Daschle's Dual Role Lifts Hopes for Health Reform

Associate Editor Denise Napoli contributed to this story.

Early signals from the incoming Obama administration have many physician groups thinking about the prospects for comprehensive health care reform.

“There are a lot of unknowns,” said Dr. Jonathan Leffert, chair of the American Association of Clinical Endocrinologists' (AACE) legislative and regulatory committee. “Anyone knows that with these reforms come a lot of potential changes. But we're going to be involved … and hopefully there at the table,” he said. “I am optimistic about what we can do.”

For the AACE, most of its legislative goals for 2009 are similar to those of 2008, including repealing the sustainable growth rate (SGR), which ties Medicare physician payments to the gross domestic product, and ensuring fair reimbursement for in-office DXA scans.

But now that a health care overhaul looks likely, Dr. Leffert said that having a voice in the shape that reform takes also is crucial.

“As endocrinologists, we want to be able to be there with our ideas related to chronic diseases like diabetes,” said Dr. Leffert. “We want to be able to put forward our thoughts and ideas as to what might be the best way to take care of a chronic disease and make that a model for chronic diseases in the reform package.”

Endocrinologists also have a thing or two to say about preventive medicine, continued Dr. Leffert. “[President Barack] Obama has discussed the issue of prevention and how important that is, and we are always trying to [convince] people to make lifestyle changes, to decrease our country's big problem with obesity. So we as an organization are going to be in the forefront of trying to give guidance to the federal government about what the priorities should be.”

The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary, who Dr. Leffert called “a very energetic and enthusiastic individual.”

Sen. Daschle's experience as Senate majority leader will no doubt be an asset in his new post, added Dr. Leffert. “That [experience] in and of itself will be very useful in trying to move something as big and unwieldy as health care reform through the halls of Congress.”

The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious Mr. Obama is about health reform, he tapped Sen. Daschle for not one, but two posts. In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

Sen. Daschle's HHS position has to be confirmed by the Senate; however, the health care czar position does not.

In another example of the focus on health care reform, Mr. Obama and congressional Democrats have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of governmental affairs and public policy at the American College of Physicians. “I think the signals are positive.”

The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the SGR. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.

If Congress chooses to throw out the SGR formula, they likely will need to authorize some fast-track pilot projects to test some of the most promising models for new payment systems such as global and bundled payments, said ACP's Mr. Doherty.

ACP officials are hoping that the Obama health reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians.

Associate Editor Denise Napoli contributed to this story.

Early signals from the incoming Obama administration have many physician groups thinking about the prospects for comprehensive health care reform.

“There are a lot of unknowns,” said Dr. Jonathan Leffert, chair of the American Association of Clinical Endocrinologists' (AACE) legislative and regulatory committee. “Anyone knows that with these reforms come a lot of potential changes. But we're going to be involved … and hopefully there at the table,” he said. “I am optimistic about what we can do.”

For the AACE, most of its legislative goals for 2009 are similar to those of 2008, including repealing the sustainable growth rate (SGR), which ties Medicare physician payments to the gross domestic product, and ensuring fair reimbursement for in-office DXA scans.

But now that a health care overhaul looks likely, Dr. Leffert said that having a voice in the shape that reform takes also is crucial.

“As endocrinologists, we want to be able to be there with our ideas related to chronic diseases like diabetes,” said Dr. Leffert. “We want to be able to put forward our thoughts and ideas as to what might be the best way to take care of a chronic disease and make that a model for chronic diseases in the reform package.”

Endocrinologists also have a thing or two to say about preventive medicine, continued Dr. Leffert. “[President Barack] Obama has discussed the issue of prevention and how important that is, and we are always trying to [convince] people to make lifestyle changes, to decrease our country's big problem with obesity. So we as an organization are going to be in the forefront of trying to give guidance to the federal government about what the priorities should be.”

The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary, who Dr. Leffert called “a very energetic and enthusiastic individual.”

Sen. Daschle's experience as Senate majority leader will no doubt be an asset in his new post, added Dr. Leffert. “That [experience] in and of itself will be very useful in trying to move something as big and unwieldy as health care reform through the halls of Congress.”

The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious Mr. Obama is about health reform, he tapped Sen. Daschle for not one, but two posts. In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

Sen. Daschle's HHS position has to be confirmed by the Senate; however, the health care czar position does not.

In another example of the focus on health care reform, Mr. Obama and congressional Democrats have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of governmental affairs and public policy at the American College of Physicians. “I think the signals are positive.”

