Daschle’s Views On Health Reform: ‘Incremental Change In Our System Is No Longer A Viable Option’
Daschle’s Views On Health Reform: ‘Incremental Change In Our System Is No Longer A Viable Option’
In a sign that he may adopt a comprehensive approach to solving the health care crisis, President-elect Barack Obama has chosen former Sen. Tom Daschle (D-SD) to head the Department of Health and Human Services.
Ezra Klein points out, “you don’t tap the former Senate Majority Leader to run your health care bureaucracy. That’s not his skill set. You tap him to get your health care plan through Congress.” Earlier this year, during an address at the Families USA Action Conference, Daschle concurred with the need to ‘think big’ on reform:
Incremental change in our system is no longer a viable option. Instead we need comprehensive reform. In growing numbers the American people are demanding that we do something. Our goal should be to build what current and retired members of Congress have today, and make that available for all Americans.
Daschle is a Senior Distinguished Fellow at the Center for American Progress and is the author of Critical: What We Can Do About the American Health-Care Crisis.
The book lays out Daschle’s vision of achieving reforms through a framework shared responsibility, in which “every player in the health-care arena — the government, employers, doctors and hospitals, insurers, and individuals — should help support a rational, sustainable system.” Some of Daschle’s proposals:
- Expand the Federal Employee Health Benefits Program (FEHBP), or create a group purchasing pool like it: Participants could choose their own provider and would have the security of knowing they could never lose their coverage. Employers could let their employees get coverage through a FEHBP plan only if they enrolled all of their workers, not just ones with health problems. The FEHP pool would also include a government-run insurance program modeled after Medicare and would have tremendous clout to bargain for the lowest prices from providers and push them to improve quality of care.
- Subsidize coverage for those who need it: The government would provide financial help on a sliding scale so nobody has to pay more than a certain percentage of their income for health insurance. Administered as a refundable tax credit, this protection would apply to employer-based health insurance as well as private insurance obtained through the pool.
- Strengthen Medicaid: Simplify and extend Medicaid to cover everyone below a certain income level. The federal government should pick up the tab for this expansion, and ensure that states don’t’ cut off people when the budget gets tight.
- Concentrate on the value of care: Strive to get more for our health care money by promoting research that compares drugs and treatments to determine which ones deliver the best bang for the buck. Daschle also proposes promoting prevention that would reduce the number of chronic conditions.
- Improve health care infrastructure: Adopt health information technology to lower expenses and allows rural residents to connect electronically with medical providers. Increase the number of community health cetners and government-funded clinics that provide basic care for the poor and uninsured.
Aside from supporting the basic principles of progressive reform, however, Daschle also proposes a Federal Health Board that “would resemble our current Federal Reserve Board for the banking industry.”
The Board would ensure harmonization across public programs of “health-care protocols, benefits, and transparency” and would set “evidence-based standards for benefits and quality for federal programs” in the hopes of lowering the complexity of different insurance regulations and ultimately lowering costs. “These standards would apply to federal health programs and contractors and serve as a model for private insurers,” Daschle writes.
Cross-posted at the Wonk Room.
When it gets rough out there, a lot of business leaders get out of the car and say, 'We're OK with minor reform.' I'm challenging you today, we're going to have to do big, serious things."
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30 Responses to “Daschle’s Views On Health Reform: ‘Incremental Change In Our System Is No Longer A Viable Option’”
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47 million people(and climbing) without health-insurance in this country is unacceptable, and intolerable.
November 19th, 2008 at 3:10 pm"Our goal should be to build what current and retired members of Congress have today, and make that available for all Americans."
Exactly, why should they get health insurance and the rest of us get screwed.
November 19th, 2008 at 3:13 pmWhat he's proposing is incremental reform. We need to dump this patchwork morass approach, cut out private insurance, and cover everyone through a not-for-profit single-payer system.
