Daschle Makes Case for Appointment to HHS Post
By Emily P. Walker, Washington Correspondent, MedPage Today|
Published: January 08, 2009
WASHINGTON, Jan. 8 -- Tom Daschle, picked by President-elect Barack Obama to be Health and Human Services secretary, said medical trainees should have school loans forgiven and receive other incentives to choose careers in primary care.
Daschle told senators at his confirmation hearing today he wants to send a message to medical students: "If you take this route, we're going to find ways to ensure that you have the financial wherewithal to become that front-line provider that we need."
Daschle testified before the Senate Health, Education, Labor, and Pensions (HELP) Committee, chaired by Edward Kennedy (D-Mass.).
Senate approval is expected for the well-liked ex-senator from South Dakota. Republicans on the committee gave him a friendly reception at the hearing, and Orrin Hatch (R-Utah) announced he would support Daschle's nomination.
Daschle told the committee he has been laying the groundwork for a healthcare reform plan, which he said cannot be dictated from the White House and Congress.
He advocated a more grassroots approach and said he's taken ideas from Obama's transition Web site, which has received tens of thousands of comments, and from local community health forums in the last several months.
Daschle said the Centers for Medicare and Medicaid Services should save money by moving to a medical-home care model and steering its focus toward prevention and wellness rather than paying for disease treatment.
The CDC should better utilize community-based prevention efforts, like smoking cessation and weight loss programs, Daschle said. He said he would "revitalize" CDC's ability to detect and investigate health threats and focus on better coordination between public and private entities.
Daschle promised to restore trust in the FDA, citing a survey that found nearly two-thirds of Americans don't believe that the agency can ensure drug safety and effectiveness.
"Ensuring the food we eat and the medications we take are safe is a core protection that American people deserve and a core responsibility of government," Daschle said.
Daschle said all the agencies he would oversee need to operate with fewer political motivations.
"I want to reinstate a science-driven environment," he said. "I want to take politics out of it as much as possible and allow scientists to do their job."
Daschle said the National Institutes of Health budget is so limited that only 10% of grant applications are funded.
"I will work to strengthen NIH, with leadership that focuses on the dual objectives of addressing the healthcare challenges of our people and maintaining America's economic edge through innovation," he said.
Although the HELP committee traditionally holds confirmation hearings for the HHS post, the Finance Committee will hold its own hearing and have final say on whether to advance Daschle's nomination to the Senate floor. That hearing has not been scheduled yet.
The HELP committee's senior Republican Michael Enzi (R-Wyo.) said the last two HHS secretaries were confirmed within two weeks of their appearances before the HELP committee.
Daschle served three terms in the Senate and was minority leader from 2001 to 2004, when he lost a re-election bid. He joined the Center for American Progress, a Democratic think tank, as a senior fellow and has advised the lobbying firm Alston & Bird.
He published a book on health care in 2008, Critical: What We Can Do About the Health-Care System. Enzi said he had recommended it to all his staff.
Today's hearing was also notable for the appearances of Kennedy, who appeared healthy and fit despite his recent bout with malignant glioma, and Robert Dole, the former GOP senator from Kansas.
Dole introduced Daschle, saying Congress and the public appear ready to address healthcare reform.
Dole, as leader of Senate Republicans in the early 1990s, had engineered the defeat of the Clinton administration's reform proposal.
He now works with Daschle at Alston & Bird.
Expensive, mediocre and too often unavailable. That about sums up the nation's health care system, former Senate Majority Leader Tom Daschle, President-elect Barack Obama's choice to head health and human services, said Thursday.
Daschle says health care system broken
Has easy confirmation hearing
Friday, January 9, 2009
Tom Daschle told a Senate committee Thursday he is ready to "change the paradigm in this country on health care" if he gets the job as Health and Human Services secretary, receiving a friendly reception from the panel and paving the way for his expected confirmation.
The South Dakota Democrat gave few specifics on his plans for health care reform during his confirmation hearing before the Senate Health, Education, Labor and Pension Committee. Instead, he focused on the broad theme that the nation's health care system is severely broken and will drag down the economy further unless fixed.
"The flaws in our health care system are pervasive and corrosive," he said. "They threaten our health and economic security."
The former Senate majority leader added that the nation's health care strategy has failed to adequately stress preventative care. He named childhood and adult obesity as among the nation's greatest health threats.
