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Tom Daschle addresses the first annual meeting of the Public Sector HealthCare Roundtable

is "as crucial a time in the public pension and health debate as we have had in our history," former Senate Majority Leader Tom Daschle said in a keynote address at the first annual conference of the Public Sector HealthCare Roundtable.

Speaking to several dozen representatives of public pension plans, public employee unions and other organizations, Daschle discussed what he called three myths about the U.S. health care system. It is a myth, he said, that the United States has the best system in the world when it is ranked 37th by the World Health Organization on health system performance. It is also a myth, he said, that change would be too costly, when today's per capita spending of $5,200 is double what the next highest-spending country pays. Finally, he said, it is a myth that comprehensive reform would lead to rationing, especially given that, with 46 million uninsured people, the nation already has de facto rationing that occurs based on a person's ability to pay for treatment.

The success of public pension plans in providing health benefits to millions of people "says volumes about the capacity of the public sector to deal with these challenges in a meaningful way," Daschle said, urging the meeting attendees to use their experience and influence to push the debate forward.

"You can be the educators," he said. "You can be the teachers. You can be the catalysts for change."

It was generally acknowledged by speakers at the Nov. 29-30 conference that health care reform is not at the top of the agenda in Washington and that lawmakers will not put it there unless they are forced to do so.

"If the political pressure isn't there, Congress is going to go to the place of least resistance," Chris Jennings, president of Jennings Policy Strategies, said.

Mark Isakowitz, a partner with Fierce, Isakowitz and Blalock, similarly said that, "Health care, eventually, is going to have to be a stakeholder-led issue." If reform is to occur, Isakowitz said, coalitions must be formed to represent groups on all sides of the issue and to apply constant pressure for reform.

"Health care only works, when it comes to making big changes, when you have some level of bipartisan consensus," he said.