November 19th, 2008 at 3:14 pmSo many of the current stories of foreclosures, you scratch the surface just a bit and what lies beneath is medical bills. I want an American National Health Service which would cost people nothing. Current events show it's necessary. Daschle's appointment says it's possible. I want my NHS card.
November 19th, 2008 at 3:19 pmWoo Hoo. I knew that Obama was just fooling when he introduced his original plan. Universal health care will go a long way towards solving our auto industry's problems along with being the right thing to do for all our citizens. Maybe with Universal health care some of the companies that sent their manufacturing over seas will be able to bring them back to the USA.
But first and foremost, I want this to be a country that respects it's citizens and feels that health care is a right and not a privilege.
January 20 can't come soon enough. I hope the auto industry can hold on until then. Apparently the Republicans see nothing wrong with bailing out Wall Street but everything wrong with bailing out Main Street. Where was their "we don't want to bail out failed companies" when AIG was bailed out (twice)?
November 19th, 2008 at 3:19 pmpinget Says:
So many of the current stories of foreclosures, you scratch the surface just a bit and what lies beneath is medical bills.
My daughter, a Bankruptcy Attorney says that she has yet to do a bankruptcy where medical bills weren't a precipitating factor in the bankruptcy.
November 19th, 2008 at 3:21 pma healthy workforce is a productive workforce. something the republuthugs can't seem to comprehend.
November 19th, 2008 at 3:23 pmOooh, I like it!! Come on, Tom, let's get busy!!
November 19th, 2008 at 3:28 pmGary Kleppe says:
cut out private insurance, and cover everyone through a not-for-profit single-payer system.
Even as one whose livelihood has been in private health insurance for 25 years, I will gladly lose my job to see the above come to be.
Making healthcare a profit driven business is immoral.
Period.
November 19th, 2008 at 3:32 pmIntresting approach...
On the EXPAND MEDICAID point, if that income level was about $40K per year for a single and maybe $75K per year family of 3 (kids ALREADY covered under the national plan?), I could go for this in a big way. Thoughts?
Of course I'd prefer SINGLE PAYER period or health care modeled after the Dutch system (recently voted the best).
Clearly, the economic crises DEMAND a national health system as part of the more meaningful approach (than the Paulson/Bernanke unfettered LOOTING.)
November 19th, 2008 at 3:35 pmAnd, let's eliminate that damn "pre-existing condition" thing that hurts everyone! If you are alive you probably have a pre-existing condition. To deny care based on this is just WRONG. I have a friend who is seperated from her husband and she has cancer. She would like a divorce, but she knows she will never obtain health insurance again, so she stays married. This should not be.
November 19th, 2008 at 3:38 pmAs one of the 40-50 million Americans without healthcare, with a family history of diabetes and heart disease, here's hoping Congress will work with Daschle, Emmanuel, and Obama to end this misery once and for all.
November 19th, 2008 at 3:57 pmWhat I find interesting, and encouraging, is that Obama's selections thus far are some of the toughest "knife-fighters" the Democratic party has to offer. I may have reservations about some of the politics but, these folks are not going to be ineffective.
November 19th, 2008 at 3:58 pmNotwithstanding all the other very valid reasons why national health care should be an American right and not a paid-for privilege, we see the auto industry going belly-up in part because of their "legacy" costs (pension and health care).
November 19th, 2008 at 4:02 pmIf we had national health care, the cost would be spread out over every taxpayer.
I do not understand why business has not advocated for this.
Unviersal health care - everyone is covered.
Every western nation has a national health care system, and their health statistics are better than ours, from new baby to longevity. If the insurance industry were to lose health care, a number of them would be out of business, but they would still have the insurance business for death benefits, and property.
We all know that insurance administrative costs in the private sector run about 23%, whereas the administrative costs in Medicare coverage runs about 4%.
Daschle's Job Is To Save The Health INSURANCE Industry!
It is NOT to provide a system whereby every American can get the health care s/he needs.
