Daschle Says We Need to Make Wellness "Cool"

The confirmation hearing for Tom Daschle, Obama's choice for Secretary of Health and Human Services as well as head of the White House Office of Health Care Reform, is underway right now in the Senate Committee on Health, Education, Labor and Pensions.  Since Daschle was chair of this same committee when he was in the Senate, the atmosphere is beyond chummy.  The "tough questions" so far have been about the FDA (basically, "Will you make sure it continues to, you know, run?"), submitting data on spending as required by law ("Will you not do anything illegal?"), and leadership ("Will you actually lead your agencies, or will you goof off?")

Despite the softball, here are five observations - and all of them are great signs for health care reform.  (That's right, folks.  I watch CSPAN so you don't have to).

1.) Ted Kennedy's health is not at all slowing him down from effectively chairing this hearing.  Given that Kennedy will be a major player in the push for reform, this is a great sign.

2.) Daschle completely gets prevention and primary care.  He talked about health care as a pyramid, with primary care, prevention and wellness at the bottom, and things like heart transplants at the top.  For every other country, Daschle said, they start at the bottom when making their budget choices and move up.  In the U.S., we start with the most expensive procedures at the top, and usually run out of money before we can adequately fund enough prevention the bottom.  As many of the commenters on this blog have been saying, our health care system is a disease care program - focused on patching, fixing, mending instead of promoting wellness and health.

3.) He's not pulling his punches, calling it an "embarrassment" that we still don't have an interoperable system for Health IT, and has some tough things to say about the prescription drug benefit in Medicare Part D.

4.) He totally gets the physician and nurse shortages in this country, calling for adequate funding for the National Health Service Corps and using "all hands on deck" from nurse practitioners, physician assistants, pharmacists and community health centers.  (Taking off the policy hat and putting on the politics - he talked about this in answer to a question about Medicare Advantage and whether that flawed program provides an essential role in increasing "access."  Kudos to Daschle to immediately shifting to a topic that has far more of an impact on access.)

5.) He's been asked a lot of questions about the various agencies under HHS and how they can work together to promote health throughout the country... and he's kicked it up a notch.  According to Daschle, it's not just about the Centers for Disease Control, the National Institute of Health and the FDA working together.  Every government agency needs to be part of the change - from the Defense Department to the Education Department to the Commerce Department.  We need to make wellness part of the culture in everything we do.  Daschle ends this stirring part of his testimony with a battle cry - "We need to make wellness cool, and prevention hot."

I'm going to echo Sen. Harkin's reaction - "Wow."  If Daschle's testimony is the opening act in the battle for reform in 2009, it's a blockbuster.