On Thursday, President-elect Barack Obama named a South Dakotan with ties to Minnesota's Mayo Clinic as his choice to spearhead the nation's long-overdue health care overhaul. One of the cures that Tom Daschle, the nominee for secretary of health and human services, is proposing is an old idea but a radical one: an independent Federal Health Board.

Despite its dull bureaucratic name, this relatively small new group would have sweeping powers to overhaul Medicare and Medicaid, the nation's sprawling entitlement programs relied on by millions of elderly, disabled and low-income Americans. Potentially, even private health plans could fall under the board's influence. Although details are still sketchy, members would likely be appointed by the president, with the idea being that this would free the board to make potentially unpopular decisions necessary to rein in costs and restructure the system.

If it sounds like an end-run around Congress and its legions of lobbyists, yes that's exactly what it is. And that's why Daschle's Federal Health Board proposal is going to be highly controversial in the months ahead and, more importantly, why it deserves a thoughtful airing. Congress has had years to address the growing health care crisis. Nevertheless, U.S. health care expenditures are the world's highest; businesses and millions of consumers can no longer afford coverage.

This go-around-Congress maneuver may be a bit surprising coming from Daschle, a former South Dakota senator who served as majority leader and minority leader. But Daschle, who made the Federal Health Board one of the key foundations for reform in his recent book on health care, has said that Congress lacks the expertise and political fortitude for serious reform. The Federal Reserve Board sets monetary policy, not Congress, Daschle argues. Why not let a similar expert board take on health care?

It's an intriguing thought. The board, modeled on one used by the British health system, would be well-suited to revamp the Medicare payment system so that providers like those in Minnesota that provide high-quality care at low cost are rewarded, not paid less. It could find solutions to another massive problem -- the billions spent on expensive new drugs and procedures that aren't any better than traditional treatments. And, the board could act fast -- a major advantage in the current economic crisis that's driven in part by soaring health care costs.

A number of Minnesotans are influential voices in the health care debate. There's support here for having a national discussion on the board's potential. Mayo CEO Dr. Denis Cortese, who serves with Daschle on the Mayo Board of Trustees, said certain administrative and regulatory functions -- such as developing new payment models that reward quality providers, defining how to measure the results of care, facilitating an insurance market that appropriately distributes risk and excludes no patient -- "should or could be insulated from political influence if we really want to improve health care in the United States."

Dr. George Isham, HealthPartners' medical director, said the economic crisis dictates rapid action to find health care solutions. "This is a device that might work to do it," he said. Former Republican Sen. Dave Durenberger offered a different take. All options need to be on the table, but he believes that there are other solutions that should be tried.

Right now, there's little detail about who would sit on the board and how broad its scope or powers would be. Much more information is needed about how it would actually work; transparency and openness would be critical. Still, there's a reason so many health task forces throughout the years have proposed this idea. The time has come to give it serious consideration. The debate will no doubt be bruising, but it's one that needs to happen.