Barack Obama has now made official the appointment of Tom Daschle
to Secretary of Health and Human Services. I'll have a lot more
on this (including some more from Tom Daschle's book on health
care, which I just finished) but just a few quick things to
emphasize.
Daschle is not reentering the public sector to run the daily
bureaucracy of HHS. He played a key role in Obama's campaign and
was rumored to be a candidate for chief of staff. The only reason
he would accept this position is if he received assurances from
Obama that health care would be a major priority of the new
administration, and that he would lead the reform effort.
In his book, Daschle discusses the unraveling of the Clinton
health care push in 1993-94 in great detail, and will try to
learn from the mistakes that were made at the time. By having him
lead the health care effort (somebody with vast experience moving
legislation through Congress) Democrats will already be a step
ahead of where they were with Hillary Clinton in 1993. He
realizes that he'll have to involve members of Congress in the
process, rather than huddling in secrecy, coming out with a plan,
and telling Congress how it's gonna be. He also recognizes that
one of the major problems with the original bill was that it was
so long and detailed, that it was too complicated to explain to
the public, and easy to pick apart by opponents.
The Obama-Daschle proposal will likely include some of the
following elements: a requirement that insurers cover those with
preexisting conditions; subsidies for individuals to purchase
insurance in a government-run exchange that will include a new
Medicare-like government insurance program as well as a choice
among private plans that would have to meet certain government
standards as far as price and benefits; a requirement that large
employers either provide health coverage or pay taxes into a pool
that would be used to purchase health care for others; and cost
saving measures involving the use of electronic record keeping.
What's not yet clear is whether any plan would include Daschle's
idea of a Federal Health Board, modeled after the Federal Reserve
Board, comprised of "experts" who would supposedly be insulated
from the political process, and able to make judgments as to what
drugs and medical procedures were necessary, and which ones we
could do without in order to save money. The Health Board
was also a key part of Daschle's vision for how to pass health
care reform – by punting the complex medical questions down
field, Congress could craft legislation that was less
complicated.
Also, in 1993, there was a lot of opposition from insurers, but
just last week, America's largest group of insurers agreed
to accept a requirement that they accept enrollees with
preexisting conditions as long as government mandates that
individuals purchase health insurance. Many businesses,
struggling with high health care costs, are also likely to
welcome government action. And the American
Medical Association is eager to see everybody covered, though
their proposal achieves that in a different way than Obama would.
I asked Sen. Jim DeMint about the health care battle this
morning, and he warned, "Because of down economic times and the
promise of free health care, I think we're in real danger of
losing this."
I'll reiterate that conservatives really need to get
up to speed on this issue. If conservatives lose this fight,
it's the end of the battle over the size of government.
