NY Times, August 23, 2009
Daschle Has Ear of White House and Health Industry
By DAVID D. KIRKPATRICK
WASHINGTON — Six months have passed since the morning when Tom Daschle,
a former Senate Democratic leader, under fire for not paying certain
taxes, called President Obama in his study off the Oval Office to
withdraw his nomination as health secretary and reform czar.
But these days it often seems as if Mr. Daschle never left the picture.
With unrivaled ties on both ends of Pennsylvania Avenue, he talks
constantly with top White House advisers, many of whom previously worked
for him.
He still speaks frequently to the president, who met with him as
recently as Friday morning in the Oval Office. And he remains a highly
paid policy adviser to hospital, drug, pharmaceutical and other health
care industry clients of Alston & Bird, the law and lobbying firm.
Now the White House and Senate Democratic leaders appear to be moving
toward a blueprint for overhauling the health system, centered on
nonprofit insurance cooperatives, that Mr. Daschle began promoting two
months ago as a politically feasible alternative to a more muscular
government-run insurance plan.
It is an idea that happens to dovetail with the interests of many Alston
& Bird clients, like the insurance giant UnitedHealth and the Tennessee
Hospital Association. And it is drawing angry cries of accommodation
from more liberal House Democrats bent on including a public insurance plan.
Friends and associates of Mr. Daschle say the interests of Alston &
Bird’s clients have no influence on his views. They say he sees no
conflict in advising private clients on the one hand and advising the
White House on the other, because he offers the same assessment to
everyone: Though he has often said that he favors a government-run
insurance option, the Senate will not pass it.
“The message I deliver to labor unions and business leaders is the same
one I share with doctors, hospitals and insurance companies,” Mr.
Daschle wrote in a brief e-mailed statement. “I do not tailor my views
to any specific group or client.”
Mr. Daschle is not registered as a lobbyist and recently told U.S. News
and World Report that he preferred to describe himself as a “resource”
to those in government and industry.
“I’d like to be a resource to my former colleagues, to the extent that I
can, to the administration, to the stakeholders and to people interested
in just kind of knowing how this is all going to play out,” he said. “I
am most comfortable with the word resource.”
White House officials say they appreciate his help. “He is one of a
number of people that provides outside advice to the White House, and
the president greatly appreciates that advice and Tom’s friendship,”
said Dan Pfeiffer, a spokesman for the White House who previously worked
for Mr. Daschle. Mr. Pfeiffer added that the former senator was “a
recognized expert on health reform who knows more about the legislative
process than just about anyone.”
Critics, though, say his ex officio role gives Alston & Bird’s health
care clients privileged insights into the policy process. They say Mr.
Daschle’s multiple advisory roles illustrate the kind of coziness with
the lobbying world that Mr. Obama vowed to end. If he had been confirmed
as health secretary, Mr. Daschle would have been subject to strict
transparency and ethics rules.
His position, some liberals say, raises at least an appearance of a
conflict of interest. “I hope the president can make a decision based on
what the country wants, not what a handful of Daschle’s clients want,”
said Representative Lynn Woolsey of California, a leader of the
progressive caucus.
Clients of Alston & Bird say Mr. Daschle advises them, sometimes
indirectly through the firm’s registered lobbyists, about the
personalities of his former colleagues, as well as strategies to achieve
their policy goals.
“He would tell us, ‘Make sure you present the value proposition of home
care with as great detail as you can, so Congress understands that home
care is part of the solution rather than a cost to be cut,’ ” said
William A. Dombi, a lawyer at the National Association for Home Care and
Hospice.
Some of the health overhaul bills would make deep cuts in Medicare
payments for home health services, but Mr. Daschle has instead argued
for an increase. And though he does not lobby, he took that message to
Capitol Hill last month, giving a paid speech at a meeting for
Congressional staff convened by a group of home health care equipment
concerns.
“My mother’s quality of life is a hundred times better given the fact
that she can live at home rather than be institutionalized at 86,” Mr.
Daschle told the audience, according to industry newsletters.
