Even before the Senate had a chance to consider his nomination to be secretary of health and human services, Thomas A. Daschle was hard at work pressing President Obama's goal of revamping the U.S. health system. But after Daschle withdrew his name after acknowledging he paid $146,000 in back taxes and interest, Obama must forge ahead without his close friend and Washington mentor. Health experts across the political spectrum described the setback as serious but not insurmountable.