What does Tom Daschle's departure mean for the future of healthcare reform? I would submit that it is not a serious setback. In fact, it may have little effect.

Granted, Daschle was uniquely positioned to serve as the Obama administration's liaison to Congress. Well-liked on both sides of the aisle, Daschle might have been able to broker some of the differences between conservatives and progressives. But the fact that the vote on the expansion of S-Chip turned out to be such a bruising battle suggests that that those are who are ideologically opposed to universal coverage are not ready for a truce.

With or without Daschle, bipartisan compromise will go only so far, and then reformers will hit issues where many feel they just cannot compromise. The idea of tightly regulating the private insurance industry, for example, will be contentious. Insurers are fiercely opposed to the idea of competing on a level playing field with a public-sector healthcare plan that some call "Medicare for all". A battle seems all but inevitable – unless Democrats simply give up on the idea of a public-sector alternative to private insurance.

It is worth remembering that as a Democratic leader, Daschle was hardly a strong figure. He did not stand up to President Bush on either the war in Iraq or tax cuts for the wealthy. (A friend refers to Daschle, somewhat uncharitably, but not inaccurately, as "a wet noodle".) Granted, Daschle is a skilled, experienced politician. But from a progressive point of view, he may not have been the healthcare tsar we wanted.

Centrists were counting on Daschle to "manage the president's left flank", observes health policy consultant and blogger Bob Laszewski. Laszewski points to "pushing on things like a public health plan to compete with the private sector" as just the sort of behaviour that could create "a big hurdle". But do we really want a healthcare tsar who, from the outset, would be ready to concede on an issue that many see as essential to meaningful reform?
Observers who lament Daschle's departure argue that reform has lost its momentum. According to the New York Times, Daschle's withdrawal "could slow the president's drive to reshape the nation's healthcare system as the White House searches for a replacement, and it could allow Congress to step into the vacuum during that delay."