WASHINGTON — By choosing former Senate Majority Leader Tom Daschle to head his healthcare reform effort, President-elect Barack Obama got more than an old congressional hand with a policy book on his resume.
Obama has also picked up a hardheaded political strategy for his push to overhaul the nation's healthcare system.
Guided by lessons from President Clinton's healthcare debacle 15 years ago, Daschle has put a premium on cooperation between the White House, Congress and major healthcare interest groups, many of whom agree that major action on healthcare is vital.
Daschle, who will lead both the Department of Health and Human Services and a new White House Office of Health Reform, favors moving decisively to seize political momentum and, if necessary, cut off opposition, something he said Clinton failed to do in 1993.
He thinks delays by the Clinton administration and soft support from the left in the early 1990s allowed Republicans and industry groups such as insurers to kill the Clinton plan with a well-organized political campaign that made voters afraid of reform.
Daschle is urging a far more aggressive push by those advocating systemic change.
"This means going on the offensive," he wrote in "Critical," his recent book about healthcare, in which he singled out drug makers and insurers as potential obstacles to a successful overhaul.
"We cannot assume that the public recognizes the distortions and fallacies peddled by the reform opponents; we have to educate people on the emptiness of the anti-reform rhetoric," he said.
Daschle has even suggested using the Senate's rules to prevent opponents from filibustering healthcare legislation, a move that one senior Republican staff member warned would make it "extremely difficult" to get any GOP support for major reform.
Daschle, who declined to be interviewed, has specific -- and potentially controversial -- ideas about how to reshape the healthcare system.
Among other things, he envisions a new federal agency, which he calls a Federal Health Board, with the authority to set guidelines for what treatments and procedures are most cost-effective.
Daschle argues that the board, which would have authority over federally funded healthcare programs such as Medicare, would insulate medical decisions from political meddling by Congress and could help design a system for achieving universal coverage.
