If you caught any part of former Sen. Tom Daschle's confirmation hearing for the job of Health and Human Services secretary on C-SPAN, you likely heard references to South Dakota. The Rushmore State got several mentions during the 100-minute hearing on Thursday, the first of President-elect Barack Obama's cabinet confirmation hearings.
While our state had a high profile, the news wasn't necessarily good, as it's not so good for the nation's health care situation.
"Health care is personal to me. I ran for Congress 30 years ago to help places like rural South Dakota, where people sometimes went without proper health care because the nearest doctor's office was too far away," he said.
Soon afterward, he noted a dire problem.
"On the Pine Ridge reservation in South Dakota, one half of the people over 40 have diabetes," he told the Senate's Health, Education, Labor and Pensions Committee. "And the life expectancy today is just 47 years, or what life expectancy was for the rest of the country in 1900. This is unacceptable. We need to make sure that every American gets high-quality care, and if you see fit to support my nomination, I'll make sure this goal includes the Indian Health Service."
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During the question-and-answer portion of the hearing, the committee members and Daschle kept coming back to South Dakota, most often as a comparison to other states.
First, though, Daschle quoted from a long-gone highway sign in answering concerns from Sen. Chris Dodd, D-Conn., about data that shows America's children of today will be the first generation less healthy than their parents and grandparents.
"That's never occurred in our history before," Dodd said.
Daschle replied: "I remember a highway sign outside of Rapid City, South Dakota, many, many years ago. All it said was, 'It's so much better to build a child than to repair an adult,'" Daschle said, promising the Obama administration would make the situation a priority. "In the long term, one of the biggest challenges we have is obesity in this country. And one of the biggest opportunities we have to address in obesity is with our children."
Beyond that, the comparisons centered on rural health care and Medicare functions, or dysfunctions, in rural areas.
Sen. Lisa Murkowski, R-Alaska, wanted to talk about rural doctors refusing to take Medicare patients.
"With both of us coming from rural states where we don't have the number of health care providers, we share the same concerns. We've seen in Alaska Medicare-eligible individuals and their ability to see a doctor, a number of doctors unwilling to take on new Medicare patients. What are we going to do about a Medicare system that is failing our seniors in many areas?"
Daschle agreed that there's a problem.
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"Anybody from the West can identify completely with your very apt description of our circumstances," Daschle said before offering a detailed explanation and saying that what Murkowski outlined is just part of the problem.
Daschle said he'd like to re-invigorate the National Health Service Corps, a federal program focused on delivering health care to underserved areas. In addition, he would like to train more primary care providers and improve health information technology, "especially in rural areas."
Daschle's support for the National Health Service Corps came up again when he was questioned by Sen. Bernie Sanders, I-Vt., about the need to provide health care to the nation's poor. Daschle repeated an earlier statement that, especially in rural areas, there is a dearth of mental health and dental services.
In perhaps the most significant exchange policy-wise, Daschle told Sen. Richard Burr, R-N.C., that a portion of Medicare that pays private insurers to provide care to the elderly and disabled, called Medicare Advantage, deserves scrutiny.
Burr said the program helps people in rural areas. Daschle wondered if it isn't too expensive.
"It has provided some support to people in rural areas, and to the extent that it has, it's been welcome," Daschle said.
Daschle gets a second hearing before the Senate Finance Committee before the entire Senate will vote on his confirmation.
Denise Ross writes Hoghouseblog.com from Rapid City.