"Coverage after you get sick should be a second line of defense," he said. "Today, it's often the first line of defense."
Mr. Daschle's appearance before the panel was the first of a bevy of confirmation hearings to take place on Capitol Hill during the next few weeks for President-elect Barack Obama's Cabinet nominees.
The health committee won't vote on whether Mr. Daschle's nomination should be sent to the full Senate for a vote. Instead, that responsibility lies with the Senate Finance Committee, which has yet to schedule its own confirmation hearing.
Mr. Daschle, an early supporter of Mr. Obama's presidential bid, is a strong proponent of the president-elect's health care reform plan that includes some form of universal insurance coverage -- a position opposed by most Republicans.
But Mr. Daschle faced little resistance from Republican or Democratic members of the committee during the more than two-hour hearing, suggesting he will have little trouble securing the nomination.
"Tom Daschle understands the urgency and the challenge of health reform," said Sen. Edward M. Kennedy, Massachusetts Democrat and committee chairman. "Reform is urgently needed and Tom Daschle is just the person for the job."
Republican Sen. Orrin G. Hatch of Utah said Mr. Daschle "will make a great secretary of Health and Human Services and I intend to support you when you're there as well."
Sen. Michael B. Enzi of Wyoming, the health committee's ranking Republican, did warn Mr. Daschle against expanding insurance coverage through more government bureaucracies, such as Medicaid.
"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," he said. "Any new insurance coverage must be delivered through private health insurance plans."
The former senator also has plenty of opponents off Capitol Hill, who say his proposals for government mandates would trample physician-patient privacy rights, among other criticisms.
"Daschle's proposal is incompatible with the traditional Hippocratic Oath," said Robert E. Moffit, director of the Center for Health Policy Studies at the Heritage Foundation, a conservative think tank. "Moreover, health insurers should be able to innovate in the coverage of medical services without waiting for permission from a special class of political appointees."
But the American Federation of Government Employees, the nation's largest federal employee union, issued a statement Thursday endorsing Mr. Daschle, saying he has "the experience, knowledge and tenacity to get the job done."
Health secretary pick seeks health care overhaul
By KEVIN FREKING - 19 hours ago
WASHINGTON (AP) - Tom Daschle told former Senate colleagues on Thursday that as health secretary he would learn from former President Bill Clinton's failed attempt to overhaul health care, an effort criticized as too long, secretive and hard to understand.
"These are good arguments for undertaking reform in a way that is aggressive, open and responsive to Americans' concerns," Daschle said at a hearing. "They are not good arguments for ignoring the problem."
Daschle, President-elect Barack Obama's choice to head the Health and Human Services Department and the former Senate Democratic leader from South Dakota, kicked off the Senate's hearings on Obama's Cabinet designees. It was friendly territory as lawmakers he once served with offered praise but few tough questions for what will be a difficult and expensive assignment.
The Senate's Health, Education, Labor and Pensions Committee summoned Daschle, although the Senate Finance Committee will be the panel that votes on the nomination. Most analysts expect Daschle will have little problem winning confirmation as HHS secretary.
He described the U.S. health care system as expensive, mediocre and too often unavailable to those in need. Another former Senate majority leader, Republican Bob Dole of Kansas, helped introduce Daschle at the hearing. Dole said Daschle had a strong understanding of health care and knew how to get things done.
"If anyone understands Congress, it's Tom Daschle," Dole said.
Daschle told lawmakers they would be partners in whatever plans were developed to improve the system.
"President-elect Barack Obama recognizes that many of you have been working for many years on these issues, and that any effort at reform will require close collaboration with Congress," Daschle said.
Sen. Edward M. Kennedy, the committee chairman, began the hearing with the first of several warm welcomes for Daschle. "Reform is urgently needed and Tom Daschle is just the person for the job," said Kennedy, D-Mass.
In the coming months, Kennedy's committee is expected to help craft legislation to expand health insurance coverage. Lawmakers were eager to get Daschle's perspective.
Republicans said they want to work with Daschle on overhauling the system and asked for his assurance he would seek their advice. "It's the only way we're going to get something done," said Wyoming Sen. Mike Enzi, the committee's top Republican.
Enzi voiced concerns about possible Food and Drug Administration regulation of tobacco products, which Obama supports. Such regulation would amount to the FDA giving its "stamp of approval" on cigarettes, Enzi said. But Daschle said it would not be construed that way.
