For immediate release:
Tuesday, January 31, 2006
12:01 a.m. EDT


Christopher Fleming

Daschle Calls for Comprehensive Health Care Reform; Sees Conditions As Increasingly Ripe For Change 

Former Senate Democratic Leader Voices Concerns About High-Deductible “Consumer-Driven” Plans To Be Touted By President In State Of The Union Address

Bethesda, MD — On the eve of the State of the Union address, former Senate Democratic leader Tom Daschle (D-SD) predicts the passage of fundamental health care reform and expresses skepticism about the high-deductible, “consumer-driven” plans that President Bush is expected to promote in his address.

“You’re going to see increasing pressure on Congress and on future presidential candidates to address the problems associated with health care,” Daschle tells Robert Galvin, M.D., General Electric Corp.’s director of global health, in an interview published today on the Health Affairs Web site. Citing a history of failed attempts at incremental measures both in this country and abroad, Daschle argues that only a comprehensive overhaul that deals with all of the health care system’s interrelated moving parts can succeed.

Daschle thinks that the filibuster-proof reconciliation process, with its bare majority, fifty-one-vote threshold for passage, could be the vehicle that delivers this long-elusive fundamental change. “If we had only needed fifty-one votes in the early 1990s, we would have passed health reform. We didn’t have sixty, but we had more than fifty-one,” the South Dakotan says.

Reconciliation should not be the initial strategy for health care legislation because “on something of this magnitude, there ought to be a supermajority,” says Daschle, now a distinguished senior fellow at the Center for American Progress. But, “at the end of the day, if all we had was fifty-one votes, I’d take it.”

Daschle points to the federal reserve system, through which the U.S. determines and implements monetary policy, as a template for a revamped health care system. The federal reserve model “works, in large measure, through the private sector, but is governed, in large measure, by decisions made within a federal infrastructure, and a governmental infrastructure at that,” he explains.

Daschle acknowledges that many powerful interests with stakes in the current system — including “insurance companies” and “some physicians, specialists in particular” — have torpedoed past attempts at change and would seek to do so again. Asked by Galvin what would be different this time around, Daschle points to the burdens rising health costs are placing on American companies. “I hope and expect that businesses will become much more proactive than they have been in the past” in seeking reform, he says.

Galvin, however, says that businesses, disillusioned with the ability of government to change provider practice patterns, are not likely to line up behind the type of reforms Daschle envisions. Instead, employers are moving toward engaging consumers through information and incentives. One form of this engagement are the so-called consumer-driven coverage arrangements, which involve high-deductible insurance policies coupled with tax-favored savings accounts: “The view is that, if you give consumers proper incentives, give them information and choice, and make them more financially responsible for their health care, you’ll stimulate forces that have been very effective in driving value in other sectors.”

Consumers with a financial stake in their health care will “end up choosing doctors and hospitals that are going to give them better care at a better price,” Galvin maintains. But Daschle notes that many Americans, including most South Dakotans, often “don’t have the luxury of choice to begin with. You don’t have the luxury of selecting from many specialists.”

Moreover, even when a selection of providers is available, Daschle tells Galvin, “I don’t think that we have empowered our patients with the information to make the choices that you, arguably, could persuade me are necessary.”

The interview can be read at


Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at


©2006 Project HOPE–The People-to-People Health Foundation, Inc.