Incoming HHS Secretary Tom Daschle Considering Appointees for Health Posts

Former Senate Majority Leader Tom Daschle (D-S.D.), President-elect Barack Obama's nominee for the next HHS secretary, is "busy assembling a team to run" the agency, Washington Post "In the Loop" columnist Al Kamen reports. Kamen examined several potential appointees, based on reporting by the Post's Ceci Connolly.

Jeanne Lambrew, a University of Texas professor who co-wrote Daschle's book on health policy and worked with him at the Center for American Progress, is "[c]ertain to be given a top post," such as HHS deputy secretary or assistant secretary for Planning and Evaluation, according to the column. CDC Director Julie Gerberding is "unlikely" to remain in her position, the column states. Kenneth Thorpe, a professor at Emory University, or Judith Feder, a former House candidate from Virginia, have spoken with members of Obama's transition team and "would be well-suited to run" CMS. Dora Hughes, a physician who has worked with Sen. Edward Kennedy (D-Mass.) and for Obama, also is "poised for a leading role," according to the Post.

In addition, Carolyn Clancy, appointed by President Bush as director of the Agency for Healthcare Research and Quality, could remain in that post. Kamen added that AHRQ "has been at the forefront of 'comparative effectiveness' research" and is "expected to take on a higher profile as Obama searches for cost-effective ways to provide health care to more Americans." Harvard University's David Blumenthal and David Cutler, top health care advisers to the Obama campaign, also could be considered for positions in the administration (Kamen, Washington Post, 11/27).

Business Groups 'Vying To Be Heard'
Business groups and lobbyists are "vying to be heard" as Obama "puts together his administration's economic team," Roll Call reports. Bruce Josten, of the U.S. Chamber of Commerce, said, "Now that they have a transition team they are reaching out to us," adding, "We have already scheduled for Dec. 4 a meeting with Obama staff on health care." Josten said, "What we don't know is what they'll do with the information we're giving them," but there is "a huge difference between primary rhetoric, general election rhetoric and ultimately governing rhetoric" (Ackley, Roll Call, 12/1).

Senate Could Address Rx Proposals
Senate Democrats expect to "have a working filibuster-proof majority on a variety of legislative issues that could provide early victories" for Obama on several health care related bills that stalled last year in Congress, the Washington Post reports (Kane, Washington Post, 12/1). The Obama administration could push numerous initiatives that would lower the price of prescription drugs in the U.S., according to the Chicago Tribune. Such proposals include the legalization of imported drugs; allowing Medicare to directly negotiate drug prices with drug companies; and opening the pathway for biotech drug competition by establishing a gateway for FDA approval of generic versions of the drugs.

Many of these proposals have been blocked or stalled by the Bush administration and the pharmaceutical industry, which contends that such pricing interference would threaten companies' research budgets (Japsen, Chicago Tribune, 11/30). A bill that would grant HHS authority to negotiate with drugmakers for lower prescription drug prices under the Medicare prescription drug benefit was approved by House Democrats last year, but the plan failed in the Senate.

If the issue is raised next year, it will have additional support from Sen. Tim Johnson (D-S.D.), who missed most of the 2007 session while recovering from an aneurysm, and six Democrats replacing Republicans who voted against the measure (Washington Post, 12/1).

Editorial
As Obama and the incoming Congress "mull a variety of fixes for the nation's ailing health care system," they should "give states the power to enable lower and middle-income families to buy prescription drugs at the same prices paid by the Medicaid program," a Baltimore Sun editorial states. According to the editorial, "It wouldn't cost taxpayers a dime but would make prescription drugs 40% to 45% more affordable for participants." The editorial encourages Obama to support legislation by Rep. Chris Van Hollen (D-Md.) that would give states the ability to create discount drug plans for residents with incomes at or up to 300% of the federal poverty level -- which "translates to cheaper drugs for as many as 50 million Americans."

According to the editorial, "For those who are struggling to pay for housing and food, such an opportunity could make the difference between being able to treat common medical ailments such as high blood pressure or leaving them unchecked." The editorial concludes, "This is one aspect of the nation's health care crisis that can be resolved affordably. And it's the kind of pragmatic, centrist approach with bipartisan support that seems to have broadening appeal in Washington these days" (Baltimore Sun, 11/26).

