Tom Daschle: Biggest Healthcare Challenges Are Cost, Quality

Obama adviser discusses the healthcare reform law.

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Well, they may feel that way about taxes, they may feel that way about other citizen responsibilities. But people ask me all the time whether healthcare is a right. And my answer is that it's a moral right. It's not a legal one. But if it is a moral right, I also think there is a fundamental personal responsibility that comes with that right. Just like there is a responsibility for citizenship in so many other ways—the responsibility to vote; the responsibility to pay your taxes; if you have a car, the responsibility to have car insurance. We've mandated car insurance if you drive a car. No one's challenged that. So it seems to me that there are certain requirements for personal responsibility that come with American citizenship. And this is one of them.

You talk about that in your book, not just the responsibility to purchase healthcare insurance but the responsibility to be more involved in the decisions, to be more skeptical of new procedures. You feel that that's something that's really important to making sure that this initiative works.

Absolutely. We have to become better consumers. And we have to become better advocates for our own well-being. We can't just wait until we get sick to be concerned about health. We have to be concerned about health in a very pro-active way, putting greater emphasis on prevention, greater emphasis on wellness, greater emphasis on our own physical well-being.

As someone who was both majority leader and minority leader of the Senate, what is your feeling on the filibuster?

I think it's grossly overused. We were averaging one filibuster a year all through the 20th century, until the 1960s. In the 1960s, we went to three a year, and then in the 1990s we went to about 10 a year. And now we're averaging two filibusters a week in the Senate in 2010. There's just been an explosion of use of the filibuster, and it has created a dysfunctionality that is very troubling to me. I think, at the very least, we should test going back to the old process of round-the-clock, 24/7 requirements, physically, to be on the floor when these filibusters occur. And not dual and triple, and run multiple tracks of legislation, that is commonly done today. That is, stay focused on one thing, as long as it takes, to get the bill done. That's harder to do, but I think it's something that we ought to take a hard look at.

How regretful are you that the issues that came up during confirmation, the financial and tax issues, prevented you from being more involved in the healthcare process?

Well, you have to deal with life's setbacks philosophically, and understand that sometimes things occur that are major disappointments. I've had two major disappointments in the last five years—my re-election effort in 2004, and then this. But I have an adage that I live by, that the windshield is much bigger than the rearview mirror. So I prefer not to look through the rearview mirror and keep looking forward. The good fortune that I've had to work with my former colleagues and the White House in an informal capacity gave me tremendous opportunities to stay involved—and writing this book, and speaking as I have around the country. I was just in Chicago yesterday, and today I'm in Missouri speaking about health, and so I'm very fortunate to have that opportunity, to continue to be involved, even though it's not a role that I had originally anticipated.


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