Obama taps 2 to monitor health care overhaul
WASHINGTON -- President Obama indicated Monday that he will be flexible in negotiations with Congress and health care providers as he seeks to remake the U.S. health care system.
Citing "some difficult trade-offs to be made," the president unveiled his choices to lead the mammoth effort by saying they would work with lawmakers and stakeholders to craft a solution to the system's twin problems: rising costs and limited access.
In introducing Kansas Gov. Kathleen Sebelius as his choice to lead the Department of Health and Human Services and Nancy-Ann DeParle to head the White House Office of Health Reform, Obama made it clear he will do things differently than the Clinton administration did in 1993-94.
Veterans of that effort — ranging from former Health and Human Services secretary Donna Shalala to Chip Kahn, who oversaw the insurance industry's "Harry and Louise" ad campaign that helped sink Bill Clinton's effort — praised Obama's efforts thus far. They said the emerging strategy will involve these steps:
• Legislation will be written by Congress with administration input, rather than the other way around. In 1993, a White House task force worked out the details and then delivered "a take-it-or-leave-it approach," said Karen Ignagni, president of America's Health Insurance Plans.
To make that point, Obama invited key members of Congress to stand with him. "It's going to be Kathleen's job and Nancy's job to work with extraordinary leaders like the ones on this stage," he said.
• Republicans will be invited to participate in the process, starting with Thursday's "health care summit" at the White House. To symbolize that strategy, Obama had Kansas Republicans Bob Dole, a former Senate GOP leader, and Sen. Pat Roberts standing with Sebelius, a Democrat. Change should focus "not on Democratic ideas or Republican ideas, but on ideas that work," Obama said.
• Obama will not ditch the current employer-based insurance system. That's smart, said Shalala, now president of the University of Miami and a board member of Gannett, which publishes USA TODAY. "People who currently have health insurance and like it don't want you mucking around with it," she said.
• He will try to act fast, before his electoral mandate disappears. "You want a president to lead that effort at a point when his political capital is greatest," said Ron Pollack, president of Families USA, a health consumers group.
Sebelius' selection, rumored for weeks, was confirmed by administration officials over the weekend. She replaces Obama's first choice, former Senate Democratic leader Tom Daschle, who withdrew from consideration because of problems with his taxes.
DeParle, who ran Medicare and Medicaid during Clinton's second term, has served on the boards of several medical technology companies. White House spokesman Robert Gibbs said that doesn't breach Obama's ethics policy barring officials from working on issues heavily related to ex-clients or employers. "The White House has confidence in her and her abilities," he said.
Outside experts said the sinking economy helps create impetus for overhauling the health care system, which should help Obama. "In these kinds of times, changes can be made," said Kahn, now president of the Federation of American Hospitals.
One challenge will be how to pay for the changes. Obama included $634 billion in his budget, half in tax increases on upper-income people, half in Medicare savings. More will be needed.
"That's the hardest part," said Billy Tauzin, president of Pharmaceutical Research and Manufacturers of America.
Contributing: Julie Appleby