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An Interview With Tom Daschle

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Tom Daschle was almost the Obama administration's health czar before tax problems foiled his nomination. But in the months since he withdrew from the White House, he's not abandoned health care. This week, he was back in the news: He released a proposal for reform that was co-signed by Bob Dole and Howard Baker, and reports emerged quoting him saying that the public plan option could be sacrificed for the good of health-care reform. Last night, we talked about his new plan, his support for the public option, and whether Democrats should use the reconciliation process. A lightly edited transcript follows.

Tell me a bit about the genesis of this proposal.

The whole idea with the Bipartisan Policy Center is for four former majority leaders to come together and see what common ground we can find on common issues. This was one of the biggest projects we've ever done.

A lot of people will look at it and say, well, that's a bit late, isn't it? Why didn't they come to an agreement back when they were serving together?

I think the answer is, first, we didn't all serve together. Bob Dole and George Mitchell and I worked together on this 15 years ago and failed. The question is what we learned. And what we laid out yesterday was the answer.

The realization first and foremost that universal coverage was a goal we have to embrace wasn't true 15 years ago. But the real issue is that the three major problems in health -- access, quality, and cost -- have gotten so much worse than 15 years ago. We all agree now that whatever we propose will be superior to the status quo.

Reading the final plan, it struck me as a pretty pure collision of philosophies. It's what would happen if some smart Republicans and smart Democrats locked themselves in a room and hammered this thing out. How different was the process from the one you experienced inside the Senate? How much, in other words, are electoral, partisan and interest-driven incentives a force versus simple philosophical beliefs?

Something happens within the legislative bodies that changes the chemistry between parties and among members. I wish I knew what it was completely. I think it's true almost across the board that I've gotten closer to every leader who I worked with actively since I left. Bob Dole, Trent Lott, Newt Gingrich. I only wish you could somehow create that camaraderie and trust and friendship that seems to come so much harder when you're in active, combative politics.

What do you think about these CBO scores we've been seeing? Things seem to be hitting some snags in the Senate.

That's only a partial score. I wish that would've been better understood. It was only a partial score because it was only a partial submission. But scoring will always be a problem. First, we're confined to 10 years, and so many of the savings come after 10 years. So we've arbitrarily made it more difficult. I could make a very good case on a 20-year score, but it's not the budget rule, so no one will accept it.

You can get to neutrality. It is doable. But all of it involves pain. Political pain and policy pain, but nonetheless, you can get there. It just won't be easy.

One thing that struck me in all of the CBO scores is that -- you mentioned pain a second ago. If you don't make hard, tough, and painful decisions about policy -- decisions that affect the center of the health-care system -- then your proposal is scored as too expensive. Which also makes passage hard and tough and painful, and forces the hard, tough, and painful decisions of cutting coverage. It's a rock and a hard place.

That's precisely right. That's the problem. It is a rock and a hard place.

You made headlines the other day for dismissing the need for a public plan. Want to talk a bit more on that?

I don't know where that came from. We've been pushing back on that all day. I didn't say that. I have said emphatically I support a public plan. A Medicare-for-all public plan. Any federal plan. For all the reasons that have been made for years. It's important for cost, for choice, for competition, for popularity. I strongly support it.

What I did say is that I'm willing to compromise on most things to bring the package across the line. The plan we agreed to yesterday was that states could offer public plans with a federal fall back. That's not my first, second, or third choice. But given the concessions my colleagues made on universal coverage and an employer mandate and everything else, that's the essence of compromise.

To focus on that for a moment, for all the controversy around this issue, I think a lot of liberals don't understand why they should have to sacrifice it. After all, private insurers aren't exactly covered in glory, and a Wall Street Journal poll just today showed that three-fourths of Americans support the policy.

This is one time when it makes good politics and good policy. There are two groups primarily opposed to it. Many of the stakeholders view it as real cost cutting. As a result, they're worried about that competition. A lot of other stakeholders are concerned about feeling the effects of a cost constraint. I've said this, and no one has ever disputed it, that I've never seen a study that didn't say the public plan would reduce costs. And we hear so much about costs, and here we are taking it off the table.

The other group is this ideological group of Republicans and conservatives who see it as government intrusion they simply can't support. It's an ideological basis that I will never understand but that that's what it is.

When we talked long ago, you were a proponent of using the reconciliation process for health reform. What do you think of that now?

I think it's still the only real fallback legislative strategy we've got. We're going to try and work this through the policy track as long as we can. I think that gives us until September. But if it fails by then, we move to the budget process.

I think Kent Conrad brings up practical reasons why it's not our first choice. But I would take the reconciliation process, even with its shortcomings, over no process at all.