Opinion Pieces

• Michael Boskin, New York Times: "The most important issues facing the country right now are income, jobs and wealth -- not energy, health care, the environment or the distribution of income," Boskin, a Stanford University economics professor and Hoover Institution senior fellow, writes in a Times opinion piece. "Obama needs to think about everything his administration does through the prism of how it will affect the economy in the next two years," which means "postponing, scaling back or slowly phasing in proposals that impose significant costs on the economy," such as energy and health care. Boskin writes that "the government should set general goals for the environment, energy and health care -- and then let entrepreneurs, investors, venture capitalists and consumers decide how best to achieve them" (Boskin, New York Times, 11/30).
  
  
• Lawrence Lindsey, New York Times: One of the "microeconomic policies" that will require Obama's attention after he takes office is the "expansion of the federal role in health care," Lindsey, former director of the National Economic Council under President Clinton, writes in a Times opinion piece. Lindsey writes that health care reform "is not really an effective economic stimulus because it moves resources into an area that already has excess demand and rising prices, not into the weak areas of the economy." He continues, "At some point, perhaps a year or two from now, health care reform might place strains on the federal budget and push up interest rates, weakening the [economic] recovery" (Lindsey, New York Times, 11/30).
  
  
• Joseph Stiglitz, New York Times: Obama first "must stop the economy from going deeper into recession," then "he needs to bring about a robust recovery, preferably in ways that support the long-term needs of the United States," such as "fixing our health care problems," according to a Times opinion piece by Stiglitz, a Columbia University economics professor who chaired the White House Council of Economic Advisers from 1995 to 1997 and received the Nobel prize in economics in 2001. "Americans are rightly afraid of losing their jobs, and with that, their health insurance and their homes," he writes, adding, "We need to provide health insurance to the unemployed and to the uninsured, and we need to do it quickly, possibly through an expanded and more efficient Medicare" (Stiglitz, New York Times, 11/30).
  
  
• Norman Ornstein, Roll Call: Health "reform" should "not wait until we have settled, or even simply stabilized, the financial system," Ornstein, a resident scholar at the American Enterprise Institute, writes in a Roll Call opinion piece, adding that "some elements of change in health policy will come in the initial stimulus package, or in discrete bills," but "[t]hen comes the hard part." He continues that "a key area that needs to be front and center in the debate and in the solution" is addressing "stupid or counter-productive" Medicare regulations. He writes experts have said there are many Medicare regulations "that may bring short-term savings but involve huge long-term costs." He concludes, "I have been skeptical of magical savings in the health care system; one person's savings is another person's lost income," but "a focus on misguided and counterproductive regulations might actually produce real savings while improving people's lives" (Ornstein, Roll Call, 12/1).
  
  
• David Broder, Washington Post: If "declining tax revenue and increasing Medicaid and welfare payments force state and local governments to cut back, that will work against the stimulus," Broder writes in a Post opinion piece in advance of Tuesday's meeting between Obama and state governors to discuss an economic stimulus package. Broder says, "The forced cutbacks in state and local spending hit the most vulnerable of our citizens" and "damage the prospects for a strong and swift economic recovery." Broder concludes, "Obama and the governors are in this together. It is good that they are meeting now and important that their dialogue continues when he takes office" (Broder, Washington Post, 11/30).
  
  
• Robert Samuelson, Washington Post: Obama's "allies clamor for speedy action to provide universal health insurance, combat global warming and support trade unions," but "Obama -- and the nation -- would be better served if he concentrated for his first year on stabilizing the economy while patiently laying the groundwork for more far-reaching proposals," Post columnist Samuelson writes. "Superficially," he writes, Obama can "tout a more efficient health care system as a way to control health costs," but such "rhetorical debating points obscure as much as they reveal." Samuelson also states that any program "to refashion the energy and health care sectors ... would be complicated and contentious." He continues that moving "ahead with a 'bold' legislative agenda ... would be a mistake," as the "country does need to face its health and energy problems as well as deficit-ridden federal budgets," but "trying to do too much too soon risks doing none of it well." In "the long run, we need to discipline our appetite for health care," our "desire for government benefits and our willingness to be taxed," he writes (Samuelson, Washington Post, 12/1).