Medical Device Daily Washington Editor

Former senator Tom Daschle announced yesterday that he is withdrawing his name from consideration for the post of the Secretary of Health and Human Services. Daschle's announcement comes at an especially sensitive time, given the urgency on the part of the Democratic Party to reshape healthcare in short order.

Daschle's announcement came almost simultaneously with an announcement by another Obama nominee, Nancy Killefer, who was tagged to serve as the administration's chief performance officer, a new post in the executive branch. Killefer failed to pay taxes for household help, and the District of Columbia placed a lien on her home in 2005 over unemployment compensation taxes, which are said to have come to roughly $950.

Daschle's tax liabilities loomed much larger. The former Senate majority leader last week paid back taxes and associated interest of more than $140,000 in connection with limousine services he used for three years at no charge. However, Senate Republicans also questioned his ties to the insurance industry, citing numerous speaking fees and other financial ties (Medical Device Daily, Feb. 3, 2009), especially given President Obama's promise to staff a cabinet that is free of special interests. However, Daschle's purported seven-figure salary for entities such as the law firm of Alston & Bird (Washington) also tore away at some of the support he might have enjoyed.

Senate Finance Committee chairman Max Baucus (D-Montana), who earlier in the day had addressed a healthcare policy gathering in Washington, said in a statement released yesterday afternoon, "it was with regret but with respect for his decision that I learned of Senator Daschle's request to withdraw his name from consideration for Secretary of Health and Human Services." Baucus noted that Daschle "would have been ... a terrific partner at HHS on health reform, and I hope and fully expect that he will continue to play a leading and valuable role in health policy for this country."

Baucus made no mention of the development yesterday morning, and his office had published the previous day an announcement that the Finance Committee would take up the nomination in a Feb. 10 hearing.

The committee's ranking member, Chuck Grassley (R-Iowa), had a less amicable view of the nominee's problems, and his comments may foreshadow an early end to the bipartisan comity the Obama administration hoped to develop. According to wire service reports, Grassley said, "I don't know whether I'm finding so much fault with people like Daschle and Geithner as I am with a president that wanted to get his administration up and running, bragged about the vetting process, bragged about not having ethics problems and conflicts of interest, but just look at the stumbles that have been made."

The bipartisan feeling was also not abetted by the fact that no Republicans and 11 Democrats voted against the House's version of the economic stimulus bill, which the Senate is currently considering.

Sen. Dick Durbin (D-Illinois), noted that the development "really sets us back a step," given that the former South Dakota senator "understood Congress" because he served in both chambers, and because "he certainly had the confidence of the president."

In a written statement, Obama said, "now we must move forward with sadness and regret," but Daschle denied any pressure from the White House.

Court denies Medicare data disclosure

A consumer advocacy group lost an appeal of a lower court decision that would have allowed public disclosure of quality data for doctors who practice under the Medicare dime, but the group promised to soldier on.

Consumers' Checkbook (CC; Washington) won a 2007 decision that would have forced the Department of Health and Human Services to release the records under the Freedom of Information Act, but HHS appealed, along with the help of the American Medical Association (AMA; Chicago), and won a 2-1 decision in a federal appeals court in Washington. CC, along with employers and insurers, made the case that access to claims data may help monitor quality and sniff out waste. The request would not have required patient identification information, and according to wire services reports, Robert Krughoff, President of CC, said "the majority opinion seems to misunderstand how these data would be used."

On the other side of the fence stands AMA, which was represented by Jeremy Lazarus, MD, a Denver psychiatrist and AMA spokesman. Wire service reports quote Lazarus as saying that the decision is "a momentous victory for the privacy rights of physicians." Lazarus also said that Medicare billing records are "basically raw data," and fail to account for the fact that some doctors see sicker patients than others.