That's Tom Daschle, President-elect Barack Obama's nominee for secretary of Health and Human Services and the nation's new "health care czar," explaining to the Associated Press why national health reform has failed in the past. Big, clumsy Clinton-style health reform bills, the size of a telephone book, read and analyzed by ordinary people - that, according to Daschle, led to fatal criticism.
Translation: If we hadn't spelled out the specifics, we could have gotten our schemes past the public.
Ironically, Daschle has given us quite a few details in a short and very readable book, "Critical: What We Can Do About the Health Care Crisis." He describes his proposal for a Federal Health Board that would make key recommendations on the kinds of medical technologies, treatments, drugs and procedures that Americans should have.
Daschle models his board on the Federal Reserve Board, with a governing body of politically appointed experts. But he insists they would be "insulated from politics." They would "oversee the health care industry" and have the power to make "complicated medical decisions and the independence to resist political pressures." Additionally, they would "help define evidence-based benefits and lower overall spending by determining which medicines, treatments and procedures are most effective -- and identifying those that do not justify their high price tags." Translation: denied payment.
The Federal Health Board would set rules for private insurers who would participate in a new national pool. They also would recommend benefit coverage to be included in all government health programs.
Daschle is refreshingly frank about the enormous power of his Federal Health Board, which he says would act like a "Supreme Court of Health." Daschle acknowledges that it would further alter the already weakened doctor-patient relationship.
The decisions of this Federal Health Board would, at first, affect only those Americans enrolled in government health programs, such as Medicare and Medicaid. But Daschle suggests expanding its powers to health plans that cover all Americans.
In short, Daschle's prescription for health care reform is centralized government control over our health care decisions by a powerful elite who will decide what's good for us, and what isn't.
Of course, the health care sector of our economy is blessed with a treasure trove of professional expertise. But only Daschle's "Supreme Court of Health" would count.
Yep, details can kill.
Robert E. Moffit, Ph.D.,is Director of the Center for Health Policy Studies at The Heritage Foundation.
First Appeared in the Boston Herald