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Daschle worked for 30 years on the Senate Health Committee. Although his nomination was dropped for Secretary of Health and Human Services, and he consults for organizations at all ends of the healthcare spectrum, he brings a lot of valuable experience to bear on the subject. He points out that our health costs are escalating for a number of reasons, including continuingly more expensive medical technologies to serve an aging population, and the need for emergency rooms to treat all comers which passes the expense on the rest us. Our medical expenses are more than double the average of industrialized nations, but our average life expectancy of 78.1 is near the bottom (50th among all nations at this point). Health insurance coverage by businesses is steadily declining and the majority of bankruptcies are now the result of an inability to cover medical bills. In addition, health insurance is a moral issue because:  “The Institute of Medicine estimates that a lack of health insurance leads to 18,000 deaths per year.” Our system also is fragmentized and disorganized which adds to the cost: “…when patients see multiple providers [in ERs] in different settings, none of whom have access to complete information, it is easier for something to go wrong than when care is better coordinated.” (P 33) When Medicare was first proposed, it also was criticized as “socialized medicine,” but “as it turned out, doctors, hospitals, and insurance companies shouldn’t have been afraid of Medicare – government sponsored health insurance for the elderly turned into a financial windfall for all of them. “ (P 63) However, “doctors, bound by the Hippocratic Oath, had no reason to know or care about the cost of what they ordered.” (P 68) In addition “some doctors order tests, perform procedures, and prescribe drugs because the have a financial stake in doing so.” (P 122) He states that publicly funded community health centers, which were expanded by George Bush, could provide a valuable option for those with limited resources. Daschle favors the creation of a Public Health Board to oversee the medical profession: “Like the SEC, [the Health Board] would ensure that the public has accurate information on providers and health plans.”
(P 136) He also complains about costs created by numerous, uncoordinated, public health agencies: “Through Medicare, Medicaid, SCHIP, the Veterans Affairs department, the Pentagon, and the Indian Health Service, the federal government provides health care to roughly 100 million people. But these programs offer different benefits to different people, with no uniform system for measuring outcomes.” (P 165)