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.


Speaking to The Wall Street Journal’s CEO Council, President-elect Barack Obama’s incoming White House chief of staff, Rahm Emanuel, “challenged chief executives and other business leaders Tuesday night to join the new administration in a push for universal health care, saying incremental increases in coverage won’t be acceptable:”

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.