Photo credit: Charles Dharapak -- Associated Press Photo.

By Ezra Klein  |  June 19, 2009; 11:42 AM ET
Categories:  Health Reform , Interviews  
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Comments

We all agree now that whatever we propose will be superior to the status quo.

Delusional.

Posted by: john7 | June 19, 2009 12:20 PM | Report abuse

"I don't know where that came from." "I didn't say that."

You missed a follow up opportunity, Ezra: Did ABC News screw up its report that badly?

"But we were concerned that the ongoing health reform debate is beginning to show signs of fracture on the public plan issue, so in order to advance the process of developing bipartisan legislation and to move it forward, it's time to find consensus here," Daschle said.

"We've come too far and gained too much momentum for our efforts to fail over disagreements on one single issue," he said."

It certainly sounds like he's willing to let the public option go as a compromise move. Sounds to me like he's trying to walk it back.

Posted by: cab91 | June 19, 2009 12:26 PM | Report abuse

Too bad he DIDN'T walk away from healthcare. He's an insurance industry shill who is far worse than useless, and he needs to shut up.

A bill without a robust public plan is NOT "compromise", it's giving up the game completely. It will result in a taxpayer-funded boondoggle for the insurers, but NO downward pressure on the spiraling cost of the "system". It will kill both the Democrats and any prospect for real reform.

Posted by: labonnes | June 19, 2009 1:11 PM | Report abuse

The idea of a alternative public insurance program to run in tandem with private insurance is a singularly bad idea. First of all, it will leave most of the $500 Billion of savings (from high overheads of private insurers, compliance costs pf physicians & patients, and high drug prices) we would acheive with Medicare for All (HR676) lying on the table. It will simply add extra cost. It will also add yet another pool of high risk individuals, the sick and the poor, to the mix. We should be striving for larger pools, not adding new ones. Of course a single payer system has the largest possible pool. Because this alternative program will inevitably wind up with those people unwanted by private companies, it will also be extremely expensive even with the cost savings of a public plan.

Also if the alternative public plan takes people with pre-existing conditions, many more people will self insure since they can avoid paying until they get sick. They would be terrible.

We need Medicare for All

Posted by: lensch | June 19, 2009 1:16 PM | Report abuse

You totally blew this interview Ezra. I say that as a longtime reader and someone who has championed you as a great progressive voice for many years.

Ezra's question itself contains a factual innacuracy that (intentional or not) allows Daschle to avoid the real substantive issue. Daschle didn't dismiss the need for a public plan, he dismissed the legislative viability of a public plan. There is a very big difference and thanks to Klein's bad question Daschle is able to avoid engaging with actual issue and instead gets to swat down a Klein created straw-man.

As Klein himself noted today, a public plan is hugely popular. The hangup is purely political and, as Ezra notes in yet another post today, the political problem lies in the United States Senate.

I'm not a professional journalist but it seems to me that if I had an interview with the former Majority Leader of the United States Senate days after he said that the crucial component of the healthcare reform agenda was politically untenable I might ask him specifically about the politics of the situation. I also would ask him how he thought that standing with Bob Dole and publicly proclaiming that a public plan (again - a plan Daschle claims to support) is dead would impact the political dynamics of the debate?

But Ezra didn't do any of that, instead he fumbled the question and allowed Daschle to dissemble and never explain why he, Daschle, thought publicly undermining a hugely popular and entirely necessary policy proposal (that he claims to support) was a good idea.

Posted by: steve_balboni | June 19, 2009 1:53 PM | Report abuse

Let's be clear on our terms: bipartisan means: dems cave; support public option means: public be damned; democrat means: I'm ready to compromise my position at any time; republican means: me, my corporations and rich people. I've been a Democrat all my life, but Harry Reid and all the other whiners make me sick. Nobody cares about Republicans--we have 51 votes. SINGLE PAYER--DO IT!

Posted by: laraine2 | June 19, 2009 2:06 PM | Report abuse

The fact that Daschle is willing to compromise away the only option that has any hope of bringing reform to US healthcare financing tells us that he is not really a reformer.

I didn't vote for Obama to get convoluted, an unworkable, inadequate extension to the private insurance model. I voted to get off the road to personal, corporate, and national bankruptcy and onto one that will deliver *care* to all U.S. Citizens at costs comparable to what citizens in every other industrialized country enjoy. Any legislation that does not THAT is out of the question.

We in this country are being hamstrung by our elected representatives and the media (most of whom enjoy generous plans and don't really seem to understand that universal healthcare is not just a poverty program).

There is no such thing as a "bipartisan" approach to health reform; healthcare isn't a partisan concern. We need a *non* partisan solution to the highly partisan, protect-the-insurance-companies, model that we've been following for the past 60 years and resulted in our paying the most for the least.

