Daschle Lays Out Ideas for Health Care Reform in Confirmation Hearing

On Thursday, the Senate Health, Education, Labor and Pensions Committee held the first confirmation hearing of HHS Secretary-nominee and former Senate Majority Leader Tom Daschle (D-S.D.), the Washington Post reports (Connolly, Washington Post, 1/9).

During the hearing, Daschle said that if he is confirmed, he is ready to "change the paradigm in this country on health care" (Lengell, Washington Times, 1/9). Daschle said, "The flaws in our health care system are pervasive and corrosive" (Yoest, Dow Jones, 1/8). He added, "They threaten our health and economic security" (Washington Times, 1/9).

Daschle spoke about the need to overhaul health care amid the current economic recession as more people lose their jobs and employer-sponsored health coverage.

Daschle said that "as we face a harsh and deep recession, the problem of the uninsured is likely to grow," adding to the need for swift action.

However, Daschle said the administration of President-elect Barack Obama would not pursue overhaul legislation under expedited budget procedures, which would limit the opportunity for debate and amendments (Pear, New York Times, 1/9).

Working With Congress

Daschle also spoke about the need for collaboration among the incoming administration and congressional lawmakers on overhauling the health care system (Washington Post, 1/9).

Daschle said, "Obama recognizes that many of you have been working for many years on these issues and that any effort at reform will require very close collaborations with Congress. He also realizes that change cannot be dictated from the White House or from Washington out but must come from the grassroots of this country and involve as many Americans as possible" (Young, The Hill, 1/8).

He added, "If confirmed, I will use these dual roles" -- as HHS secretary and director of the new White House Office of Health Reform -- "to marshal the talent and energy necessary to at last succeed in making health care affordable and accessible for all Americans" (Wayne, CQ Today, 1/8).

Daschle said, "I really want to work in a collaborative way," adding, "It's the only way we're going to get this done" (Levey, Los Angeles Times, 1/9).

Other Measures, Prospects for Confirmation

During much of the hearing, Daschle focused on expansion of health coverage. He said that "ensuring all Americans have health care is integral to the mission of HHS" (Dow Jones, 1/8).

Daschle also said he would work to improve morale at FDA and ensure that the agency's decisions are "guided by evidence and effectiveness, not by ideology." He also spoke about a "paradigm shift" from treating illnesses to promoting healthy lifestyles (Washington Post, 1/9).

Daschle said, "Coverage after you get sick should be a second line of defense," adding, "Today, it's often the first line of defense" (Washington Times, 1/9).

Daschle said that as HHS secretary, he would:

Reduce the influence of politics at federal science agencies;
Seek additional funding for community health centers;
Speed up the approval process for lower-cost generic versions of prescription drugs;
Try to increase Medicare payments to providers;
Increase federal support for rural health care providers; and
Encourage greater use of health information technology.

Daschle also spoke about basing Medicare provider payments on "healthy outcomes" and "episodes of care" rather than a fee schedule (New York Times, 1/9).

During the hearing, Daschle "encountered few probing questions on his plans for programs such as Medicare, Medicaid and" the State Children's Health Insurance Program, the Post reports.

Committee members also did not "delve into the substantive policy differences that exist between Obama and many on Capitol Hill on such issues as the tax treatment of health insurance, the question of an individual mandate requiring all Americans to have coverage, and whether the federal government should create an optional public insurance plan," according to the Post (Washington Post, 1/9).

In addition, "Daschle was not asked, and did not say, how he would pay for ... new initiatives" proposed by the incoming administration, the New York Times reports (New York Times, 1/9).

Next Steps

The Senate HELP Committee will not vote on whether to send Daschle's confirmation decision to the full Senate; the decision will be made by the Senate Finance Committee, which has yet to schedule its own confirmation hearing of Daschle (Washington Times, 1/9).

According to the New York Times, during the Senate Finance Committee hearing, Daschle "is likely to face tougher questions about Medicare, Medicaid and other entitlement programs"; however, he "appears likely to win confirmation soon after Mr. Obama takes office on Jan. 20" (New York Times, 1/9).

Comments

Senate HELP Committee Chair Edward Kennedy (D-Mass.) during the hearing said, "Reform is urgently needed, and Tom Daschle is just the person for the job" (Freking, AP/Kansas City Star, 1/8).

Senate HELP Committee ranking member Mike Enzi (R-Wyo.) objected to Daschle's plan to create a new public health insurance program (Washington Post, 1/9). In a statement, he said, "Forcing private plans to compete with a public program like Medicaid, with its price controls and ability to shift costs to private payers, will inevitably doom true competition and could ultimately lead to a single-payer, government-run health program" (Frates, The Politico, 1/8).

Enzi also stated his opposition to allowing FDA to regulate tobacco products (The Hill, 1/8).

However, Enzi said, "I know that we have a shared commitment to reducing the number of uninsured Americans, containing costs, improving quality and making health care more accessible to everyone" (Washington Post, 1/9).

On Thursday, the American Federation of Government Employees endorsed Daschle, saying he has "the experience, knowledge and tenacity to get the job done" (Washington Times, 1/9).

Editorial

The "main thing we learned" from Daschle's confirmation hearing was that Obama "sure picked the right man to stage manage his health care reforms as secretary of [HHS] and as health czar at the White House," a New York Times editorial states. According to the New York Times, the hearing "was mostly a love-fest as senators from both parties expressed admiration for their former Senate colleague and signaled a willingness to work collaboratively with him on the daunting task of improving the costly, dysfunctional health care system."

The editorial concludes that "Daschle may face tougher questions at a second confirmation hearing before the Senate Finance Committee, which has jurisdiction over Medicare and Medicaid, but the real struggles will begin when a detailed plan is put forward by the Obama administration" (New York Times, 1/8).

Broadcast Coverage

On Friday, NPR's "Morning Edition" reported on Daschle's confirmation hearing (Rovner, "Morning Edition," NPR, 1/9).
On Thursday, PBS' "NewsHour with Jim Lehrer" reported on Daschle's confirmation hearing. The segment includes analysis from experts on a number of issues related to health care overhaul (Bowser/Suarez, "NewsHour with Jim Lehrer," PBS, 1/8).

This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.