The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the SGR. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.

If Congress chooses to throw out the SGR formula, they likely will need to authorize some fast-track pilot projects to test some of the most promising models for new payment systems such as global and bundled payments, said ACP's Mr. Doherty.

ACP officials are hoping that the Obama health reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians.

Associate Editor Denise Napoli contributed to this story.

Early signals from the incoming Obama administration have many physician groups thinking about the prospects for comprehensive health care reform.

“There are a lot of unknowns,” said Dr. Jonathan Leffert, chair of the American Association of Clinical Endocrinologists' (AACE) legislative and regulatory committee. “Anyone knows that with these reforms come a lot of potential changes. But we're going to be involved … and hopefully there at the table,” he said. “I am optimistic about what we can do.”

For the AACE, most of its legislative goals for 2009 are similar to those of 2008, including repealing the sustainable growth rate (SGR), which ties Medicare physician payments to the gross domestic product, and ensuring fair reimbursement for in-office DXA scans.

But now that a health care overhaul looks likely, Dr. Leffert said that having a voice in the shape that reform takes also is crucial.

“As endocrinologists, we want to be able to be there with our ideas related to chronic diseases like diabetes,” said Dr. Leffert. “We want to be able to put forward our thoughts and ideas as to what might be the best way to take care of a chronic disease and make that a model for chronic diseases in the reform package.”

Endocrinologists also have a thing or two to say about preventive medicine, continued Dr. Leffert. “[President Barack] Obama has discussed the issue of prevention and how important that is, and we are always trying to [convince] people to make lifestyle changes, to decrease our country's big problem with obesity. So we as an organization are going to be in the forefront of trying to give guidance to the federal government about what the priorities should be.”

The economy is one reason that health reform may have a greater chance for success now than it did during the Clinton administration, said Dr. Nancy H. Nielsen, president of the American Medical Association. As more Americans lose their jobs, they are also losing their health insurance, she said, driving policy makers to address the issue of the uninsured. “There may be more tension for change now than there has been in the past,” she said.

President Obama addressed that tension head-on during a press conference last month to announce former Sen. Tom Daschle (D-S.D.) as his choice for Health and Human Services secretary, who Dr. Leffert called “a very energetic and enthusiastic individual.”

Sen. Daschle's experience as Senate majority leader will no doubt be an asset in his new post, added Dr. Leffert. “That [experience] in and of itself will be very useful in trying to move something as big and unwieldy as health care reform through the halls of Congress.”

The current state of health care in the United States—with rising premiums and the large number of uninsured Americans—is having a direct and negative impact on the U.S. economy, President Obama said. “If we want to overcome our economic challenges, we must also finally address our health care challenge.”

In a move that many agree signals how serious Mr. Obama is about health reform, he tapped Sen. Daschle for not one, but two posts. In addition to serving as HHS secretary, Sen. Daschle is slated to serve as director for a new White House Office on Health Care Reform. Jeanne M. Lambrew, Ph.D., a health policy expert who coauthored the health care book “Critical: What We Can Do About the Health-Care Crisis” with Sen. Daschle, was chosen as deputy director of the new White House office.

Sen. Daschle's HHS position has to be confirmed by the Senate; however, the health care czar position does not.

In another example of the focus on health care reform, Mr. Obama and congressional Democrats have signaled their interest in including health information technology incentives as part of an economic stimulus package, said Robert Doherty, senior vice president of governmental affairs and public policy at the American College of Physicians. “I think the signals are positive.”

The Obama transition team appears to be learning from some of the mistakes made during the Clinton administration's attempt at health reform, Mr. Doherty said. For instance, there has been a much greater effort by the Obama staff members to be open about their process and to gather input from the physician community.

Physician societies are making their priorities known to the new administration, emphasizing the need for physician payment reform to be a part of any reform package.

The AMA is pushing Congress and the administration to enact permanent Medicare physician payment reform by eliminating the SGR. Without congressional action on the payment formula within the next year, physicians will be faced with a projected 21% cut in Medicare payments starting in 2010, Dr. Nielsen said.

If Congress chooses to throw out the SGR formula, they likely will need to authorize some fast-track pilot projects to test some of the most promising models for new payment systems such as global and bundled payments, said ACP's Mr. Doherty.

ACP officials are hoping that the Obama health reform proposal will include some of their top priorities—coverage of the uninsured and improving access to primary care physicians.