NCPA - National Center for Policy Analysis


March 5, 2008

Former Senator Tom Daschle's (D) new book, "Critical," provides a detailed blueprint of the Democratic approach to overhauling American health care.  Given his support for Barack Obama and the likelihood of his prominence in an Obama administration, his views are worth looking at closely, says Scott Gottlieb, a physician and resident fellow at the American Enterprise Institute.

One proposal is the creation of a Federal Health Board, modeled on the Federal Reserve Board:

  • Its duties would include recommending coverage of those drugs and procedures backed by solid evidence and exert influence by ranking services and therapies by their health and cost impacts.
  • The board would change the entire health care market by forcing expanded Medicare, Medicaid and veterans programs to follow its lead.
  • Private health insurers would follow along, too, in part for the political cover such a move would give them to make unpopular but cost-conscious decisions not to pay for certain benefits.

As for the uninsured:

  • All Americans would be opened up to the Federal Employee Health Benefits Plan -- a menu of private insurance options now accessible only to government workers.
  • There would also be, in addition to the current plans, a government-run program, presumably similar to Medicare, although he provides few details.
  • There would also be some form of means-tested premium support (or tax benefits) for Americans who couldn't afford one of the available plans.

Surely this is not the best way to go about reforming the U.S. health-care system, says Gottlieb.  The next occupant of the White House, whatever his party affiliation, will undoubtedly try to broaden insurance coverage.  One alternative to empowering government agencies would be simply to help individuals buy affordable private insurance.  That effort might start by leveling the playing field between big purchasers, who get better rates for their employees, and individuals, who make up the bulk of the uninsured.

Source: Scott Gottlieb, "Obama's Health Plan -- a Preview," Wall Street Journal, March 4, 2008.

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