Daschle Seeks True Reform, Not Just Budget Cuts, in Deficit Debate

DALLAS – Former Senate Majority Leader Tom Daschle told attendees at Press Ganey’s National  Client Conference this morning that current efforts by a congressional "super committee" to reduce federal  spending on Medicare and Medicaid should focus on true reform, not just cutting payment rates.

"We have to do a better job as a nation of distinguishing between cost-shifting and cost savings," he said. "Medicare and Medicaid budget cuts shift costs to hospitals. Raising the Medicare eligibility age shifts costs to beneficiaries. Real cost control involves the redesign and improvement of the health care system."

That redesign began with passage of the 2010 Affordable Care Act. As a result of that law and other new federal initiatives, Daschle called today "the most transformational time in the history of American health care, equal in importance to the creation of the Federal Reserve and Social Security."

Daschle was a key player in passage of the reform law, and recently wrote the book Getting it Done: How Obama and Congress Finally Broke the Stalemate to Make Way for Health Care Reform.

He said reform won’t alter the basic infrastructure of health care, which he said is not a true system. "We will continue to have a collage of subsystems – government programs, the Blues plans, the Aetnas, local hospitals and clinics, but we will not become a national system."

Daschle said his hope is that in the next decade the focus will shift to wellness and prevention, in the process creating a high-value, high-functioning health system.

He called for far greater collaboration through new forms of provider organizations, particularly accountable care organizations, which he said "can be a central factor of efforts to improve quality of care and patient satisfaction." He praised the Centers for Medicare and Medicaid Services for dramatically revising the rules governing ACOs and Medicare Shared Savings Program, creating greater financial incentives, reduced barriers for entry into the program and fewer administrative burdens.

In particular, Daschle said there needs to be greater adoption of health information technology. "Right now we are at 17% adoption of health IT. We need to roll that out nationally if we are to reduce costs, reduce medical errors and create a 21st century health system."

Daschle said he does see a growing national consensus on the need for lower cost, greater access and higher quality health care. With 51 million people without insurance coverage each year, health spending at 17% of GDP, 20% of every health dollar going to paperwork, low access to primary care and the equivalent of a 747 jetliner of preventable deaths in hospitals every other day, Daschle said that even with reform, "we're only at the 30-yard line on true reform."

He said the lesson of the past 20 months is that the passage of the Affordable Care Act did not end the debate on reform. "It's a close call" on whether the Supreme Court, which has agreed to hear arguments on the insurance mandate at the heart of the reform law, would rule in favor of the law, even though his reading of judicial precedent says it should, he said.

Regardless of the outcome of the court case and efforts to amend the law in Congress, now is the time for innovators to step forward in health care, Daschle said. "At this moment in history, there is great uncertainty and great opportunity. Can we unleash the innovative spirit in health care to find creative ways to deliver care more effectively and efficiently? That will take leaders who are willing to take risk, who engage. We need them more than ever."