There was a lot of hand-wringing this week among the left about Tom Daschle's newly released health care proposal and how it "undercut" the Obama administration on the public option.
Via ABC:
In a blow to President Obama and many of his Democratic allies in the health care fight, the plan recommends that there be no federal public option, but rather state or regional public-sponsored networks that would compete with private health plans, according to the summary released today by the Bipartisan Policy Center.
It's interesting that this is characterized as a "blow" to Obama. The media seems to assume that a year-long study directed by the guy who Obama wanted as his "Health Czar," which was praised by the Obama administration, is somehow counter to Obama's wishes.
Of course, Daschle (supposedly pictured in the "Senate portrait" above, although the resemblance is somewhat dubious) is viewed with suspicion after his tax problems and extensive lobbyist efforts were made public during HHS confirmation dealings. So what does the Daschle/ Dole deal contain exactly?
The root of the plan is a reformulation of the incentives that guide our health care system. The delivery of health care would be tied closely to pay-for-performance initiatives; payments for low-value services would be reduced. Community-based "chronic health teams" would be dispatched to at-risk areas to provide care for those with chronic care. Over time, these delivery reforms -- so far unspecified -- would be integrated into medical education for health professionals. The leaders say they'd realign reimbursement in federal programs to patient outcomes over time.
There'd be an individual coverage mandate; insurance companies would be required to cover everyone and there would be limited variation of premiums, although patients would be able to alter their premiums in exchange for "healthy behavior," like losing weight. There'd be lots of tax credits for employers and municipalities who implemented wellness programs that worked.
There's no "public plan" per se, but there'd be a "federal fall back" if the insurance companies didn't or couldn't implement cost-cutting and efficiency measures on their own.
Writing for the government watchdog Sunlight Foundation, Paul Blumenthal takes a more cynical view:
Today, former senators Tom Daschle and Bob Dole released a plan for health care reform that is being hailed a bipartisan way forward. Headlines blare about the Daschle/Dole plan for health care. But were these two to not have had illustrious careers in the Senate, the headlines would tell a far different story: “Health Care Lobbyists Release Health Care Plan.”
Both Daschle and Dole work for a major Washington, DC lobbying firm, Alston & Bird. Many of Alston & Bird’s major clients are from the health care sector including the American Hospital Association, HealthSouth Corp, and pharmaceutical companies Abbott Laboratories, Bayer, Celgene, and Mylan Laboratories. In total, Alston & Bird is currently representing 31 clients from the health care sector. Of the $2,730,000 reported income received from clients, nearly 50% of that, $1,070,000, comes from these 31 health care clients.
Not being a health care expert myself, I'll leave others to assess the merits, or lack thereof, of the plan. But does the Daschle-Dole proposal represent a betrayal of Obama? I suppose it's possible that Daschle has "gone rogue" since being defeated as HHS Secretary. But a mountain of evidence points in the opposite direction.
People tend to forget that Tom Daschle, largely disliked or viewed suspiciously among the activist left, played a major role in launching the career of Barack Obama. Peter Rouse, Daschle's longtime Chief of Staff and one of the most powerful non-Senators in the Senate, took Obama under his wing as soon as he entered the Senate. Today, Rouse is in the White House - in fact, he is one of only three people who can claim the title of "Senior Advisor" to the President (the other two are David Axelrod and Valerie Jarett).
Other members of Team Obama were also culled from the Daschle camp. Robert Gibbs, for instance, was handpicked by Daschle for DSCC spokesman.
While Obama was busy fighting Hillary Clinton for the Democratic nomination, Daschle was already working on health care. He was giving speeches, and one might say, greasing the wheels a little bit. The Health Industry Distributors Association forked over a cool 14k for a speech on "the impact an Obama administration will have on the industry." He pulled in another 20k for a single speech in front of America's Health Insurance Plans, an insurance lobby group.
He also published a book laying out his solutions for health care. Somewhat amusingly, the "Advance Praise" reads like a who's who of the health care effort:
“I may not agree with some of the political statements but Senator Daschle is right on target on the need to start a serious dialogue on health care for Americans. His thoughtful health-care proposals will move the process forward. Senator Daschle and I agree on the need for nonpartisanship in coming to grips with this number one domestic problem.”
—Bob Dole, former Senate majority leader
“The American health-care system is in crisis, and workable solutions have been blocked for years by deeply entrenched ideological divisions. Sen. Daschle brings fresh thinking to this problem, and his Federal Reserve for Health concept holds great promise for bridging this intellectual chasm and, at long last, giving this nation the health care it deserves.”
—Senator Barack Obama (IL)
“This book provides real solutions for America’s broken health care system.”
—Senator Harry Reid (NV), Senate majority leader
“Critical provides answers to one of the most vexing challenges of our time.”
—John Podesta, president and CEO of the Center for American Progress and a former White House chief of staff
All in all, Daschle didn't make out too bad:
Daschle made nearly $5.3 million in the last two years, records released Friday show, including $220,000 he received for giving speeches, many of them to outfits that stand to gain or lose millions of dollars from the work he would do once confirmed as secretary of Health and Human Services.
In April, 2008 he launched the Bipartisan Policy Center effort with Dole, whose findings were released last week.
The culmination of all this was supposed to be Daschle's ascent to the role of Health Czar in the Obama administration, a nomination that strangely went down in flames over some tax issues while the press largely ignored or played down his industry ties. But Daschle appears to retain prominence in the Democratic health care effort:
The White House praised the Bipartisan Policy Center’s approach in a statement that continues to touch on only the broadest of goals.
"This group of extraordinarily experienced legislators agree with the President that health reform must be enacted this year because the status quo -- skyrocketing health care costs, rising premiums, swelling deficits – is unsustainable," said White House Press Secretary Robert Gibbs.
"With this report, they have demonstrated what can be achieved with bipartisan effort. The Bipartisan Policy Center has produced a significant report, and the White House applauds their efforts," added Gibbs.
Does that mean that Obama/ Daschle health care reform will be 100% bad, or a boondoggle? Not necessarily.
But the media, and the left, should pay closer attention to the players involved, especially when they are surprised that Democrats waver on "core principles" like the public option. Because what is NOT present here is a process free from influence by the industry players. To the contrary, one could argue they are helping direct the process.
UPDATE: Some commenters below don't seem to be able to believe that Dashcle's lobbying efforts have a thing to do with his HHS nomination. Let me suggest that, contrary to being damaging to the Dem effort, exposing the extent of industry influence could shame Congress sufficiently to create a STRONGER push for a public option. Or, as former Presidential candidate (and co-author of the current plan) Bob Dole famously said: