Over the past few days, before the Daschle story broke, several news outlets began arguing that health reform isn’t happening this year. Key stakeholders sounded less than optimistic and some prominent Democratic lawmakers questioned the imminence of reform.

Today, the Washington Times’ Sean Lengell reports (before the Daschle story broke, it seems) that even Sen. Max Baucus (D-MT), the chairman of the Senate Finance Committee and a big supporter of comprehensive reform, thinks that health care may have to wait:

“Why might reform not happen this year? As is often the case, the new administration and the new Congress face competing priorities,” said Sen. Max Baucus, Montana Democrat and Senate Finance Committee chairman, at a health policy conference in Washington hosted by AcademyHealth and Health Affairs magazine. “These priorities compete for time on the agenda and attention in the press and in public.” “The president’s dance card is indeed full,” he added.

This is the alternative theory of why Daschle dropped out. As one of my colleagues suggested, Daschle may have read the tea leaves on health reform and concluded that the economic crisis has rendered health reform unaffordable. So, he drops out and provides Obama with a rationale for failing to enact health reform during his first term.

What do you think?

Tom Daschle’s deep political connections and interest in health care wonkery made him a prime candidate for the health care job. He really wanted to reform the system and he had the political ability and connections to make it happen. Nobody questioned Daschle’s commitment to reform, but some commentators and lawmakers were still surprised about his decision to step aside. Here is a sampling of the live cable coverage:

SUSAN PAGE: I think not inevitable. I think Tom Daschle probably could have gotten confirmed….In fact, I think you saw support from a fair number of Republican senators. [MSNBC, 2/3/2008]

CHRIS CILLIZZA:If we had been doing this interview at 9:00 this morning or 8:30 this morning, I would have said he’s probably going to make it. He’s going to come out a little bruised but he’ll make it. [MSNBC, 2/3/2008]

TOMMY THOMPSON: Oh I think he would have [been confirmed] – I think there is no question that whoever Obama nominates they are going to get confirmed because of the overwhelming superiority of numbers that the democrats have. [Fox News, 2/3/2008]

ED HENRY: I can tell you, just in the last couple of hours, I’ve spoken to some of Tom Daschle’s confidants, and they were insisting he was going to make this…This is a big shocker at the White House. [CNN, 2/3/2008]

Sen. John Kerry (D-MA) also expressed disappointment. “I wish Tom Daschle had not decided to withdraw his nomination for Secretary of Health and Human Services,” Kerry said in an issued statement. “This was no ordinary appointment and today is not a good day for the cause of health care reform.”

Daschle seemed to believe that his tax controversy distracted from health reform, but critical media coverage may have also influenced his decision. As Andrea Mitchell points out, “Daschle specifically cited the New York Times–which I take to mean this morning’s editorial calling for his nomination to be withdrawn. Surely it wasn’t the only factor, but it was probably a non-trivial one.”

Moreover, a source close to Daschle says “he didn’t have the stomach for the fight.” “The double-barreled combination of a blistering New York Times editorial and a front-page story raising questions about President Obama’s commitment to ethics reform in Washington convinced Daschle he had to go.”

Daschle’s choice to step down certainly places more pressure on Obama to use the presidential bully pulpit and convince the American people that the economy demands health reform.

Still, the need for health reform may eclipse this set back. With the right team, we can still make it happen.

Since his tax improprieties and industry ties have become the stuff of headlines, Tom Daschle has withdrawn his nomination for the Health and Human Services post.

The real question is whether Daschle will hold on to his appointment to head the White House Office on health reform. Remember that Obama also tapped tapped Daschle “to lead a new White House Office of Health Reform, a position that comes with a West Wing office and a voice in virtually all of the administration’s major domestic policy debates.”

Still, Daschle’s withdrawal from HHS certainly undermines the probability of imminent reform. Obama nominated Daschle for his intimate knowledge of Congressional procedure, his progressive policy solutions, familiarity with health care policy, and the lessons he learned fighting for health reform in 1993.

This isn’t to say that Daschle is somehow so uniquely suited for the job that the health care system will rot without him. Other leading contenders for the job, Govs. Howard Dean (D-VT) or Kathleen Sebelius (D-KS), could serve as powerful advocates for health care reform.

Over at Managed Care Matters, Joe Paduda highlights the hypocrisy of conservatives who argue that comparative effectiveness research will ration health care:

I’m completely disgusted with the hypocrisy of the libertarian right; those who have screamed for years about the ineffectiveness of government, ranting nonstop about how government can’t do anything right, yet are now screaming even louder as government attempts to make sure they are responsible stewards of the public’s funds.

This is a good way of defending effectiveness research from the onslaught of conservative attack: since over $700 billion is wasted on care that does not contribute to healthy outcomes, figuring out what works and what doesn’t and then throwing resources towards the former is, well, the function of government, conservatives have always told us. So what’s so different this time?

I would add that even the smallest kind of guidance improves health outcomes. As a recently published study in the New England Journal of Medicine concludes, simply using checklists cuts “deaths nearly in half.” So imagine the savings that can be garnered if we actually invest money to figure out what works and what doesn’t. Republicans love saving money and defunding initiatives that don’t produce desirable outcomes. With comparative effectiveness research, we can hold their feet to the fire.