No matter what side of the political aisle readers may find themselves on, there’s no denying the historic magnitude of the health care reform bill. And yet, no matter how closely they’ve followed the news, many Americans remain as confused and misinformed about the legislation as ever. Former Sen. Tom Daschle (D-S.D.) is looking to remedy that with the October release of Getting It Done: How Obama and Congress Finally Broke the Stalemate to Make Way for Health Care Reform.
In the book, Daschle leaves no stone unturned: the history of heath care reform in America, the contentious back and forth that characterized the national debate on health care and the behind-the-scenes machinations that led to the bill’s eventual passage in March. The former Senate Majority Leader also looks forward from what he calls a “transformational moment” in American history with an in-depth look at the bill, suggestions to improve it and the challenges that the country still faces. Daschle recently spoke with Kirkus about health care as a civil right, what we can learn from other countries with nationalized health care systems and who he thinks will end up on the right side of history.
You’re widely known as a politician whose focus has always been health care issues.
I developed an interest [in health care] in part because I have had so much personal experience as I traveled South Dakota and witnessed firsthand what it was not to have insurance, or what it was not to have access. [I can’t recount] how often families would express their anxieties and fears about health care. I feel fortunate that I have lived through this moment.
I believe that health care is one of the last major civil rights issues in our country. It may not necessarily be a constitutional right, but it’s certainly a moral right to have access to good health care. As somebody who grew up in the ’60s, I’ve understood civil rights in the context of race and gender. This new context has every bit as much meaning to me as those did.
Do you think most Americans agree with you that health care is a civil right?
I think that most people believe that it should be a right. And in some ways, we’ve made it so through the backdoor. In an inadvertent way, we’ve provided that—guaranteeing emergency room care. Emergency room access is increasing in this country, but emergency room capacity is not so there’s greater and greater congestion and challenge to provide [care]. The capacity hasn’t changed to meet the demand and one of the huge problems we’re facing is providing the access that was already guaranteed by law.
Why do you think people have been so resistant to health care reform?
In part because there have been a lot of myths that have been perpetrated about health care in America. [It’s believed] we have the best system, which is far from true. That we have access to whatever we may require—that’s a total myth. We’re spending vastly more—50 percent more than the second most expensive country—and we don’t even come in the top 30 in regards to overall quality of our care. We have a huge value problem, in that we’re paying more and getting less. We can’t afford not to address it.
The health care reform bill was passed six months ago. What kind of substantive changes have already been made?
It’s too early to see any real substantive changes. I’ve said before, this only puts us on the 30-yard line…we’ve got a long, long way to go before we get to the goal line. As we consider how to get the rest of the way there, we’ve still got to recognize the millions of people that are still uninsured, the huge issues involving the cost of care and cost containment. We’ve also got to make serious improvements in the quality and delivery of that care. This is going to require additional legislative action down the road. We haven’t seen enough yet to know what it’s going to take.
Are there any systems in particular that are currently in place around the world that we can or should look to for guidance?
We’re the only country in the world that doesn’t have a health system. We have a health market. A system is defined by two things in particular: a central decision-making authority and a central administrative authority. We have neither. We’re going to have to determine if moving to a more systemic health care system is going to work for us.
We could look to the German model for an insurance concept that’s worked pretty well. Theirs is a public-private hybrid. The British do a great job of preventative care, with an emphasis on wellness. The Swiss system [we can look at for suggestions in terms of] an overall improvement in delivery. And the Scandinavian countries provide the highest quality care for the lowest cost. We can learn lessons from all of these countries on how to do our job better. But it’s important not to believe that we can replicate any of these systems. The American people have different expectations, a different culture. We’ve got to make the American health market better, but that doesn’t mean adopting the unique characteristics of another country and expecting them to work the same here.
Anything else you’d like to add?
I have such admiration for those who stuck up their political careers, who really put their whole selves into this effort—Nancy Pelosi, Harry Reid and President Obama. They deserve tremendous gratitude and admiration for what they did. There’s been a great deal of negative political attack based on their involvement, but I think that history’s going to judge them very well. What now looks like a political liability will be a political asset in a very short period of time.