Point Man on Health

Posted Jan. 25, 2009, at 6:45 p.m.

Tom Daschle, slated for secretary of the Department of Health and Human Services and director of a new White House Office on Health Care Reform, has already told President Barack Obama how to get started: “The next president should act immediately to capitalize on the goodwill that greets any incoming administration.”

In his 2008 book on the subject, Mr. Daschle went on: “If that means attaching a health-care plan to the federal budget, so be it. The issue is too important to be stalled by Senate protocol.”

The slim book, “Critical: What We Can Do About the Health-Care Crisis,” explains past failures and outlines a new system to serve all Americans.

A veteran of past losing fights on the issue, Mr. Daschle advocates a middle course that he hopes will attract bipartisan support. That means, at least for the present, avoiding the liberal dream of a “single-payer” plan like those of most other advanced nations, which cost less than half of the current U.S. health care system and provide generally better overall results. He recognizes that opponents have successfully demonized government-run systems as “socialized medicine.”

Nor does he want to break the present connection between employment and health benefits, even though many employers are reducing or dropping coverage and many, both large and small, find it an intolerable burden. He points out that many Americans are satisfied with their present plans and fear change.

He blames past failures partly on what he calls two myths that are still widely believed: first, that the United States has the world’s best health care system. For some, of course, it is superior, but it lags overall behind many foreign systems by such measures as longevity, infant mortality and access to service. His second myth is that we can’t afford universal health care. He contends that we can’t afford not to reform, since we now are “wasting money by paying top dollar for mediocre results.”

His “hybrid” solution involves building on what we have but taking it one step away from Congress. He would preserve the present system of Medicare, Medicaid, employer benefits, veterans’ benefits, private insurance and the special program that now serves federal employees and members of Congress. To cover the 46 million uninsured Americans, he would expand the present Federal Health Benefits Program, which already covers 8 million federal workers, their dependents and retirees. This would create a huge insurance pool with equal premiums and equal benefits. Employers could participate if they enrolled all their employees, not just those with health problems.

Since health care details are too complex for either Congress or the American public to plan or manage, he would put them into the hands of a Federal Health Board, a body of experts appointed by the president and confirmed by the Senate for 10-year terms.

If, as Mr. Daschle suspects, most members of Congress would be glad to avoid controversial health policy decisions, his plan may have a chance where others have failed.

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