U.S. Healthcare To Be Reformed

By Margarita Nahapetyan

Yesterday, former U.S. Senate Majority Leader Tom Daschle testified in his confirmation hearing for Secretary of Health and Human Services.

Mr. Daschle said if confirmed by the Senate he will work to make health care more affordable for more Americans. Health care reform is a top domestic priority for the incoming President-elect Barack Obama administration. Obama nominated Daschle to be his chief on Health Care Reform in December. In addition to being the secretary of heath and human services, Daschle would be a leader of the White House Office of Health Reform.

Members of both Senate parties offered a warm and friendly welcome to Mr. Daschle who wasted no time in picturing and describing a sense of urgency on the very important issue of health insurance. The senators expressed a big respect for their former Senate colleague and showed their willingness to collaborate with him on the hardest task of improving and reforming the expensive, dysfunctional health care system.

"I really want to work in a collaborative way," Daschle told committee members. "It's the only way are we going to get this done." He said it is unacceptable that one out of four Americans doesn't have health insurance.

About 46 million Americans, which is almost 15% of the population, have no health insurance at all. While Americans pay more per person for care than people in any other country, research shows that they are in a worse health, they suffer much more from medical mistakes, they have higher rates of newborn deaths, obesity, diabetes and heart disease, and are less happy in general with their medical care.

Mr. Daschle spoke passionately about the hardship he had witnessed himself among people without insurance, who he declared faced "total economic destruction" if they got sick. He suggested wider insurance coverage, lower costs, care which should be of a higher quality and more preventive, he repeatedly emphasized on keeping people well, suggested to invest more money for community health centers, electronic medical recordkeeping, and also vowed to restore confidence in federal agencies such as the Food and Drug Administration, which, in his words "lost the confidence" of Americans.

Mr. Daschle said he'll free scientists to do their job without any political pressure. "I want to reinstate a science-driven environment. I want to take ideology and politics, as much as possible, out of the process and allow the scientists to do their jobs," he added.

The former Senator recently wrote a book, "What We Can Do About the Health Care Crisis." In the book, besides the number of worrisome ideas proposed by him is the idea to create a "Federal Health Advisory Board." The board would offer recommendations and advice to private insurers to make a single standard of care for all public programs, including which procedures doctors may perform, what medication patients may or may not take, and how many diagnostic machines hospitals really need. Mr. Daschle calmly and with confidence predicts in his book, "the health-care industry would have to reconsider its business plan."

Mr. Daschle said he would gladly welcome any changes in the way Medicare paid doctors. At this point, Medicare has a fee schedule, which means that a separate fee for each service is being paid.

Instead of this arrangement, Mr. Daschle suggested that Medicare should pay for "healthy outcomes" and "episodes of care," which could include the work of doctors as well as hospitals in general.

"When health care reform collapsed in 1994," Mr. Daschle said, "I remember all the criticisms people had after the fact. They said it took too long, they said the process was too opaque, they said the plan was too hard to understand and they said the changes felt too dramatic".

"These are good arguments for undertaking reform in a way that is aggressive, open and responsive to Americans' concerns," he said. "They are not good arguments for ignoring the problem."

At present, most Americans receive their health coverage through a third party, leaving health-care decisions to an employer or the government. In an new system Americans will be given the opportunity to choose and purchase the insurance which better fits their needs, insurers would be pushed to focus mostly on patients. And when patients really have their own health plans only then will we see the accountability and flexibility needed to ensure quality care and necessary cost-lowering efficiencies.

Unfortunately, the hearing did not tell us much at all about how the incoming Barack Obama administration plans to pay for its health care programs or how Mr. Daschle will cope with the very real and very big differences his team has with Republicans on this and other important issues. President-elect Barack Obama and members of Congress suggest it is possible to insure all Americans without significantly raising total health spending. But Daschle did not offer any specifics of Obama's health care plan as well as he did not indicate how far and how fast Mr. Obama would go in efforts to remake the health reform.

Thursday's confirmation hearing was the first for an Obama cabinet nominee. Mr. Daschle may face very tough questions at a second confirmation hearing before the Senate Finance Committee, which has jurisdiction over Medicare and Medicaid and which will vote before the plan is presented to the full Senate.