National Press Club

Daschle, Leavitt Spar Over Health Care Reform

June 3, 2009 | By Mark Schoeff Jr. | mschoeff@workforce.com

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Two prominent veterans of past health care reform efforts expressed doubt that a comprehensive bill will be approved by Congress this year at a June 2 Newsmaker that filled the Press Club ballroom.

Former Senate Majority Leader Tom Daschle and former Health and Human Services Secretary Michael Leavitt discussed--and sometimes sparred over--the prospects for reform in a session moderated by Mark McClellan, former administrator of the Centers for Medicare and Medicaid Services.

“I think there’s only a 50-50 chance that something is going to pass,” Daschle told an audience of about 175.

One key to getting legislation to President Obama’s desk is leadership from Obama himself, Daschle said. Another is for lawmakers to avoid making “the perfect the enemy of the good” as they hammer out a bill.

Leavitt, who headed HHS during President Bush’s second term, is a little more optimistic.

“I think something’s going to pass,” Leavitt said. “The reason I say that is because the president and Congress have stepped out so far.”

But Leavitt doesn’t foresee a comprehensive bill. Instead, he projects that the legislation will represent incremental change that includes expanding Medicaid and instituting quality improvement methods like studying the comparative effectiveness of medical treatments.

But the bill won’t settle the debate--and pundits will parse the result, he said.

“There will be a mad scramble to define what it was and what it wasn’t,” Leavitt said.

Daschle and Leavitt found plenty of areas of agreement. They both want to see a system in which health care payments are based on value of treatment rather than volume. They also endorse expanding access and lowering costs.

But they split on whether the government should offer its own insurance plan, the so-called public option. Leavitt called it a “Trojan horse” that would lead to a federal takeover of health care by driving private insurance out of the market.

Daschle gave a “qualified yes” to a public plan. He argued that a public option would provide more competition and choice. He said that it would help ensure widespread coverage and avoid the “donut hole” problem related to the Medicare Part D prescription plan.

“We still have huge problems with regard to coverage for drugs for senior citizens,” Daschle said.

Leavitt touted Medicare Part D as a model for health care reform because he said that it has made participants informed consumers.

“They beat a path to higher quality and lower costs,” Leavitt said.

Government should organize what is now a “disconnected” and “siloed” health care system, Leavitt said. But Washington shouldn’t “own it,” in the way that it does national defense.

Daschle and Leavitt also differed on paying for the estimated $1.3 trillion that health care reform would cost over 10 years. Leavitt said that Congress hasn’t accounted for the spending.

Financing reform over a longer timeframe than 10 years would make it more affordable, according to Daschle. He said that the costs can be offset and that Congress shouldn’t push off paying the bill
indefinitely. But he also stressed that the spending should be seen as an investment in providing coverage for all Americans.

“If we’re going to do this efficiently, we have to bring everyone under the tent,” Daschle said.