Health and the 44th Presidential Administration (Part I)
Last Thursday, in a press conference from Chicago, President-elect Obama’s announcement of former Senator Tom Daschle as designate for Secretary of the Department of Health and Human Services was of little surprise. This has been speculated upon and anticipated for weeks since the election.
The announcement of more significance was the formation of the White House Office of Health Reform. As Director of this new office, Senator Daschle will have dual posts in the new administration. Dr. Jeanne Lambrew, a health policy expert will serve as the Deputy Director. Establishing an Office of Health Reform within the White House suggest the President-elect fully comprehends that the magnitude of the task of reforming America’s health care system is greater than that which can be met by the handful of individuals who will serve on his Domestic Policy Council. And, as the name reveals, these individual are responsible not simply for health care but all domestic policies. Obama stated, “[Daschle] will be responsible not just for implementing our health care plan — he will also be the lead architect of that plan.” Hopefully this newly formed Office of Health Reform will be used to formulate strategy and inject continuity and integration into a process—legislative policy-making—which by its very nature is incremental and piece-mill. I believe such coordination and systems thinking is essential to the successful reform of health care in America.
The Obama brain-trust for health policy also includes Daschle staff alumni Mark Childress and Bill Corr each formerly having served as Cheif Counsel and bring a wealth of legislative experience to this endeavor. Experience that will be highly valuable in shepherding reform legislation through Congress. Subject matter experts include Dr. David Cutler, a health economist, Dr. Nicole Lurie, a physician-scientist noted for her research in the areas of health care disparities and public health preparedness and Dr. Jonathan Moreno, a bioethicist. Together with Dr. Lambrew, these experts have proposed linking medical payment to improved health care outcomes (and not simply the medical intervention), emphasis on prevention, and coordinating care through disease management programs as key goals for health care reform. Each of which is difficult to attain in the absence of an integrated health care delivery system. (More on the details of the Obama health plan and further integration of the system to follow in Part II of this post).