If I were a member of Congress, I'd find Tom Daschle's health reform predictions to be a bit discouraging. A former U.S. Senator and Senate leader who came within a hair's breadth of being HHS Secretary, Daschle certainly knows how things work on Capitol Hill--and that includes the steps it will take to pass a reform bill. And given current forces, he believes that health reforms have no more than a 60 percent chance of passing, he told a healthcare conference audience.
Daschle, who spoke at the Healthcare Capital Conference (HCap) in Washington, D.C., concedes that there are a few broad areas where both branches of Congress--and most of the public--seem to find common ground. These include the need to expand healthcare coverage and access, lower costs and improve care quality, he said. But that's where most people part company, he notes. "There is definitely broad agreement on some issues," Daschle said. "But there are deep philosophical differences on others."
One positive note is that many key stakeholders seem ready to jump on board with at least some portion of proposed reforms, he notes. "Most agree that the status quo is unsustainable, and that staying in the room is in their best interests," Daschle said.
There's also been progress on insurance, payment and delivery reform models, he notes. For example, most legislators seem to agree on creating an insurance exchange for individual and small business coverage, and that provider reimbursement models must be changed to favor models with quality and efficiency incentives built in, such as bundled payment, capitation and episode-based fees.
On the other hand, there's little consensus on how planners should address problems such as addressing lagging quality and medical errors.
As if that wasn't enough confusion, to get a bill through the process reform champions will have to resolve divisive ideological debates over the role of government, settle on appropriate financing mechanisms and have the right strategy to lead the bill through the legislative process, all of which will be a big challenge.
That being said, Daschle ended his talk with a hopeful note, arguing that we're at a uniquely "transformational" time in history where major chances may just occur. He noted that during the civil rights activist's long incarceration, Nelson Mandela was challenged by a fellow prisoner who argued that apartheid would never end. Mandela's response, Daschle says? "Many things seem impossible until they're already done."