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COLUMNISTS
TODAY'S STORIES
19.11.2008
Daschle at HHS = Good News for Health Reform

So much health care news, so little time to blog. But let me weigh in on the news, via, CNN, that Tom Daschle will be Secretary of Health and Human Services. He will also serve as the White House point person on health care reform.

This is a perfect role for Daschle. Although he was always been interested in health care, in the last few years he's become a true wonk on the subject, publishing a book called Critical: What We Can Do About the Health-Care Crisis. It urges precisely the sorts of reforms President-Elect Obama and his congressional allies are promoting right now. 

Daschle is particularly interested in creating a "federal health board"--an independent govenrment-chartered body, structured like the Federal Reserve, that would both help set up the new system and then play a role in running it. One of its major goals would be to set basic coverage guidelines, to weed out payments for wasteful or unnecessary care. It's a complicated and politically dangerous notoin, but one that's necessary if we ever want to improve health care quality and get costs on control. (For more on the concept, and how to avoid its political pitfalls, see Ezra Klein's interview with Daschle from a few months ago.) 

Daschle has also thought long and hard about the failures of the 1994 reform effort--and how to avoid them. He was actually the first person I heard mention the possibility of using the budget reconciliation process this time around. (Under reconciliation rules, it takes only 50 votes to pass something, since there are no filibusters.) He did it during an appearance at the Chicago Tribune/Printer's Row Book Fair, back in June, during a session I moderated.

Like Senator Max Baucus, who has also raised this possibility, Daschle was careful to say that reconciliation should be a fallback option--something to use only if bipartisan progress became impossible because Republicans were reprising their role from 1994 and refusing to compromise. But he also noted that it was an option Democrats had to keep on the table, in order to make cooperation more likely.

Dasche has, to my knowledge, always had open-minded views about how quickly to push health care reform. When I've spoken to him in the past, he's suggested it would depend on the political environment. But given Barack Obama's substantial victory and the numbers in the Senate (58 Democrats and counting) I imagine that Daschle, like incoming chief of staff Rahm Emanuel, will be inclined to "throw long and deep."

Update: There's a video of that Chicago book fair session here. It's the entire afternoon, via C-Span; the Daschle session is the last one and begins at around the 6:00:00 mark.In addition to speaking about reconciliation, Daschle also discusses his ideas about a Federal Health Board.

Update 2: Karen Tumulty at Time has a nice write-up on Daschle, covering--among other things--an early conversation he had with Obama.

--Jonathan Cohn 

Posted: Wednesday, November 19, 2008 1:06 PM with 9 comment(s)

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Political Animal said:

DASCHLE TO HEAD HHS?.... Even before the election, drafts of what an Obama cabinet might look like had former Senate Majority Leader Tom Daschle taking the lead at HHS. If the reports today are accurate, that's exactly what's going to...

November 19, 2008 1:23 PM

blackton said:

Fixing health care can also fix the problems with our industrial base. The faster it is done the faster companies like the big 3 won't have to go broke providing health care while the automakers in every other country get a free ride. I hope this is priority number one for Obama. His plan (as opposed to Hillary's take no prisoner approach) is one of the reasons I supported him, because it seems far more politically feasible. Now I can see if I was right.

November 19, 2008 1:51 PM

Handful of Sand said:

The elite cabinet posts (State, Defense, Justice, Treasury) usually get the most press, and with good reason. These are the elite posts because they have authority over the most powerful departments. This administration may be different. With reports

November 19, 2008 2:06 PM

Peter.k said:

The Dakota Effect at its finest.  ( www.themonkeycage.org/.../the_dakota_effect.html )

November 19, 2008 2:59 PM

williamyard said:

blackie: nice post.

Peter.k: Fascinating! The Dakotas as democracy's Silicon Valley--who knew!?

November 19, 2008 4:31 PM

reganad said:

Blackton,

A free ride?  I don't think the other companies or companies in other countries are getting a free ride.  Certainly those countries are charging taxes to pay for the health care, aren't they?

But, since our "system" is so inefficient, it would almost certainly be cheaper to have single-payer.

November 19, 2008 5:48 PM

mgoozner said:

You should have mentioned his Alston + Bird lobbyist connections to the health care industry, covered in this morning's New York Times. Let's face it. If we're going to have health care reform that is affordable, the companies getting a haircut are going to have to be in the room. And I agree Daschle is the right guy for the job of reining in the special interests. From his time on the Hill and in the lobby shop, he knows where the high cost bodies are buried.  But if Obama sticks to his lobbyist rules, Daschle may have to recuse himself from key matters in the first two years. Look for him to appoint a top aid like Jeanne Lambrew to be the shepherd on health care reform.

November 20, 2008 8:57 AM

blackton said:

reganad, ok, a far cheaper ride. Japan spends far less than we do and has better outcomes. Japanese automakers are not saddled with any of these legacy costs or employee costs that American ones are. I saw on TV yesterday some nitwit bringing up the British automakers as a counter example, but Britain has been a second rate power for a couple of generations, it is like comparing the Yankees against the Reading Phillies, there really is no comparison. We are spending something like 4% more of our GDP on Healthcare than the Japanese, and the automakers are spending far more since in Japan that 4% is spread out among everyone, in America companies that provide insurance shoulder more of the burden. This is just nuts.

November 20, 2008 10:07 AM

Daily Intel said:

He's not exactly following the Team of Rivals model here.

November 20, 2008 12:04 PM