It is to save the multi-billion-dollar slush fund.
Health Insurance is the business equivalent of tapeworms. It is a parasitic industry. It contributes nothing, it only withdraws nutrients, robbing the host of necessary sustenance...
November 19th, 2008 at 4:08 pmtokin librul Says:
Daschle’s Job Is To Save The Health INSURANCE Industry!
It is NOT to provide a system whereby every American can get the health care s/he needs.
It is to save the multi-billion-dollar slush fund.
Where are you getting that?
November 19th, 2008 at 4:18 pmPlease provide a link, unless its to stinky fingers from pulling this out of your a$$
Bravo on the list of some of Daschle's proposals!
November 19th, 2008 at 4:25 pmPBS ran a special on "Health Care Systems around the world", focusing on several different countries, and how their Universal Health Care System actually works.
Despite the fact that the End Goals of these countries is the same...health care for ALL their citizens...the details are , surprisingly different.
One country, Taiwan I think, did what we need to do. They wanted to Create a Single Payer Plan for their citizens... so the STUDIED how other countries did it, and Picked the parts they felt would best fit in with their Unique Country.
The Time is Right for A Bold Plan to Insure the Healthcare of ALL Americans.
The Voters are Angry and AWAKE. Even Harry and Louise are Now on the Bandwagon.
November 19th, 2008 at 4:47 pm'Frontline' had a program on health care in several democratic countries around the world. All industrialized.(if Switzerland can be called industrialized.) The concensus was the citizens were satisfied in all countries. Doctors, insurance companies and hospitals not so. Daschle could do worse than looking at all models and attempting to use the best of each. I personally have Medicare along with my wife. I also carry a health insurance plan with the American Postal Workers Union we are totally satisfied with. Even before Medicare. Being a retired Postal Worker the Postal Service creates a lower premium. I pay $241.00/mo. I myself am an outpatient in the VA Hospital system and am also very satisfied with theis care also. I have been in the VA system since 1956 and the service has improved exponentially the past 20 years. Early on I hated to go but the waiting times between appointments has decreased and the time spent waiting to see a doctor or tecnician has also diminished.
November 19th, 2008 at 4:55 pmI say this to suggest those entrusted to overhaul health care in this country look to the VA for hospital and Dr. care and Medicare to provide subsidizede insurance care. The Insurance companies of the countries surveyed by "Frontline' were non-profit and the hospitals and doctors were fee regulated. The countries had a lot of opposition at first but came to mostly embrace it. (my critique)
There is only one real answer to the health care crisis in this country, and indeed this will be "big, serious things." We are the only advanced industrial nation that people can either go bankrupt or die because of the healthcare system in this country. One answer: national health care with a single-payer system. As long as profit remains in a healthcare system, people will be poorly served. Decent health care is as much a right as is the right to air and water. Competition in health care has done nothing but drive costs up for years (and I worked in these industries for most of my career, so I know.) So those who say "competition will reduce costs" are back in time about 30 years ago. That's what "they" said then...and did it work? NO!
November 19th, 2008 at 5:12 pmSee how the US fares: it's DISMAL:
http://eatg.org/eatg/Global-HIV-News/Access-to-treatment/US-health-system-fares-poorly-Dutch-does-well-again-in-new-study
A copy of the EHCI report can be found here:
November 19th, 2008 at 5:22 pmhttp://www.euractiv.com/en/health/dutch-healthcare-system-best-europe-2008/article-177165?Ref=RSS
One Big change that Needs to Happen is the Establishment of Neighborhood and Community Walk in Clinics.
It is ridiculous to use Expensive Emergency Rooms to handle Minor and Routine Health Care Needs.
We are using the MOST Expensive Health Care Facility to act as a Stopgap Healthcare System for people who Can't Afford Healthcare.
