Former Senator |
September 23, 2009 – The nation could be entering a historic turning point as lawmakers seek to transform nearly one-fifth of the nation’s economy, former Senator and Health Secretary Nominee Tom Daschle told the national Medicaid Drug Rebate Program conference in Chicago on Tuesday.
Equally historic, he said is the fact that all stakeholders in the health care debate — including many of the leading manufacturers attending the conference — are still at the table willing to move forward with reform in some fashion.
The challenge facing Congress now, Daschle said, is figuring out who pays what to finance health care reform — and overcoming disagreements over such critical questions as whether health insurance should be mandatory, whether to allow insurance to be sold across state lines, and how big the government’s role should be in the new system.
But to those who suggest that government has been disproven as an insurer and should be disqualified from a role in health care reform, Daschle noted that public programs already account for 40 percent of the health care market and that the nation’s 1,300 private insurers struggle with the same bureaucracies and inefficiencies as do government-run programs.
The goal, he said, should be to simplify the health care system to help private and public players alike cut costs.
“I think it’s a misnomer to say this is a government take-over, because the public-private system will stay in place,” Daschle, 61, told a conference room full of mostly drug manufacturers and their consultants.
“The question is whether we can create a framework that allows the maximum degree of involvement by the private sector, with the maximum degree of choice, the maximum degree of competition, and the maximum degree of transparency. That to me is what the goal of this health reform effort is: create that balance and to find ways to simplify the system to allow what works well to work better.”
History in the making, former Senator says
Since losing his Senate seat in 1994, Daschle has worked for the Washington law firm Alston & Bird as a special policy advisor, serving clients in the health arena.
He co-authored “Critical: What We Can Do About the Health-Care Crisis,” a 2008 book that laid out a framework for reform.
He was nominated by President Barack Obama to serve as Secretary of Health and Human Services but withdrew his nomination amid controversy over unpaid taxes. Daschle remains a critical voice in the health care debate, advising the Obama Administration and traveling the country to speak on reform.
“You could not have picked a more appropriate time to hold this conference,” he said Tuesday. “We will make history, one way or another.”
The Senate Finance Committee on Tuesday began to plow through no fewer than 564 amendments that have been introduced to tweak the health care reform bill the committee released last week. Manufacturers are following their proceedings with a mix of angst and hope, with many acknowledging that they will both lose and gain if proposals to raise Medicaid rebates and make health insurance mandatory become law.
Daschle ran down the numbers to explain why reform may succeed in 2009 after failing for the past 70 years: 48 million residents in the U.S. are uninsured, 48 percent of the insured can’t afford all the care they need, 10,000 people lose health insurance every day — with insured Americans carrying the cost for the uninsured to the tune of $1,100 annually.
The United States is the most expensive country in the world for health care, charging its residents more than $8,000 a year on average in premiums, taxes and out-of-pocket expenses. And yet, the country ranks 37th in health outcomes, he noted.
Part of the problem, he said, is that while other countries start at the bottom of the health care pyramid and focus on primary care and wellness, the U.S. starts by sending its patients to the top to see the most expensive specialists and undergo the costliest procedures.
Today, there is consensus in Congress to shift the system toward wellness and prevention, he said. There is also strong support in Congress for coordinated care. This includes giving pharmacists an enhanced role in consulting with their patients on the effects of their medications, and authorizing them to be paid for such work.
“Medication therapy management is increasingly seen as a proven way to improve access, reduce cost and ensure better quality,” Daschle said. “Every member of Congress realizes that there is tremendous progress that could be made in this regard. And the key to medication therapy management is fair reimbursement.”