Political system may be Daschle's biggest obstacle
On the same morning President-elect Barack Obama introduced Tom Daschle, the former Senate majority leader, as his prospective secretary of health and human services and his point man on health-care reform, of constituency group leaders met to assess the prospects for success.
Taking the microphone, in turn, at a Washington hotel were the head of the Business Roundtable, speaking for corporations; the CEO of Pfizer, the giant pharmaceutical company; the president of America's Health Insurance Plans, the trade association; and spokesmen for the National Federation of Independent Business and AARP.
All agreed major health legislation has a better chance of passage in the next Congress than when Bill and Hillary Clinton tried back in 1993-94. And so did John Harwood of CNBC and myself, two journalists on the panel.
Comments of the corporate representatives were particularly important because the small-business, insurance and pharmaceutical lobbies were instrumental in killing the Clinton reforms. As John Castellani, president of the Business Roundtable, said, "This is not 1994." Today, status quo has become unendurable for almost everyone.
What Obama said was the simple truth. "Some may ask how, at this moment of economic challenge, we can afford to invest in reforming our health-care system. ... I ask how can we afford not to." The president-elect went on to say, "small businesses across America are laying off (workers) or shutting their doors for good because of rising health care costs. Some of the largest corporations in America, including major American carmakers, are struggling to compete with foreign companies unburdened by these costs."
Daschle is a shrewd choice to lead the Obama effort. The former South Dakota senator knows the politics of Capitol Hill intimately. He recently wrote a book on health reform with Dr. Jeanne Lambrew, who will be his deputy. By designating Daschle also as head of a newly created White House Office of Health Reform, Obama has circumvented one of the problems that plagued the Clintons.
Hillary Clinton formulated her proposal through a secretive White House Task Force, which hid its work from Congress, the Department of Health and Human Services and from Treasury. The heads of those departments let Congress know they were skeptical - and damaged its chances. Obama and Daschle should be able to avoid that snare.
As auspicious as the start has been, enacting a major health-care bill will still be daunting. When you talk about reorganizing one-sixth of the U.S. economy and changing the way a vital service is delivered, every decision from the most trivial to the monumental will be controversial.
But Obama has the good fortune that the four-committee chairmen who will handle his legislation have strong personal motives to make it succeed. For one Senate chairman, Montana's Max Baucus, this is an opportunity to report the largest bill of his two-year tenure. For Ted Kennedy, now battling brain cancer, it is the chance to achieve the main goal of his long Senate tenure - while he still has time.
In the House, one chairman, California's Henry Waxman, is brand-new in the post, so this is a test of his legislative skill. The other, New York's Charles Rangel, is a veteran now under scrutiny by the House Ethics Committee for possible conflicts of interest. If he survives, this bill offers him a chance for vindication. If he falls, his successor, like Waxman, will find it his first and most crucial assignment.
It will really test the political system to determine if the fragile emerging consensus on the need for reform can overcome the thousand particular issue-battles that are certain to erupt. Can representative government work?
© 2008, Washington Post Writers Group