Daschle: Health Care Overhaul 'Within Our Reach'

Tom Daschle i i

hide captionTom Daschle, shown earlier this year on Capitol Hill, has been recruited to help persuade reluctant Democrats to support health care overhaul legislation.

Susan Walsh/AP
Tom Daschle

Tom Daschle, shown earlier this year on Capitol Hill, has been recruited to help persuade reluctant Democrats to support health care overhaul legislation.

Susan Walsh/AP

Senate Democrats may have scored a procedural victory Saturday night, but the real battle is set to begin after Thanksgiving, when debate over health care legislation will begin.

Majority Leader Harry Reid hopes to get a bill to the president's desk by the end of the year. But getting 60 votes to support the bill in its current form is by no means guaranteed.

Arkansas Democrat Blanche Lincoln says she won't back a bill that includes money for a government-run public health care plan. The same goes for other conservative Democrats, like Louisiana's Mary Landrieu and Nebraska's Ben Nelson.

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Liberal senators say just the opposite.

To help bridge that divide, President Obama has recruited Tom Daschle, the former Senate majority leader from South Dakota and one-time nominee to run the Department of Health and Human Services. Daschle spoke to Weekend All Things Considered host Guy Raz.

Guy Raz: The president has deputized you to help Vice President Biden to try and persuade reluctant Senate Democrats to pass a bill. How will you convince senators like Blanche Lincoln to vote for it?

Tom Daschle: Well, first of all, Guy, I don't want to overblow my role. I'm just an informal resource, and there are a lot of people in my capacity. There are a good number of people that want to see this legislation pass and want to see the president succeed. This is the farthest we've ever come, and I think it's really important that we get the job done now. But I think, to your question, the most important thing is to make sure that everyone understands the tremendous problems that will occur in this country if we do nothing. The status quo is probably the worst option of all. And so to convince them that we simply can't sustain the status quo is where the argument begins.

Raz: So you sort of try and talk about the weight of history, for example?

Daschle: That's right. In part, you look at what we've seen with access costs and quality problems in this country. We have about 50 million people who are uninsured, and about half of those who are insured are underinsured. Today, 18,000 people, at least, die because we don't have adequate insurance. Our costs now have gone through the roof — $8,000 for every man, woman and child in the country. And we are tremendously behind with regard to quality. So understanding those complex and very difficult problems, I think, is one of the most persuasive ways of which to make sure people understand the consequences of failure.

Raz: Many senators say they will not support a bill with a public option. Is it worth dropping that?

Daschle: Well, I feel very strongly about the importance of a public option, but obviously, you've got to thread that needle, as well. And I think it's going to be very difficult. Sen. Reid thought he might have been able to do that by saying, look, let's just make it voluntary. And I think if you make it voluntary, you really aren't mandating that a public option take place anywhere in the country. [Republican Maine] Sen. [Olympia] Snow has suggested, well, that state option still goes too far. What if you just trigger something down the road? You don't have a state option, but you trigger it if we don't meet certain expectations within five years. That may be a way to thread the needle in this case.

Raz: Which may not be enough for some of the more liberal members of the Senate who say they will not vote for a bill unless it has a robust public option.

Daschle: Well, and the question you'd ask those people is, "Is having nothing at all better than having no public option?" And I would argue that having nothing at all, again as I said, is the worst possible option we could choose.

Raz: What about funding for abortion in the bill? Do you believe Senate Democrats might be willing to strengthen legislation that limits federal money for abortions in order to get the votes they need?

Daschle: Well, again, I thought Sen. Reid did a masterful job in trying to find a way to balance the extraordinary complexity and the standoff that we've seen on both sides. He's very close, and I think if we can just continue to work the language a little bit, we're getting very, very close to finding something that all sides can agree on. It's not going to take much. I'm confident we can do it.

Raz: In the end, if you need to compromise so much to get the 60 votes, how do you make sure the result isn't simply a watered down version of health care legislation that doesn't do all that much at achieving the goal of insuring millions of uninsured people?

Daschle: Well, first of all, at least 31 million people will be insured for the first time. There would be no lifetime limits. Nobody would be dropped because they're sick. They would have extraordinary new opportunities to get care and to get the coverage and have the confidence that they can get through the difficult times when poor health may require it. So it is an historic breakthrough. But I think the bottom line is, we've got to realize — even if this legislation passes — in my view, we're on about the 30-yard line. That is, we still have about 70 yards to go in order for us to complete the work on health reform in a way that accomplishes everything we need with insurance reform, payment reform and delivery reform that will begin with this process.

Raz: But compromises are going to have to be necessary ...

Daschle: No question.

Raz: And that may include dropping the public option, that may include dealing with issues with respect to the pharmaceutical industry that some of the more liberal members of the Senate have opposed.

Daschle: Well I don't want to prejudge. I don't want to predict that anything is necessary. Sen. Reid is going to continue his efforts, as is the president. Keep in mind, at the end of the day, what we need is 60 votes to end debate. You only need 51 votes to pass the bill. There's a little bit of misunderstanding about that, but I think it is important. And that may be a distinction without a difference. But nonetheless, I think we're going to get there.

Raz: It was announced this week that you will join the law firm DLA Piper as a senior policy adviser. Some government watchdog groups have pointed out that the firm represents clients in the medical industry — Rite Aid and other pharmaceutical companies. What's your response to those who say it's a conflict of interest for you to be involved in any way?

Daschle: Well, I don't change my views regardless of who it is I'm speaking to or working with. I have very public and very strongly held views about the need for reform. Those people who work with the firm are certainly entitled to their own views and have them, but I think it's important for me to be as transparent and be as clear about that as possible. I have never made one call or made one office visit on behalf of a client, and I don't intend to, because that's not my role. There are those who can lobby and do a very good job of it. That's not how I see my role to be. So I don't think there's any conflict at all.

Raz: How confident are you that a health care bill will land on the president's desk for signature before the end of this year?

Daschle: Well, I would say that there's better than an even chance that we can get this done now. We really crossed an extraordinary threshold last night. And with the passage of the cloture vote, I am at least as encouraged as I have been all year long that this is now within our reach. This is certainly doable, and I think we're going to get it done.

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