WASHINGTON — Tom Daschle told former Senate colleagues on Thursday that as health secretary he would learn from former President Bill Clinton's failed attempt to overhaul health care, an effort criticized as too long, secretive and hard to understand.
"These are good arguments for undertaking reform in a way that is aggressive, open and responsive to Americans' concerns," Daschle said at a hearing. "They are not good arguments for ignoring the problem."
Daschle, President-elect Barack Obama's choice to head the Health and Human Services Department and the former Senate Democratic leader from South Dakota, kicked off the Senate's hearings on Obama's Cabinet designees. It was friendly territory as lawmakers he once served with offered praise but few tough questions for what will be a difficult and expensive assignment.
The Senate's Health, Education, Labor and Pensions Committee summoned Daschle, although the Senate Finance Committee will be the panel that votes on the nomination. Most analysts expect Daschle will have little problem winning confirmation as HHS secretary.
He described the U.S. health care system as expensive, mediocre and too often unavailable to those in need. Another former Senate majority leader, Republican Bob Dole of Kansas, helped introduce Daschle at the hearing. Dole said Daschle had a strong understanding of health care and knew how to get things done.
"If anyone understands Congress, it's Tom Daschle," Dole said.
Daschle told lawmakers they would be partners in whatever plans were developed to improve the system.
"President-elect Barack Obama recognizes that many of you have been working for many years on these issues, and that any effort at reform will require close collaboration with Congress," Daschle said.
Sen. Edward M. Kennedy, the committee chairman, began the hearing with the first of several warm welcomes for Daschle. "Reform is urgently needed and Tom Daschle is just the person for the job," said Kennedy, D-Mass.
In the coming months, Kennedy's committee is expected to help craft legislation to expand health insurance coverage. Lawmakers were eager to get Daschle's perspective.
Republicans said they want to work with Daschle on overhauling the system and asked for his assurance he would seek their advice. "It's the only way we're going to get something done," said Wyoming Sen. Mike Enzi, the committee's top Republican.
Enzi voiced concerns about possible Food and Drug Administration regulation of tobacco products, which Obama supports. Such regulation would amount to the FDA giving its "stamp of approval" on cigarettes, Enzi said. But Daschle said it would not be construed that way.
Sen. Richard Burr, R-N.C., mentioned Obama's proposal to reduce payments to private insurers that administer Medicare benefits to the elderly and disabled. Burr said the program, called Medicare Advantage, was crucial to giving rural people a choice in how they get their health benefits.
"We have to look at whether we're getting our money's worth," Daschle replied.
Daschle has made it clear in the past year that he believes Congress must move fast on health legislation. Kennedy thinks so, too. His staff has spent recent months meeting with trade and interest groups that have much at stake in the issue.
Obama has put Daschle in line for two prime jobs: health secretary and director of a new White House office on health reform. In previous administrations, the White House and not the Cabinet agency has led attempts to expand coverage.
Daschle told lawmakers it was unacceptable that 1 in 4 people in the United States don't have health insurance coverage. He said that's only part of the problem, though. Incentives for reimbursing health care providers are not focused enough on prevention. Also, costs are rising too quickly as insurance premiums rose three times faster than overall inflation during the past nine years.
"Any health care reform plan must achieve the three goals of increasing access and quality while containing cost," Daschle said.
Daschle said one point of emphasis will be on lowering drug prices for consumers. For example, he said he would support giving the secretary of HHS authority to negotiate drug prices on behalf of Medicare participants.
"I think that there's a great deal to be said for that," he said. "I've supported it in the past, and I'd support it in the future."
Critics of that approach say that the private sector is better at generating price concessions than the government.
Daschle also voiced support for reducing a coverage gap in the Medicare drug benefit, known as the doughnut hole, where insurance no longer covers part of the cost of a participant's medicine.
"It's a very expensive fix," Daschle said. "We'll have to work together to see how we find solutions to that."
Former President Clinton pushed a universal health care plan, developed at the White House under first lady Hillary Rodham Clinton, but it failed to gain congressional approval and helped Republicans win control of the Senate and House in 1994.
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