Signs And Portents On Health Care Reform

It's not January 20th, yet. We don't have a new President (and not to disappoint David Letterman, he can't start early). But there are interesting things happening out there on health care reform that one should take notice of.

To start off with, there's the Max Baucus white paper of general principles toward health reform. This put health reform front and center for debate and discussion even before the inaugural.

Next was Ted Kennedy announcing health care working groups, including this:

One group, led by Senator Tom Harkin of Iowa, will work on prevention and public health. Another led by Senator Barbara Mikulski of Maryland will work on improvements in the quality of care. And the third, led by Senator Hillary Clinton of New York, will work on insurance coverage.  

The above is important because one of the major criticisms of the push during the Clinton years was that it was an executive (i.e WH) crafted program with little input from either Congress or the public. That's what made it so vulnerable to Harry and Louise commercials. This time, it's starting with Congress.

Next is incoming CoS Rahm Emanuel, from a WSJ article:

President-elect Barack Obama's incoming White House chief of staff challenged chief executives and other business leaders Tuesday night to join the new administration in a push for universal health care, saying incremental increases in coverage won't be acceptable.

Finally comes today's announcement that

According to CNN's Ed Henry, Tom Daschle will serve not just as Secretary of Health and Human Services, but will also be the administration's point person on the push for a universal health care plan. (A push that Rahm Emanuel apparently has gotten behind.)

More from WaPo:

Daschle, a South Dakota Democrat, will also reportedly be given a policy portfolio that stretches beyond the department in order to help shepherd health care reform legislation in 2009.

There are a couple of thing to be gleaned from reading the tea leaves.

1. The new administration seems serious on spending political capital early on health reform.

2. The approach is coordinated (Emanuel and Daschle appear to be the same page, whatever that page is, and Kennedy and Baucus are interested in Congressional action) and won't be just from the WH.

3. There is a domestic focus from the new (and not-so-new) kids in Washington that's been seriously lacking.

4. This is one of the areas where one can truly say "elections have consequences". One consequence is the dearth of GOP Senate "old bulls" (Stevens, Dominici, Craig, Lott, Warner) inclined to oppose this. One suspects Senate attitudes – the Senate is where health care bills usually go to die – will be a tad different in the next Congress.

5. The biggest question on the table is the (decades-old) debate between expanding coverage and controlling costs. Any program that suggests progress on both will get an interested hearing from Congress, business and the public.

6. If health reform were easy, it'd have been done by now. Expectations should be dampened until we see the work product, particularly on the Congressional side.

7. With Tom Daschle at HHS, another side-issue is whether public health will get the attention and respect it deserves (it needs to be funded properly as part of health reform). It will help to have a star-power figure at HHS. So, what's next for CDC?