Today, at 11am Eastern, Barack Obama will officially announce that Tom Daschle will serve as head of Health and Human Services, and as leader of the administration's health reform effort. I wrote this piece a month ago, when the appointment first leaked, and so I'm reposting it today.CNN is
reporting that Tom Daschle will not only be Health and Human Services Secretary, but also health reform czar under the Obama administration. This is the clearest evidence yet that Obama means to pursue comprehensive health reform. You don't tap the former Senate Majority Leader to run your health care bureaucracy. That's not his skill set. You tap him to
get your health care plan through Congress. You tap him because he understands the parliamentary tricks and has a deep knowledge of the ideologies and incentives of the relevant players. You tap him because you understand that health care reform runs through the Senate. And he accepts because he has been assured that you mean to attempt health care reform, and will not waste his time.Compare the choice of Daschle to Clinton's decision to task Hillary Clinton and Ira Magaziner with health care reform. Neither Clinton nor Magaziner had any relevant experience in Washington, either with the health care bureaucracy or with the legislative branch. They did not have deep relationships on the Hill or a nuanced understanding of the players. Hillary Clinton had spent the last few decades in Arkansas. Magaziner had helped Rhode Island build a new economic plan. Both of them were, fundamentally, policy wonks. And so they built a process that was, in essence, by wonks and for wonks. The resulting bill might have passed a meeting of the Brookings Institution's Executive Committee. It was an elegant and innovative policy idea. But it was not a robust piece of legislation. It was not responsive to the concerns of the public, and it was not built to win votes in Congress. All of this is explained at greater length in
the lessons of 1994.The choice of Daschle suggests that the Obama team has learned those lessons well. Magaziner and Clinton signaled that the Clinton administration viewed health care as a policy problem. For them, the key to success was the genius of the policy team. Daschle signals that the Obama administration view health care as a political problem. The key to success is votes. And Daschle is a guy whose last job was lining up votes. He is also a guy who has recently written a book on health reform.
Critical: What We Can Do About the Health-Care Crisis
should now be on every health wonk's reading list. Among other things, his book argues that reform must be comprehensive, as we can no longer afford incrementalism or inaction, and that the real problem with health care reform is, well, Congress.
Related: I interviewed Daschle on his book
here.
Today, at 11am Eastern, Barack Obama will officially announce that Tom Daschle will serve as head of Health and Human Services, and as leader of the administration's health reform effort. I wrote this piece a month ago, when the appointment first leaked, and so I'm reposting it today.CNN is reporting that Tom Daschle will not only be Health and Human Services Secretary, but also health reform czar under the Obama administration. This is the clearest evidence yet that Obama means to pursue comprehensive health reform. You don't tap the former Senate Majority Leader to run your health care bureaucracy. That's not his skill set. You tap him to get your health care plan through Congress. You tap him because he understands the parliamentary tricks and has a deep knowledge of the ideologies and incentives of the relevant players. You tap him because you understand that health care reform runs through the Senate. And he accepts because he has been assured that you mean to attempt health care reform, and will not waste his time.Compare the choice of Daschle to Clinton's decision to task Hillary Clinton and Ira Magaziner with health care reform. Neither Clinton nor Magaziner had any relevant experience in Washington, either with the health care bureaucracy or with the legislative branch. They did not have deep relationships on the Hill or a nuanced understanding of the players. Hillary Clinton had spent the last few decades in Arkansas. Magaziner had helped Rhode Island build a new economic plan. Both of them were, fundamentally, policy wonks. And so they built a process that was, in essence, by wonks and for wonks. The resulting bill might have passed a meeting of the Brookings Institution's Executive Committee. It was an elegant and innovative policy idea. But it was not a robust piece of legislation. It was not responsive to the concerns of the public, and it was not built to win votes in Congress. All of this is explained at greater length in the lessons of 1994.The choice of Daschle suggests that the Obama team has learned those lessons well. Magaziner and Clinton signaled that the Clinton administration viewed health care as a policy problem. For them, the key to success was the genius of the policy team. Daschle signals that the Obama administration view health care as a political problem. The key to success is votes. And Daschle is a guy whose last job was lining up votes. He is also a guy who has recently written a book on health reform. Critical: What We Can Do About the Health-Care Crisis
