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Dashed Hopes

Written by Kathy Shaidle

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December 08, 2008
By Kathy Shaidle
FrontPageMagazine.com
Throughout his presidential campaign, Barack Obama vowed to "free the executive branch from special interest influence" and pledged that none of his appointees would be "permitted to work on regulations or contracts directly and substantially related to their prior employer for two years." Obama's own ethics rules, moreover, bar lobbyists from working on his transition team in areas in which they have exerted any influence during the previous year.
But at least one nominee has managed to evade the president-elect's promised scrutiny of lobbyists: Tom Daschle, Obama's current health care policy adviser and his nominee as Secretary of Health and Human Services.

A former Democratic Senator from South Dakota, Daschle was one of Obama's first high-profile supporters, having joined his campaign back in February 2007 (bringing along his carefully cultivated mailing list of 85,000 donors). But in rewarding Daschle for his support, Obama has run afoul of the very conflict-of-interest rules whose enforcement he championed on the campaign trail.

The source of the conflict is that, since losing his Senate seat in 2004, Daschle has served on the board of the Mayo Clinic, the Minnesota-based medical non-profit group. For the past three years he has also worked as a public policy advisor for the Washington D.C. law firm Alston & Bird, providing "strategic advice" to their clients in the health care field, including CVS Caremark, Bayer and the Generic Pharmaceutical Association. During Daschle's tenure, Alston & Bird earned $16 million from these powerful healthcare industry players, by lobbying the Food and Drug Administration, the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services on their behalf. (Daschle himself is not a registered lobbyist. However, his wife, Linda Hall Daschle, is considered one of the most powerful registered lobbyists in Washington.)

Given this background, it comes as no surprise that watchdog groups have sounded alarms about the possible conflict of interest - or, at the very least, the appearance of impropriety - of hiring someone so closely involved with healthcare lobbying to head the Department of Health and Human Services. "We can't figure out any way that he would qualify to be secretary of health and human services under the policy that [Obama] has laid out," said Taylor Lincoln of the watchdog group Public Citizen.

These objections may not derail Daschle's nomination. The president-elect's personal popularity, combined with a Democratic majority in Congress, make it unlikely that Daschle's appointment will meet with resistance. However, Bill Allison, a senior fellow at the Sunlight Foundation, which campaigns for government transparency, explained that Daschle's appointment will be still reviewed by the Office of Government Ethics (as will all of Obama's appointments). The Office will then draft an ethics agreement in which Daschle will agree to resign from all other positions, and recuse himself from any matter involving his former clients - which could be awkward, considering Alston & Bird's high profile roster.

Perhaps more troubling than Daschle's lobbying résumé is what he will do in his new HHS role. To judge from his new healthcare policy manifesto, Critical: What We Can Do About the Health Care Crisis, Daschle's proposals for revamping the U.S. health care system are cause for concern. Among them is his proposal to create a "super board" of "experts" to oversee decisions about medical care for average Americans. As Daschle explains in his book, "In choosing what it will cover and how much it will pay, [this ‘super board'] could steer providers to the services that are the most clinically valuable and cost effective, and dissuade them from wasting time and money on those that are neither."

Dr. David Gratzer, a senior fellow at the Manhattan Institute, notes that "much of the book is standard fare." He worries, however, about Daschle's vision of a bureaucratic "super board." "Daschle envisions using public money to demand that doctors, clinics, and hospitals comply with the best practices set out by the all-powerful super board," says Gratzer. "If his idea is implemented and it works, the very practice of American medicine would change. The doctor-patient relationship would become the doctor-patient-super board relationship."

Gratzer warns against the dangers inherent in such a bloated bureaucratic system. "How would a government panel figure out the best treatment for, say, depression? How can payment consider ‘best practices' without massively increasing paperwork for everyone involved? The U.S. federal government is already involved in a massive pricing experiment of health-care services -- Medicare pays for 9,000-plus services, pricing them down to the penny. No one is satisfied with that system. Now the federal government would have to judge not only price but quality?"

Overall, Gratzer is concerned that Daschle's proposals, if implemented, would greatly expand the reach of government into healthcare. If Daschle's prescriptions come to pass, he notes, "Washington's role would be significantly increased: literally determining what is good care and funding services accordingly. The United States wouldn't have a Canadian-style system in terms of payment (that is, a single payer system), but -- like the Canadian and British systems -- the government would be much more dominant."

Barack Obama won the presidency on a platform of "change." As part of that platform, he promised to take on lobbyists and special interests, while introducing new ideas for reform. In turning to Tom Daschle, however, the president-elect has made the kind of selection that he once might have dismissed as "politics as usual."


Kathy Shaidle blogs at FiveFeetOfFury.com. Her new book exposing abuses by Canada's Human Rights Commissions, The Tyranny of Nice, includes an introduction by Mark Steyn.
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