U.S. Rep. Jim McDermott, calling the nation’s new health care law “the biggest change in social policy since 1930,” told Islanders he’s running for a 12th term in the House because the landmark legislation needs much more work.

Sounding at once both pleased by what Congress accomplished and frustrated by the new law’s shortcomings, McDermott, a leading figure in health care reform, compared the law to building a house. The foundation has been laid, he said.

“And we’re now beginning to do the rest of the finish work. It’s not all done,” he said.

McDermott came to Vashon on Sunday to discuss the new health care legislation at the request of three groups — the Sunrise Ridge Health Services Board, Vashon Youth & Family Services and the Vashon-Maury Island Community Council.

McDermott, 73, is no stranger here, however. The Seattle Democrat, a long-time fixture in the region’s political landscape, owns property on Maury Island where he has installed a well and hopes eventually to build a house.

At Sunday’s gathering, held at McMurray Middle School, McDermott, a psychiatrist and a champion of the so-called single payer system of health care, talked easily and at length about the new law, some of its nuances and the bigger policy shift he believes it signifies. He also answered several questions offered up by the 30 or so people in attendance.

President Obama was attempting to address two critical issues when he put forward a health care reform package, McDermott said — ensuring that all Americans have access and controlling the country’s runaway health care costs.

“And you need a national system to do that,” he said.

But controlling costs is a tough one, he contended, especially since Obama decided to keep insurance companies in the picture, rather than opting for a single-payer system that would have created a government-run Medicare-style program.

“I love this president. But he sometimes does things I wouldn’t have done,” McDermott told the group.

Costs are driven up in large part, he went on, because of all those insurance companies vying for customers, billing patients and supporting their large infrastructures. As a result, he told the group, the United States spends about 16 percent of its gross national product on health care-related costs, compared to 8 percent by the French and 10 percent by Canadians.

“Our health care system right now is a financial system. It’s not a health-care delivery system,” he said.

Hilary Emmer, a member of the audience, challenged McDermott’s support of the bill, noting that because of the so-called Hyde amendment, women can’t get abortions covered if there’s any federal money involved.

“I’m tired of liberals making women a bargaining chip,” she told the congressman.

But McDermott said lawmakers needed to begin somewhere.

“If we didn’t start this process, we wouldn’t have anything for anyone,” he told her.

McDermott also paid tribute to Dorothy Johnson, an Islander who helped to start the Vashon Health Center some 40 years ago.

“That’s the kind of tenacity we need on health care reform,” he said.