WASHINGTON — Far from pulling back on his commitment to overhaul the nation's healthcare system, President-elect Barack Obama on Thursday said the economic downturn makes major changes more imperative, not less.
"The time is now to solve this problem," Obama said at a Chicago news conference, where he formally announced he would nominate Tom Daschle, the former Democratic Senate leader from South Dakota, to be secretary of Health and Human Services. "It's not something that we can sort of put off because we're in an emergency. This is part of the emergency."
If successful, Obama will have achieved a goal that has eluded presidents since Franklin D. Roosevelt.
Obama, who last month offered Daschle a post in his administration, said he planned to nominate Daschle to lead a new White House Office of Health Reform as well.
Obama also announced that Daschle's deputy at the White House health office would be Jeanne M. Lambrew, who worked on healthcare in the Clinton White House and co-wrote a book with Daschle about healthcare reform that Obama called "groundbreaking."
The president-elect has provided few details about his healthcare proposal. And he has declined to outline how his administration would pay for an overhaul that some estimate could exceed $100 billion a year.
Obama did raise the prospect of reviewing payments to private insurers that provide coverage to Americans enrolled in Medicare. Federal payments to insurers participating in the Medicare Advantage program are growing rapidly at the same time that questions are growing about the effectiveness of the private insurance.
He additionally suggested that better use of technology and more prevention efforts could yield savings.
Some interest groups saw Obama's comments about the need for action, and his selection of Daschle, as an indication that Obama would not abandon campaign promises to expand insurance coverage, hold down skyrocketing costs and improve care.
"It signals that the incoming administration intends to prioritize comprehensive healthcare reform," said Karen Ignagni, president of America's Health Insurance Plans, the industry's Washington lobbying arm. Fifteen years ago, insurers played a central role in defeating a healthcare overhaul.
As the economy deteriorates, a new effort to tackle healthcare will have to compete with other priorities -- including a multibillion-dollar stimulus package that Obama has said he wants to enact early next year.
A healthcare overhaul also will face political challenges, particularly if some of the ideas Daschle has championed become part of the Obama administration's plan.
In his book "Critical: What We Can Do About the Health-Care Crisis," Daschle endorsed a mandate for all Americans to get insurance -- a requirement opposed by some consumer groups.
He also has called for a public insurance program that would compete with private insurers -- a proposal that many insurers and Capitol Hill Republicans resist.
And Daschle envisions a new government agency to set standards of care -- which could face opposition from some doctors and hospitals.
No major overhaul attempt has been undertaken in Washington since President Clinton's healthcare push collapsed in 1994 amid opposition from interest groups and some members of Congress.
But in recent months, an array of business leaders, healthcare officials and consumer groups has been working to build momentum for overhauling a system that fails to insure some 46 million people and whose costs are weakening many businesses.
And on Capitol Hill, senior Democrats have outlined plans for a major legislative campaign next year focused on healthcare.
(BEGIN TEXT OF INFOBOX)
Age: 61; Dec. 9, 1947; Aberdeen, S.D.
Experience: Distinguished senior fellow, Center for American Progress; special public policy advisor, Alston & Bird; Senate minority leader, 2003-05; Senate majority leader, 2001-03; Senate minority leader, 1995-2001; U.S. Senate, 1987-2005; U.S. House of Representatives, 1979-86; aide to Sen. James Abourezk, 1972-77; representative for financial investment firm; intelligence officer, U.S. Air Force, 1969-72.
Education: Bachelor's in political science, South Dakota State University, 1969.
Family: Wife, Linda Hall Daschle; three children from a previous marriage.
Source: Associated Press