Families USA Health Action 2008: Tom Daschle on Reform

Former Senator and Majority/Minority Leader Daschle gave the opening address on the 2nd day of the Families USA Health Action conference. Mr. Daschle has a new book coming out in March on America's health system and our past efforts to fix it.


I was honestly impressed with Mr. Daschle's grasp of the sweep of health care problems and how they play out. Mostly importantly, he was clearly aware of the deep challenges associated with getting meaningful change, given the industry's control of Congress and the policy-making process.

"One of the biggest tactical mistakes we've made, the opponents of health reform have defined the debate. As a result, we've lived under a number of myths. Perhaps the biggest myth of all is that the US has the best health system in the world. So before the debate can begin, we need to all understand the same basic facts. We need to understand how we got here and where we need to go."

"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."

Here are some elements of his platform.

- Establish an autonomous oversight body for health care comparable to the Federal Reserve for our monetary sector. We need to give this group the ability to control costs, starting with chronic disease, which represents the largest block of costs to the system.

- Investments in information technology would result in quantum leaps in efficiencies and quality improvements.

- Pooling would aggregate the risks/costs for small business and individuals.
- Negotiate drug pricing. Build on and leverage the purchasing volumes that government already  is responsible for.

- Prevention. Wellness, easy access and early intervention clearly saves enormous dollars.

- Comparative Effectiveness. As the Congressional Budget Office and Institute of Medicine have recently pointed out, an autonomous national institute that could use large data sets to identify the approaches that work best would clarify and unify clinical practice throughout America, and would have significant impact on both quality and cost.
- Transparency. We cannot fix our problems until we can see them more clearly.

- Medical Malpractice. Make it easier for physicians to make the best decisions, and protect them from frivolous legal actions.

- Patient-provider interactions. Take advantage of technology to smooth the flow of communications between patients and the health system.

- Universal Coverage. Increase access through health vouchers and coverage.

This is a much more thorough list than Ms. Pelosi offered, and Mr. Daschle seemed more aware of, sensitive to and committed to the political challenges represented by the relationship between Congress and health care special interests. While none of his recommendations are novel or particularly surprising, there is no question that Mr. Daschle's experience, access to governmental and business power, and clarity about what needs to be done represent important potential in the ongoing effort to actually get real change accomplished