Sen. Richard Burr, R-N.C., mentioned Obama's proposal to reduce payments to private insurers that administer Medicare benefits to the elderly and disabled. Burr said the program, called Medicare Advantage, was crucial to giving rural people a choice in how they get their health benefits.
"We have to look at whether we're getting our money's worth," Daschle replied.
Daschle has made it clear in the past year that he believes Congress must move fast on health legislation. Kennedy thinks so, too. His staff has spent recent months meeting with trade and interest groups that have much at stake in the issue.
Obama has put Daschle in line for two prime jobs: health secretary and director of a new White House office on health reform. In previous administrations, the White House and not the Cabinet agency has led attempts to expand coverage.
Daschle told lawmakers it was unacceptable that 1 in 4 people in the United States don't have health insurance coverage. He said that's only part of the problem, though. Incentives for reimbursing health care providers are not focused enough on prevention. Also, costs are rising too quickly as insurance premiums rose three times faster than overall inflation during the past nine years.
"Any health care reform plan must achieve the three goals of increasing access and quality while containing cost," Daschle said.
Daschle said one point of emphasis will be on lowering drug prices for consumers. For example, he said he would support giving the secretary of HHS authority to negotiate drug prices on behalf of Medicare participants.
"I think that there's a great deal to be said for that," he said. "I've supported it in the past, and I'd support it in the future."
Critics of that approach say that the private sector is better at generating price concessions than the government.
Daschle also voiced support for reducing a coverage gap in the Medicare drug benefit, known as the doughnut hole, where insurance no longer covers part of the cost of a participant's medicine.
"It's a very expensive fix," Daschle said. "We'll have to work together to see how we find solutions to that."
Former President Clinton pushed a universal health care plan, developed at the White House under first lady Hillary Rodham Clinton, but it failed to gain congressional approval and helped Republicans win control of the Senate and House in 1994.
Editorial NY Times
'Cuddly Welcome for Mr. Daschle'
Published: January 8, 2009
The main thing we learned from Tom Daschle's confirmation hearing in the Senate on Thursday was that President-elect Barack Obama sure picked the right man to stage manage his health care reforms as secretary of health and human services and as health czar at the White House. The hearing before a Senate health committee 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.
Unfortunately, the hearing did not tell us much at all about how the incoming Obama administration intends to pay for its emerging health care programs or how, for all of his smoothness at the hearing, Mr. Daschle will deal with the very real and very big differences his team has with Republicans on this and other vital issues.
Instead, the senators avoided asking such tough questions, and Mr. Daschle bent over backward to reassure Republicans that he would not try to ram anything too unpalatable down their throats. He pledged to cooperate with Congress on an aggressive, open reform effort that would be guided by evidence, not ideology.
When Senator Mike Enzi, the ranking Republican on the committee, asked if Mr. Daschle would share information with members of both parties and respond rapidly to their requests (something the Bush administration rarely did), Mr. Daschle answered unequivocally, "yes." More telling, when Mr. Enzi asked if Mr. Daschle would discourage the use of budget reconciliation, a process that prevents filibusters and would allow a simple majority to approve health reform legislation, Mr. Daschle again said, "yes."
That seemed to indicate that the Democrats will be pushing for reforms that can command support from large bipartisan majorities in Congress. Yet the seeds of partisan conflict are already being planted. Mr. Enzi issued a press release warning against expanding insurance coverage through government-run bureaucracies like Medicaid and asserting that any new coverage must come through private health insurance plans.
If he meant that literally, he would have to oppose major elements of the Obama health plans, which envisage expanding existing public programs and probably adding a new public program to compete with private plans. Of course, if the Republicans become too obstinate in blocking major elements they don't like, Democratic leaders in the Senate could choose to close off debate no matter what Mr. Daschle has recommended.
There were few if any surprises in Mr. Daschle's broad-brush statements on policy. He wants wider insurance coverage, lower costs, higher quality care, more preventive care, an emphasis on keeping people well, greater use of information technology, more money for community health centers, a stronger Food and Drug Administration and speedier approval of low-cost generic drugs, among other issues.
He gave no indication of how to pay for all this or how to rein in the escalating costs of entitlement programs, and he was not asked such probing questions by a committee that seems certain to recomme