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With Obama's presidency ascendant, there has been an outpouring of speculation as to if/when/how an initiative to reform the health care system will emerge. I turned into a hack promoting the purchase of Tom Daschle's book to encourage awareness of what may be coming down the pike. In today's Washington Post Davids S. Broder writes:
The Wall Street Journal has weighed in repeatedly:
Strap yourselves in, little dudes, it's gonna be a wild ride.
No one who knows the history of such efforts, from Harry Truman's administration through Bill Clinton's, needs to be reminded of the difficulties that inevitably confront any plan to overhaul one-seventh of the U.S. economy and bring high-quality medicine to millions of the uninsured.
But developments at both ends of Pennsylvania Avenue last week -- and across the country -- pointed up both the urgency of the problem and the prospects for seeing significant action.
When Barack Obama's transition team let out word that former Senate majority leader Tom Daschle would be his choice to run the Department of Health and Human Services and to quarterback his work on health reform, it signaled that Obama is serious about his campaign promise to make that issue a first-term priority.
Daschle would not leave a lucrative job at a law firm to twiddle his thumbs. Only with a clear understanding that the new president will put his own political capital at risk in this cause would the South Dakotan sign up for the job.
Daschle can be of great help to Obama in achieving the goal. He has made his own in-depth study of health-care issues and brings a genuine passion to the subject. And he knows the Senate, where past efforts have foundered.
There are positive signs within the Senate as well. Max Baucus of Montana, the chairman of the Finance Committee, one of the two main centers of Senate action, moved first by releasing a detailed outline of his preferred piece of legislation. Edward M. Kennedy of Massachusetts, the chairman of the other committee of jurisdiction -- Health, Education, Labor and Pensions -- quickly asserted his right to be at the center of action. He organized three task forces within his committee and reached out to Baucus to suggest that their staffs start exchanging ideas as well.
One issue that could have clouded House prospects was resolved when the Democratic caucus voted to make Henry Waxman of California chairman of the Energy and Commerce Committee, replacing John Dingell of Michigan. Both are skilled legislators; Waxman is closer to Speaker Nancy Pelosi.
A fast start is important because it takes untold hours to work through all the complex issues involved in comprehensive health care. When Bill Clinton delayed in getting Hillary Clinton's legislative proposal up to Capitol Hill until the end of 1993, his first year in office, he made it much easier for opponents to throw up roadblocks.
The architects of the Clintons' defeat were Newt Gingrich and Bob Dole, then the leaders of GOP forces in the House and Senate. Gingrich has now become an advocate for systemic change in the way health care is financed and delivered. His approach differs from Obama's, but it starts from the same premise: The current system is too wasteful and unproductive to be sustained.
And Dole, who in 1994 moved belatedly to opposing the Clinton effort as his own presidential ambitions rose, told me last week that today's circumstances make a repetition of those scorched-earth Republican tactics inappropriate. Instead, he is reminding Republicans of his own contributions to bipartisan successes -- the 1983 Social Security rescue and the passage of the Americans With Disabilities Act in 1990.
Dole and Daschle have both worked for the firm of Alston and Bird for the past few years, and it would not surprise me if Dole finds ways to be helpful to Daschle and Obama in the coming fight.
Some have argued that Obama will be forced to delay his promised effort at health-care reform, either because of the urgency of the economic problems facing the country or because there will be no money in the budget to pay for such an enterprise.
But every indication is that he will not wait. Indeed, he could well argue that the current plight of the Big Three automakers stems in part from the burden that Ford, General Motors and Chrysler are carrying for the failures of our employer-based health-care system. One of their basic competitive disadvantages stems from the fact that Japanese and other foreign carmakers are operating in countries where government and society as a whole -- not individual companies -- pay the costs of health care.
The Wall Street Journal has weighed in repeatedly:
One signal is yesterday's news that Barack Obama has selected Tom Daschle, the very liberal former Senate warhorse, to head the Health and Human Services Department. But an even clearer sign was last week's release by Montana Senator Max Baucus of a policy blueprint that closely resembles the one Mr. Obama campaigned on for 17 months. The plan is significant not only because its author is Chairman of the powerful Finance Committee, which oversees taxes and about half of all government spending. Mr. Baucus is also one of the more moderate, and cautious, senior Democrats.
If the Obama White House decides that reorganizing the 17.1% of the economy that the U.S. is likely to spend on health care in 2010 is a first-year priority, then Mr. Baucus's bill will be the place they start. Americans need to learn what they'd be paying for.
First, Democrats want the government to create a national insurance exchange, or marketplace, in which all comers could buy into a range of heavily regulated private policies at group rates. These private plans would then "compete" with a new public insurance option, i.e., a program managed by the government and modeled after Medicare. Lower-income earners would get subsidies to make coverage "affordable." Businesses that didn't cover their employees would pay a tax on some portion of their payroll.
The last cog is the "individual mandate." This requirement that everyone buy coverage has grabbed most media scrutiny of the Baucus plan, because Mr. Obama opposed it during the campaign. But the many moving parts don't work together unless the young and healthy foot the bill for care of the older and sicker -- one reason Hillary Clinton kept nagging Mr. Obama about the individual mandate during the primaries.
Strap yourselves in, little dudes, it's gonna be a wild ride.
It sounds like someone has been watching too much of 
