How Tom Daschle Might Kill Conservatism

The creation of a Federal Health Board sounds somewhat reminiscent of DHHS' National Center for Health Care Technology (1979-82) whose charge was to assess the value of established and new technologies. Although its tenure was short-lived, one should learn from the reasons for its demise.

Dennis Cotter of MD 10:30AM December 30, 2008

When the previous President claimed a mandate based on a .5% lead, he proceeded to make drastic changes in our government which resulted in declining incomes and a declining economy attributable to a war of choice. I think it is fair for President Obama to declare this a mandate, and it is fair for this reporter to call this election a landslide. Republicans lost the election because of the economy, and health care is an essential need which is unavailable completely to many who can not seek treatment under current government mandated programs with strict standards. McCain's position on health care was bad. It was not bad because he could not explain it. When people do not have money, they do not want to hear a plan for saving those non-existent capital resources. As to the point of the article, the Republican party will have to either accept this systems or create a viable private alternative. Unfortunately with the recent rash of corporate ethics controversies, 401ks disintegrating, and looming bankruptcy, the private market doesn't look as appealing. Most of the conservative parties in Europe have become more liberal and accepting of social programs of this nature. Once you value life over money, perhaps you will too.

Paul of NC 1:39PM December 09, 2008

It is time for a change. Too many people are are dying (upwards of 25,000 a year) because they cannot afford health care/necessary medications. Over a two year period. about 70 million people are at some point without health care.

Basic issue: health care should be a right in a civilized country! If it up to us working class seniors, we are going to make it happen for us and our children(Checkout the CHAMP bill in Congress).

Aaron Beckerman of 7:31PM November 30, 2008

If we want healthcare spending and the inequities of the current system to continue at their present rate of change, we should perpetuate the current system of incentives and disincentives.

Special interest groups are extremely successful in maintaining the status quo. Any attempt to be proscriptive in communicating a detailed plan to change the existing systems is sure to be met with fear mongering. Why should the special interest groups (the AMA, the American Hospital Association, drug companies, insurance companies, and supply companies) articulate a detailed plan to change our existing system when all they have to do is attach a label like, "Obamacare" or "socialized medicine" and they can effectively dissuade millions of Americans from changing our system?

Daschle, in his book, "What We Can Do About the Healthcare Crisis," recognizes the power of these special interest groups and suggests that Congress is incapable of keeping politics from affecting their decisions on healthcare. He acknowledges the complexity of the issues and suggests forming a Federal Health Board insulated from the political pressures associated with the normal legislative process. He points out that the Federal Reserve Board was established for much the same reasons that we need a Federal Health Board . . . . that a higher level of expertise is needed as is insulation from the many special interest groups.

Daschle queries, can you imagine how political the setting of interest rates would be if Congress made decisions on the federal funds interest rate?

I've been in hospital administration for 26 years and the problems to be overcome cannot be solved without mandated changes. Many of the needed mandates will save money . . . . but the people who benefit may not be the people who are asked to expend the resources to derive the benefits, i.e., information technology expenditures by hospitals will benefit insurance companies and governmental payers directly through lower healthcare utilization. Thus, we need to have an oversight group who can function independently (but who is accountable to Congress) so that we can begin to make some of the changes that are easy to make but which have been virtually impossible due to our system of misaligned financial incentives.

We currently spend 16% of our GDP on healthcare and that percentage is expected to grow to 20% by 2020.

I'm a conservative who thinks Daschle is on-target with his plan for a Federal Health Board that begins to reshape our national healthcare delivery system with the objective of reducing waste, aligning incentives, retaining both private and public payer sources, identifying and communicating best practices, treating the uninsured population before their conditions become expensive and advanced, retaining provider choice, and reducing costs.

Andrew Rybolt of OR 1:30PM November 26, 2008