozens of them every day on projects less than a block from my hotel. Perhaps one day someone will publish a coffee-table book called Cranes of the UAE.

During my stay, I’ve met hotel workers, cab drivers, shopkeepers and tour guides from Sri Lanka, Bangladesh, Egypt, Kenya, Syria, India—everywhere but the UAE. In fact, I’m not certain I’ll meet an actual Emirati while I’m here.

Of course, Emiratis are not necessarily clamoring for jobs. Many young people in the country want to cruise around in Mercedes SUVs financed by family wealth based on oil or real estate. Or they want to work in cushy federal jobs.

But the government of the UAE is putting an emphasis on developing its workforce through a process called Emiratization. It is apparent by following news coverage and billboard advertising for e-learning that the UAE wants to invigorate the economy by improving the skills of its labor market.

The UAE is teaming with U.S. higher education institutions such as Purdue University and New York University for MBA and other programs. One with George Mason University recently collapsed, but I’m sure that the country will continue to look for other U.S. academic partners.

This week, I have seen news stories about the launch of a research and education network that will connect UAE schools to “rich multimedia teaching content through high-definition videoconferencing, inter-library success, grid computer and e-learning,” according to an April 6 story in Gulf News.

On the front page the same day, there was a story about the establishment of the Emirates National Competitiveness Council that will coordinate development efforts between the public and private sectors.

Yes, the UAE is a high-wage area that is not conducive to U.S. outsourcing. But even the world’s rich are focusing on the critical role of workforce development in a sustainable economy. It’s the same kind of trend that was apparent in India when I visited last year.

We had a tour guide the past couple days who just graduated from a high school curriculum that emphasizes science and math. After earning money for a while, he hopes to study aerospace engineering in college and eventually work for Emirates airlines. The draw is the company’s rich benefits offerings. Some job attractions are universal.

This young man is from Sri Lanka. The UAE has started a process of trying to develop homegrown talent—a desire that is shared across the world.