President Obama’s health care reform effort recently took a step ahead with the stimulus bill and a step back with Tom Daschle’s withdrawal. The New York Times is reporting that Kansas Gov. Kathleen Sibelius is the leading candidate for the HHS Secretary position, but she would not concurrently hold the health care reform czar position as Daschle would have. Meanwhile the Politico reports that Office of Management and Budget Director Peter Orszag is picking up the slack created by Daschle’s withdrawal:

Now Orszag is preparing for the biggest week of his career, with a “fiscal responsibility” summit Monday and the release of Obama’s first budget Thursday.

He’s signaling that the moves in the stimulus package are just a hint of what’s to come in a budget that will begin in earnest the arduous process of health care reform.
“What has already been accomplished is a huge start toward a more efficient [health care] system, and I think you’re going to see more in the budget next week,” he told Politico.

Though the budget’s details have been closely held, Orszag revealed, in broad terms, two: a continued focus on health care policy and a plan “to restore the nation to a sustainable fiscal trajectory over the five-to-10- year window.”

The next step on health care, he said, is a set of “changes to Medicare and Medicaid to make them more efficient, and to start using those programs more intelligently to lead the whole health care system.”

With a growing body of research finding some practices more cost-effective than others, the program’s reimbursement rules can be used to force changes at those hospitals — a sort of back door to health care reform.

“Medicare and Medicaid are big enough to change the way medicine is practiced,” he said.

Meanwhile, the Commonwealth Fund released a report recommending national health care reform along the lines that President Obama proposed in his campaign, e.g., a Massachusetts connector model.