November 19th, 2008 at 5:26 pmThis fight is not just about health care, it's about power over the people. Why do you think health care comes along with a job??? Employer pays writes off deduction and you get health care. Wrong. You only get health care if it's cost effective and two- if there is compitition amoung corporations for qualified people. Otherwise companies don't give a crap!!
Did you know , if single payer were implemented...each family would save between $4000 and $12,000 per year. How many of you could pay your mortgages with thtt money ??? How many of you could save a little more for your kids education???
It's time we get something for our tax dollars besides bombs and bullets. If you took $250billion out of the military budget we wouldn't have this discussion. Even at $500 billion for the military, it's more than every other country combined for it's military expenditure. In other words....if you don't die by the bullet , you pay for the bullet.
This is not the American way!!
November 19th, 2008 at 5:28 pmA universal, health care system will free up businesses from paying astronomical health care costs, and they can use that money to create new jobs. Why more business leaders don't see this I have no idea. It's probably this ridiculous, quasi-religious devotion to the "market", even though the market is killing us right now.
November 19th, 2008 at 6:57 pmI now live in Germany, and my wife is in the German tax and social system. She has the choice of public (cheaper, and very average service) or private, which costs more and provides better service. German doctors who compare their earnings to American doctors are not satisfied. They do however, have at least the same dedication and commitment to their patients as American doctors. Other European countries have similar systems, and they work. Whether public or private, employees must pay part of the medical insurance, its just that private is considerably higher. US needs to learn from others, and not be arrogant about "the best health care in the world". Its just not true.
November 19th, 2008 at 7:19 pmCan anyone comment on how the proposed FEHBP idea would affect SELF-EMPLOYED people currently at the mercy of Blue Cross et al?
As a self-employed independent contractor, would I be able to get a policy regardless of pre-exisint conditions?
The part of the article that makes me nervous is this:
Employers could let their employees get coverage through a FEHBP plan only if they enrolled all of their workers, not just ones with health problems.
Since I have no "company" how do I become a member of a "pool"?
November 19th, 2008 at 8:39 pmHe won't have to worry about Cheney sending him Anthrax Letters anymore.
November 20th, 2008 at 1:08 pmI CERTAINLY HOPE THE OBAMA ADMINISTRATION CAN MAKE AFFORDABLE HEALTH CARE INSURANCE A REALITY. I WILL HAVE TO WORK ANOTHER 10 YEARS WITHOUT IT. WITH AFFORDABLE HEALTH CARE MY WIFE AND I COULD RETIRE AT 55. EARLY RETIREMENT WOULD OPEN UP TWO GOOD PAYING AEROSPACE JOBS FOR THE NEXT GENERATION. GOOD LUCK TOM AND DON'T LET INSURANCE COMPANIES INTIMIDATE YOU. DO WHATS BEST FOR OUR COUNTRY.
November 22nd, 2008 at 11:28 amThere can be NO improvement in our health care as long as there are profit-driven insurance companies in the system.
A poster earlier asked for "links" and "proof" that "Daschle’s Job Is To Save The Health INSURANCE Industry!
It is NOT to provide a system whereby every American can get the health care s/he needs.
It is to save the multi-billion-dollar slush fund."
The link is where you are and the proof is what is being proposed. Had you read it, you wouldn't have needed to ask for the proof.
December 13th, 2008 at 6:31 pmThe PBS program was called "Sick Around the World". Every country that has some form of national health care would not go back to what they had before. Switzerland's healthcare won by a mere 1% margin but now that they've had it for over 10 years they made it clear they would never go back to the for-profit system.
Health insurance is the only business that makes a profit by NOT providing services. In fact, their employees are told to refuse care as much as they can in order to make more money for the company. Their CEO's sure aren't hurting either. I agree that health care should be treated as a right not a privilege. By making it government run, the costs and overhead would be kept to a minimum. Profit shouldn't factor into it anymore than it does with fire and police protection.
December 15th, 2008 at 1:03 am