You don't have to look too far to find the views of former Senate majority leader Tom Daschle, President-elect Barack Obama's nominee to be his health and human services secretary. They can be found in his February 2008 book, Critical: What We Can Do About the Health-Care Crisis, which outlines his provocative ideas, including establishing a Federal Health Board modeled on the Federal Reserve System.
Bottom Line: Former Senate majority leader and current Secretary of Health and Human Services nominee, Tom Daschle, outlines his health care reform views.
Author: Thomas A. Daschle
Publication Date: 2008
What It Covers: Daschle provides his vision for reformed health care, "a seamless, value oriented system that offers affordable health care to everyone. Whatever plan we come up with, it must expand access, lower costs and improve quality. Making sure everybody has insurance is essential. If we don't reach that goal, it will be difficult to control costs and improve quality."
He identifies problems with other models for overall reform and states we should avoid "a ‘pure model' system....we should build on the one that we have." Specific key elements of his coverage proposal include:
- Keep individuals in employer-based system or government program like Medicaid, State Children's Health Insurance Program (SCHIP), and Medicare, but expand Federal Employees Health Benefits (FEHB) Program or create a group purchasing pool like it
- One option under expanded FEHB Program would be a Medicare-like government run program with bargaining power and administrative efficiencies
- Government would provide financial help on sliding scale, perhaps peg premium to percentage of income, administered as a refundable tax credit
- Strengthen Medicaid, eliminate disparities between states, and close gaps in coverage
- Increase prevention, mandate mental health parity in coverage, and expand access to dental care
He also addresses a crucial element of reform called the Federal Health Board that would be modeled on Federal Reserve, emulating its neutrality and reliance on experts. This board would have enormous responsibly and influence to:
- Set rules for expanded FEHBP and promote competition, curb admin costs and protect consumers in the pool; and work to develop public insurance option
- Promote high-value medical care by recommending coverage of those drugs and procedures backed by solid evidence and suggest research priorities for National Institutes for Health (NIH) and others
- Align incentives with high-quality care-pay providers based on health outcomes rather than services delivered
- Make the health care system more transparent, removing secrecy from success rates and prices, and
- Rationalize health care infrastructure by creating a map to guide resource investments.
Recommended For: Anyone interested in health care reform in the government, non-government and the private sector.
About the Author: Tom Daschle is a former U.S. Senator and Senate majority leader from South Dakota. He is currently a special policy advisor at the law firm Alston & Bird LLP, a visiting professor at the Georgetown Public Policy Institute, and a Distinguished Senior Fellow at the Center for American Progress.
Currently, Daschle is the nominee to run the Department of Health and Human Services (DHHS).
Excerpts:
"The consensus in the middle of the political spectrum, among both Democrats and Republicans, is that we should create a public-private hybrid that preserves our private system within a strengthened public framework."
"We take great pride in our high-tech medical equipment, but our health-care system is incredibly primitive when it comes to using the information systems that are common in American workplaces. Only 15 to 20 percent of clinicians have computerized patient records, and only a small fraction of the billions of medical transactions that take place each year in the United States are conducted electronically....We are years if not decades behind European nations in harnessing in health care information technology's potential."
"...the American people need to know that decisions on coverage and cost are being made for the public good, and aren't tainted by politics or special interests...Professional expertise and trustworthiness-these are qualities that Congress lacks when it comes to health care. But there is a way out of this predicament. In other areas where Congress has these deficiencies, we've delegated power to quasi-independent entities comprised of credible experts who are immune from political pressure. I believe health care calls for the same approach."
"In our fragmented health-care system, only the federal government is in a position to develop national quality standards that everyone would follow."
"A reformed health care system also should place a greater emphasis on treating chronic conditions...care for people who are chronically ill has to be collaborative since it often involves multiple providers. Communication between patients doctors and caregivers is crucial and health information has to follow patients as they move from to doctors office to hospital to nursing home and back...yet too often doctors and hospitals in our country operate in isolation providing care without have complete information about a patient's condition, medical history, or previous care they might received."
"In a health care system with so many actors, there is only one with the clout to improve quality and control costs: the federal government."
Suggested Backdrop: Certainly not at a hospital; what could be more depressing than health care reform? But if you are a health care policy wonk or just fed up with the system and need yet another dose of health reform medicine, this book may not be the panacea, but it will certainly suggest some treatments.
OhMyGov! Rating: Having seen what a political land mine health care reform can be (e.g., Hillary Clinton), we are keeping our fingers crossed: 3 out of 4 stars.