Posted by: Athena_news | June 19, 2009 2:28 PM | Report abuse

Dashcle, are you listening? We, the people, dont want to compromise on the one reform that is important to us - a public plan. How do you justify compromising against popular will? And for whom?

WE WANT SINGLE PAYER AND WANT TO GET RID OF THE THIEVERY IN THE NAME OF PROVIDING HEALTH INSURANCE.

We dont want to be tied to bad employers or companies because they provide health insurance. Where is the FREEDOM that Americans talk about all the time?? Say NO to employer provided health insurance and embrace the public option for all.

Posted by: Mom21 | June 19, 2009 3:02 PM | Report abuse

Why on earth are Democrats like Tom Daschle compromising with and making concessions to a bunch of obstructionist corporate lackeys?

Bipartisanship (even if it weren't a joke to the Republicans) is NOT the goal here...

Posted by: AHermit | June 19, 2009 3:19 PM | Report abuse

Senator Tom Daschle said:

"I think it's true almost across the board that I've gotten closer to every leader who I worked with actively since I left. Bob Dole, Trent Lott, Newt Gingrich".

When you are saking the same tree, in this case "Uncle Sam Tree" and ripping us off the taxpayers, of course, you will come more closer.

Every one of them he named are losers. Instead of going back to their respective states or city after losing elections, they stayed in Washington and constantly ripped us off to trillions of dollars. We are not talking hundreds any more.

Do you have any shame!

Posted by: YesWeCanForFREE | June 19, 2009 3:24 PM | Report abuse

states could offer public plans with a federal fall back

Isn't this BASICLY what Medicaid IS? A State Medical Assistance Program with Federal Funds and State Funds combined? And every year since Jimmy Carter lost to Reagan, Medicaid funds have been cut, eligibility has been rolled back, families have been forced to separate when in financial crisis in order to get treatment for sick children, coverage has been cut back for those who do qualify, more and more drugs have been taken from the list of "covered" drugs with almost NO recourse for people who CANNOT take the "preferred", or cheaper choice of executives or politicians. Michigan, and I'm sure other states as well, recently cut dozens of Medicaid services used mostly by the elderly and disabled. Doctor's pay has been cut to the point there are no longer any doctors left who can afford to TREAT Medicare and Medicaid PATIENTS, some, like myself, who have life threatening illnesses that MUST be treated in a timely manner.
I'm so very sick of hearing the lies from politicians as to what they "can or cannot" do when we ALL know THEY made the LAWS in the first place that gave the billionaires their king's ransoms and complete say over PROFITS above PEOPLE. They can darn well fix it if they WANT to but they DON'T WANT TO because they ENJOY too many benefits from playing GOD and sitting up there in DC deciding who lives and who dies based on their financial PLACE in the pecking order and their CONNECTIONS to their biggest DONORS who BUY the votes that keep the profits HIGH, not to MENTION their own investment in the corps they are supposed to regulate. It's definitely NOT in their best interests to do the jobs they were elected to do. It's much more profitable for THEM to work AGAINST the people who elected them than FOR them. We can't PAY them ENOUGH!

Posted by: weslen1 | June 19, 2009 3:55 PM | Report abuse

It is very interesting to me that Daschle keeps referring to "my colleagues." Does he think he is still in the Senate? If so, that's delusion #1 and if he believes that he did not attempt, along with Dole and Baker, to take the public option off the table yesterday, that's delusion #2. Maybe those weird red eyeglasses are affecting his brain.

Posted by: crosbykh | June 19, 2009 4:25 PM | Report abuse

Ezra- great interview, you forced him to defend his position. I wish you had brought up the issue of campaign money given to congressmen by the insurance/health industry, and the effects on legislation.

Posted by: abiodunaodeleye | June 19, 2009 4:28 PM | Report abuse

I think Daschle pretty much confirmed that ABC got it right. Daschle threw the public option out because the Reeps made concessions. What horse pucky! He caved. He forgot that the Reeps didn't support Social Security and opposed Medicare and only supported Bush's Drug bill because it was a complete sell out to the pharmaceutical industry. Daschle is an (__0__) !

Posted by: afgail | June 19, 2009 4:41 PM | Report abuse

There is absolutely no reason why the health care plan has to be 'bipartisan'. There are a lot more public voices in this country than just republicans and democrats. If politicians are really interested in the serving the people, they should just ignore all interest groups and just do what is best for the people.

Democrats like Daschle serve lobbyist more than the people. They would want God to compromise with the Devil, just so they can claim to be bipartisan.

Posted by: Dave77 | June 19, 2009 5:06 PM | Report abuse

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