There's been something of a debate about whether a universal health care system will come only from Washington, D.C., or whether it will involve state governments. Now that Tom Daschle is slated to become the head of Barack Obama's Department of Health and Human Services as well as the administration's universal health care czar, I'd say we know where the new administration comes down: decidedly with those who say a health care solution must come from both the federal government AND the states. That's the really big news about Daschle's appointment.
Watch Daschle's keynote speech at the Progressive States Network meeting just a few months ago - he's very explicit:
As the founder of the Progressive States Network, I'm obviously a fan of Daschle on health care -- he's ready to be a major leader on the issue, and PSN is ready to work with him. And I hope you go over to PSN's website and sign up for the Stateside Dispatch, and if you can, make a donation.
Though as a former Senate Majority Leader Daschle seems like a conventional cabinet pick, his deep understanding of the integral role that states must play sets him apart from much of the Washington-centric Establishment and makes him something of an out-of-the-box appointment - and that's a good thing.
As I wrote in a column a while back, states are making a lot of progress on health care, and are uniquely situated to play a major role in national reform. Resisting the Beltway's conceited urge to ignore states, and resisting our media culture's affinity for single centralized silver-bullet solutions is going to be a major challenge for the Obama administration -- but clearly, the Daschle pick shows the new White House is ready for that challenge.
This isn't an either/or choice -- it's not either we do health care at the federal level or we do it at the state level, and it's not either we do health care at the federal level, or we don't do it at all. It is an "and" situation -- we must work to expand health care at the federal level AND at the state level. Daschle gets that important truism.