Washington is really buzzed now!

HHS Secretary-designee Daschle had what was mainly a “love-fest” first confirmation hearing this week. He will surely be confirmed. It is interesting that the Transition is alleged to prefer Sanjay Gupta for Surgeon General (SG) over UV Provost Tim Garson. Garson wants to help—and has a lot to offer. But, even if the selection relates more to a “known voice” over “known expertise,” in my view Garson would make a great Asst. Secretary for Health (the SG's boss). The FDA post seems wide open still. But, the HHS team is hoped to be formed shortly after the Inauguration, somewhat dependent on getting Mr. Daschle’s confirmation completed.

I was privileged to have a chat with Sen. Daschle last week (Mr. Obama made an excellent cabinet choice here). Mr. Daschle is interested in establishing support for a national health board to wrestle with the really tough policy and reform issues -- a good idea. Daschle is optimistic about using the stimulus dollars to advance health IT in the short term, and he appropriately promoted health IT, rural health, community clinics, payment reforms, the sunset of the SGR, and promotion of other quality improvement incentives in the first hearing. He is interested in the College's views on health IT adoption strategies, on quality reporting, and on how to engage physicians and the ACC in the reform process. We hope to set up a leaders meeting with him soon. Daschle has become a health care visionary, and he has the trust and support of Congress -- what a dynamite combination!

sCHIP: It appears the House could move a stand-alone sCHIP (state-Children's Health Insurance Program) bill this week. The intention is to move identical CHIP bills through the House and Senate; therefore, no conference committee would be necessary. Timing on the Senate CHIP bill is less certain. The program has to be reauthorized by March 1 for sure. But, getting it done sooner would make major system reform discussions less complicated in the next two months.  The current new funding for sCHIP is rumored to be coming from a tobacco tax increase and an offset of some sort involving specialty hospitals (uh-oh?).

Stimulus: I suspect the stimulus package timeline could be delayed until almost the spring. President-Elect Obama has signaled to Congress that he wants to sign a stimulus bill by mid-February, but the Senate wants more time to consider what the specifics would be for ideas being floated about increased funding for comparative effectiveness, FMAP relief (the Medicaid state funding formula), and for COBRA insurance extensions for unemployed workers. Health IT is still a big stimulus priority too, but the interoperability and privacy issues are very controversial. We might see pilot projects rather than sweeping changes.

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