Daschle Appointment Confirms Health Care Change to European Type System Coming
Multiple sources including MSNBC which has become Barack Obama’s personal news service have announced that former Senator Tom Daschle will be named to the Cabinet to head the Department of Health and Human Services. While Senator Daschle has been a key figure in the Obama campaign he also has spent the last two years traveling around the country as a Senior Fellow for the liberal think tank, The American Center for Progress, holding forums and has written a book, Critical: What We Can Do About the Health Care Crisis, which offers a detailed plan for changing the American health care system.
The Reorganization and Restructuring of the American Health Care System
A Federal Health Board (FHB) will be created for health care to work similar to the Federal Reserve for banking. Daschle has looked at models in Europe and Canada for inspiration on this idea. The members of this board would be appointed like the members of the Federal Reserve. The job of the FHB will be far reaching. Standards for medical practice, hospitals, drugs, health insurance, acceptance of new technology, approval of hospital resources, and research funding will come under the authority of the FHB.
Medical insurance will be based upon the Federal Health Benefits Program. Private insurance will have to meet federal standards set by the FHB to work allowed. In addition Medicare, Medicaid, Indian Health Care and Veteran’s Health Care systems will continue.Individuals or families that do not qualify or cannot get private insurance will get a basic program from the Federal government probably by extending Medicare/Medicaid.
In forums across the country Senator Daschle has presented 10 key points to his program
- America’s health care system should be a combination of a private system and the public system now in place through programs like Medicare, the Indian Health Service and the Veterans Administration.
- Universal access should be a universal goal.
- Any new system should be based on a model “that we know works,” the Federal Employee Health Benefits Program.
- Policy-makers should recognize the need for “complete care,” which would include insurance coverage for mental health services and dental insurance.
- Incentives should shift to wellness and prevention away from expensive disease treatment after a patient is sick.
- Transparency is needed. Deaths and injuries should be subject to federal review and public reporting such as takes place under the Federal Aviation Administration after a plane crash. Daschle said physicians and others should get safe harbor from lawsuits if they follow best practices.
- Records should be computerized to avoid the sea of redundant paperwork now in place.
- Eliminate unnecessary care. Of the $2.4 trillion spent on health care each year, some estimate $700 billion is unnecessary.
- Shift from a fee for service, which promotes lots of procedures (see Nos. 5 and 8), to payment based on the quality of health of patients.
- A governing authority, a Federal Health Board, should oversee the system as the Federal Reserve oversees the banking system.
What Changes Are Going to Happen?
Given the fact that President Elect Obama has essentially a filibuster proof Senate and add in the fact that the reducing the cost of health care will be necessary to increase the employment, I am expecting quick action on the health care plan. Its no accident that many Democrats were saying today that aid to the auto industry can only succeed if a new health care plan is passed.
Our blog has predicted that there will likely be significant organizational and structural changes in health care. The removal of fee for service payments to physicians will likely mean that the government is going to combine (bundle) fees for health care providers and facilities together. Most physicians will become employees or contractors to hospitals or clinic. Not for profit health care providers such as the Mayo Clinic and the Cleveland Clinic will likely continue to propagate throug out the country replacing private stand alone hospitals and private practitioners.
Separate insurance for auto accidents, work injuries, and liability coverage may be all combined into regular insurance once insurance is mandated for all.
The creation of a National Health Board will likely reduce the roles of local and state health authorities like State Medical Boards. Senator Daschle has stated that no hospitals or health facilities will be allowed without Federal approval. Hospitals will need to request permission to build new beds, add new equipment, or do new procedures from the FHB.
Malpractice and Peer Review will come under Federal regulation. Senator Daschle says that if a physician practices under the Federal guidelines he will protected.
Critics of the Daschle plan including Robert Goldberg, Vice president of the Center for Medicine in the Public Interest, have said that the new plan will result in long waits for necessary procedures and rationing of health care. In the New York Post he was quoted as saying that “countries with national health boards routinely deny patients access to the latest treatments for breast cancer, brain tumors, Alzheimer’s and multiple sclerosis on the grounds that they cost society too much”.
There is no doubt that America’s health care system as we have previously said needs to undergo major change. The appointment of Senator Daschle as Secretary of HHS is a clear indication of the urgency with which it is likely that Congressional Democrats and President Elect Obama will likely proceed with reform. Conservative thinkers may oppose this plan but currently do not have a well conceived alternative to counter the Daschle plan. The American public is angry over high medical bills and lack of insurance coverage. It is doubtful given the current climate of corporate mistrust that private health care only proponents could convince the American public to have faith that America’s private health insurance companies will provide lower cost care without action. They will be given a chance to compete with the government plan to prove whether private health care can survive.
Tony Magaña grew up in McAllen Texas, attended Texas A&M University, holds a doctorate from Harvard University. The co-founder of Contempo Magazine has participated in Valley business for over 20 years.He is a member of the National Association of Hispanic Journalists.
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