Wednesday, February 04, 2009

The Next HHS Secretary: All Signs Point to Kansas

So we thought we would be done with this game, but apparently not. Now that Tom Daschle has withdrawn his nomination, the question on everyone’s mind is: Who will replace him?

All signs point to Kansas Governor Kathleen Sebelius. The Governor made a name for herself in her home state as an insurance reformer. She stopped Blue Cross Blue Shield from merging with another out of state company and she refused to accept contributions from insurance companies during her campaign.

She was a key surrogate for President Obama during his campaign and remains close to him. Maybe most importantly, she was already thoroughly vetted for Vice President and was thought by many to be a close second to Joe Biden. As a serving public official, she would bring none of the lobbying concerns that weighed down Daschle’s nomination and eventually torpedoed it.

If Sebelius is the pick, we imagine that Jeanne Lambrew will be named head of the White House Office of Health Reform and Sebelius will take on the more classic role of the HHS Secretary.


If President Obama attempts to remake the pick in the mold of Daschle—a legislative general with knowledge of the issues—here’s our list of potential candidates.

Rosa DeLauro (US Congress): The Connecticut Congresswoman was originally a candidate the first time around, so why not the second? DeLauro currently chairs the agriculture appropriations subcommittee in the House, which among other things oversees FDA's budget. She's no fan of DTC ads, sloppy overseas manufacturing, or anything that looks like overly cosy relationships between industry and regulatory.

DeLauro knows as well as anybody the ins and outs of Congress and where the levers of power are.

And remember that cozy little Super Bowl Party President Obama threw at the White House for a select few members of Congress? Well, DeLauro was invited and attended. We’re just saying…The President may need her as part of the stimulus plan passage/maintenance/implementation but ignore her at your peril.

Ron Wyden (US Senator): Wyden, weirdly, has been one of the forgotten figures of health reform. However, he’s got a bill floating out there and he’s taken a long-term interest in health care. The Health Americans Act, co-sponsored by Utah Senator Robert Bennett, aims to get universal coverage by creating a new private insurance market and uses state-based purchasing pools.

Plus Wyden has served in both the House and Senate, so he knows both worlds well. Not only that, my friends (John McCain reference), but one Emanuel seems to really like his approach. That would be NIH’s Ezekiel Emanuel who is on detail at the Office of Management & Budget. But if one Emanuel likes your thinking, don’t they all?

Donna Shalala (former HHS Secretary): President Clinton had one HHS Secretary for all eight years: Donna Shalala. Is there anyone who knows HHS better? Or the lessons of the failed Clinton health reform plans?

She could step in from Day 1 and hit the ground running while coordinating seamlessly with the White House health care group. In addition, Shalala has spent her post-government life as a university president at the University of Miami.

She appears to garner wide respect from both sides of the aisle. President George W. Bush awarded her the Presidential Medal of Freedom last year. Shalala has also remained very engaged in the health reform debate showing up at reform meetings involving all of the critical stakeholders.

Jay Rockefeller (US Senator): If you can’t get a Kennedy, why not a Rockefeller? (that one goes to one of our blog colleagues). Rockefeller has been intensely engaged and personally moved by the health reform because of family experience. His stake in the Clinton Reform effort is well documented.

Rockefeller would carry the interest, knowledge, experience in the Senate, and gravitas to the position of HHS Secretary. And as Senate Finance Health Subcommittee Chairman, he has the right title.

He has been particularly visible during hearings on Medicare Part D drug prices over the last few years. Before you dismiss this one out of hand, we have it on good sources he considered the Major League Baseball Commissioner job very seriously many years ago because he loves new challenges. We would categorize health care reform and universal coverage as a challenge.

Richard Gephardt (former US Congressman): We think Gephardt would be perfect for the Daschle-like role of legislative general. He served in the House of Representatives from 1977 to 2005 and was both the House Majority Leader and Minority Leader.

In fact, we would think his Daschle-like temperament and experience would make him perfect for the job. Except for one thing: he’s been a consultant to DLA Piper and Goldman Sachs since he left public life. That probably sticks a fork in any chance of Gephardt getting the job even if he wanted it, but you never know. 

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