Tom Daschle’s withdrawal from consideration as future secretary of Health and Human Services had to happen. So seemingly strong on health care policy but weak on ethics, the man President Barack Obama had picked to remake the American health care system had set off wild mood swings among the public.
What a mixed bag he was. On one hand, the former senator from South Dakota brimmed with smarts on reforming health care. On the other, his failure to pay at least $128,000 in back taxes and eagerness to make big money off the people he would regulate spoke of sloppy standards, at best, and an infuriating sense of entitlement.
Taxes were only one piece of his baggage. In the four years since losing his Senate seat to Republican John Thune, the Democrat made an easy $5 million letting various businesses use his name and influence. Experts say that his activities fell short of lobbying government (by the technical definition), but not by much. Most distressing was the near quarter-million he made from health care companies.
Drawing a sharp line between life in government and life in commerce had never been a Daschle strength. While Tom held a leadership position in the Senate, his wife, Linda, worked as a paid lobbyist for, among other industries, health care.
Such relationships ate into hopes that Daschle could help create the sort of rational health care system he promoted in public. On paper, he correctly framed the mission as more than bringing health coverage to the uninsured. It was also to control costs. That is the hard part because it means interrupting someone’s revenue stream.
Daschle had supported including a government plan in any smorgasbord of coverage options, which the insurance industry would fight fang and claw. He talked of creating an independent Federal Health Board empowered to decide what government health programs would cover. And he wanted to deny payment for expensive new drugs and procedures that don’t improve currently available treatments. Companies invested in these medications and gizmos would slam any effort to leave them out.
Daschle also backed making single payments for a medical episode (for example, a heart attack or knee replacement). That would reduce the financial incentives for unnecessary care. It would also give doctors and hospitals another reason for doing a good job the first time.
And he continued to criticize the Medicare drug benefit for its awful design. The program is enormously expensive because it cut private insurers into the deal.
That was Daschle talking good health care policy. But when new legislation gets written, could we trust an author so keen to make money from corporate interests? A strong sense of propriety could contain questionable behavior. But what power did decorum have here? Note the unblushing ease with which Daschle shrugged off his unpaid taxes and his wife’s lobbying work.
While critics on the right bitterly denounced this compromised nominee, most Senate Republicans interviewed over the weekend seemed ready to give Daschle a pass. Who knows when they might want to take a lucrative stroll in the private sector – and “forget” to pay their taxes – before returning to government.
And others, so hungry for a national health plan, did not want to further damage the reputation of one who had shown so much promise and whom Obama had chosen to lead. Understandable, but there was too much money at stake to put someone with Daschle’s history in charge of health care reform.
No one expects the Obama administration to be as clean as the candidate vowed. But had Daschle sailed through, then the political capital that promise held would have vanished. Meanwhile, others can do the job.
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