Far from pulling back on his commitment to overhaul the nation's health care system, President-elect Barack Obama reasserted his commitment yesterday, saying that the economic downturn makes major changes more imperative instead of less.
"The time is now to solve this problem," Obama said at a Chicago news conference, where he formally announced that former Senate Majority Leader Tom Daschle would head his health care team. "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 chief executives since Franklin D. Roosevelt was president.
Obama, who last month offered Daschle a post in his administration, said he planned to nominate the South Dakota Democrat to lead the Department of Health and Human Services as well as a new White House Office of Health Reform.
Obama also announced that Daschle's deputy at the White House health office will be Jeanne M. Lambrew, who worked on health care in the Clinton White House and co-wrote a book with Daschle about health care reform that Obama called "groundbreaking."
The president-elect has provided few details about what his health care reform proposal would include.
And he declined to outline how his administration would pay for an overhaul that some estimate could cost more than $100 billion a year.
Obama did raise the prospect of reviewing payments to private insurers who 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 in the future.
Obama's comments about the need for action, coupled with his selection of Daschle, were seen by some interest groups as an indication that Obama would not back away from his campaign promises to expand insurance coverage, hold down skyrocketing costs and improve the quality of care.
"It signals that the incoming administration intends to prioritize comprehensive health care reform," said Karen Ignagni, president of America's Health Insurance Plans, the industry's Washington lobbying arm. Fifteen years ago, insurers played a critical role in defeating health care reform.
As the nation's economic environment continues to deteriorate, a new effort to tackle health care reform will have to compete with other priorities, including a new multibillion-dollar stimulus package that Obama has said he wants to enact early next year.
A health care overhaul will also face daunting political challenges, particularly if some of the ideas that 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 new mandate that would require all Americans to get insurance, a requirement opposed by some consumer groups.
He also has called for the creation of a new public insurance program to compete with private insurers, a proposal that many insurers and Republicans on Capitol Hill resist.
And Daschle envisions a new government agency to set standards of care, which could face opposition from some doctors and hospitals.