Representative Jason Altmire, a Pennsylvania Democrat who spoke
alongside Mr. Daschle, praised the former senator but said it was
inevitable that his dual roles would draw criticism, especially “given
the high profile this president has given to trying to show some
distance from the lobbying business.”
Mr. Altmire added, “That makes it even more difficult for him to be
involved.”
Mr. Daschle does not shrink from his leading role in the debate.
Speaking at a hospital industry conference last week, for example, he
accepted billing as “the architect of President Obama’s health care plan.”
Before such industry groups, Mr. Daschle can sometimes cheer on their
lobbying efforts, as he did at a meeting on Aug. 8 of chain drugstore
executives when he urged them to push lawmakers to raise certain
Medicaid reimbursements.
“This is a message that I hope each and every one of you will take to
your member of Congress,” he said. “There is no more critical time to do
that.”
He both recommends and predicts an incremental approach.
“We are not going to see this happen overnight. It can’t. It is too big
a shift in the economy,” Mr. Daschle told a biotechnology trade group in
May. If the legislation can begin to “ramp up” coverage for all, health
information technology and some cost controls, he said, “we will have
succeeded.”
He often enumerates what he considers areas of political momentum as
well as points of disagreement, including the government insurance plan.
“There is no consensus on whether there ought to be a public option,” he
told the drugstore executives.
Last week he told the hospital executives, “There is virtually no
support among Republican members for a public option, and that remains
an unresolved element of this debate.”
Senate Democratic leaders have recently said they concur it is unlikely
to pass.
Mr. Daschle’s friendship with the president goes back to Mr. Obama’s
first days in the Senate. An early and important backer of Mr. Obama’s
presidential campaign, Mr. Daschle also sent a steady stream of former
aides to Mr. Obama’s Senate office and White House staff. Mr. Obama’s
senior adviser Pete Rouse was Mr. Daschle’s chief of staff. Jeanne
Lambrew, a top White House adviser on health care reform, was a
co-author of Mr. Daschle’s 2008 book, “Critical: What We Can Do About
the Healthcare Crisis.”
Mr. Daschle’s cabinet nomination was done in by the disclosure that he
had failed to pay taxes on the use of a friend’s car and driver while
making millions advising Alston & Bird’s clients. After he withdrew his
nomination, he threw himself into preparing a bipartisan proposal for
health care overhaul with two Republicans who were Senate leaders: Bob
Dole, a colleague at Alston & Bird, and Howard H. Baker Jr., now at
another law and lobbying firm. Their proposal, released in June, was
among the first to spell out the idea of helping states establish health
insurance “co-op plans with consumer boards.”
Senator Kent Conrad, Democrat of North Dakota and one of Mr. Daschle’s
closest friends, began pitching the idea at about the same time and has
become its champion. Mr. Conrad is among six members of the Senate
Finance Committee working on their own compromise proposal that aides
say looks increasingly like the Daschle-Dole-Baker report.
As a backstop, their plan provided that if state co-ops or other
programs failed to meet certain cost and coverage goals in five years,
the president could create a public plan on a fast track without threat
of a Senate filibuster.
That feature, known as a trigger, was briefly acknowledged as another
possible compromise by the White House chief of staff, Rahm Emanuel.
Though it was little discussed, Senator Olympia J. Snowe, Republican of
Maine and one of the Finance Committee’s group of six, has recently
expressed support for the concept, and committee aides say the idea is
under consideration.
To address doctors’ fears of lawsuits, Mr. Daschle and his collaborators
proposed a “safe harbor” from legal liability for doctors who follow
certain rules. Mr. Obama took up the idea in a mid-June speech to the
American Medical Association.
After Mr. Daschle left the Oval Office on Friday, a White House
spokesman described their meeting as a “quick check-in” on the overhaul
process. The spokesman said the two “agreed to stay in touch over the
coming weeks and months.”
_______________________________________________
pen-l mailing list
[email protected]
https://lists.csuchico.edu/mailman/listinfo/pen-l
