Health and the 44th Presidential Administration (Part III). In three nearly back-to-back announcements, President Obama is working prodigiously to fill his leadership roster for health care. Of course, the most newsworthy was his selection of Kansas Governor Kathleen Sebelius as Secretary-designate of the Department of Health and Human Services (HHS). The White House Office of Health Reform, however will be lead by Nancy Ann DeParle who headed up the Center for Medicare & Medicaid Services during the Clinton administration. The administration may deem DeParle, a Beltway-insider, as having a greater amount of political clout to handle what is sure to be high-stakes negotiation within the White House Office of Health Reform. Both women have a depth of experience in health care financing and health insurance, a stakeholder group incidentally with a powerful voice in previous rounds of the health reform debate.

The Office of National AIDS Policy is set to be led by Jeffrey S. Crowley. With a background in public health, Crowley will bring the appropriate knowledge for managing the health of populations and the dynamics of epidemics in leading the effort to set an appropriate national policy. He will also serve as a member of the Domestic Policy Council. The President stated the following:

“In [AIDS and disability policy], we continue to face serious challenges and we must take bold steps to meet them. I look forward to Jeffrey’s leadership on these critical issues.”

Mary Wakefield has been appointed Administrator of the Health Resources and Services Administration (HRSA). President Obama made the following comments regarding her appointment:

“As a nurse, a Ph.D., and a leading rural health care advocate, Mary Wakefield brings expertise that will be instrumental in expanding and improving services for those who are currently uninsured or underserved. Under her leadership we will be able to expand and improve the care provided at the Community Health Centers which serve millions of uninsured Americans and address severe provider shortages across the country.”

For even more insight into this health braintrust, check out what’s on the bookshelf (a widget to the right) featuring books and articles with references and contributions from these political appointees. Several leaders are now in place and not a moment too soon. With the American Recovery and Reinvestment Act of 2009 now signed into law and the more recent unveiling of the budget proposal for 2010, there is plenty of (health care) work to be done.

Sources:

Sebelius at HHS at the White House Blog and Administrator of HRSA Announced and Obama Names Head of AIDS Policy Office and Obama Picks Kansas Governor Sebelius as Health Secretary – washingtonpost.com.

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Health and the 44th Presidential Administration (Part II). The New York Times editorial is believed to have crystallized the issues of the current political climate and helped former Senator Tom Daschle choose to remove his name from further consideration and confirmation as Secretary of Health and Human Services.

Despite Daschle’s legislative policy expertise and significant history working on health policy issues, his work at Alston & Bird, LLP (though not as a registered lobbyist) and the mounting opposition from Senate Finance Committee Republicans may have ultimately proved an albatross to great to bear. Perhaps, it is ironic that the very attributes that would suggest former Senator Daschle would be a tremendous asset to shepherding and ultimately passing health care reform in America (ie. legislative policy expertise and significant familiarity with policy and industry stakeholders) is also the gauntlet that forced the President’s nominee and friend to fall short of the new ethical standards placed upon this administration.

What does this mean to the average health consumer?

Substantively, the elements of the Obama health plan will not change as the remainder of the President’s braintrust for health remains in tact. If former Senator Tom Daschle were the heart of that effort, then his former co-author, Dr. Jeanne Lambrew is (if at least in part) the brains of the effort. Only time will tell as elements of health reform begin to make their way through the legislative process if there exist another health care champion with the political moxie to accomplish what the Clintons could not back in the 1990’s—reform America’s health care system.

Read:

Editorial – The Travails of Tom Daschle – NYTimes.com.

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Source: Jim Wilson/The New York Times

Last Thursday, in a press conference from Chicago, President-elect Obama’s announcement of former Senator Tom Daschle as designate for Secretary of the Department of Health and Human Services was of little surprise. This has been speculated upon and anticipated for weeks since the election.

The announcement of more significance was the formation of the White House Office of Health Reform. As Director of this new office, Senator Daschle will have dual posts in the new administration. Dr. Jeanne Lambrew, a health policy expert will serve as the Deputy Director. Establishing an Office of Health Reform within the White House suggest the President-elect fully comprehends that the magnitude of the task of reforming America’s health care system is greater than that which can be met by the handful of individuals who will serve on his Domestic Policy Council. And, as the name reveals, these individual are responsible not simply for health care but all domestic policies. Obama stated, “[Daschle] will be responsible not just for implementing our health care plan — he will also be the lead architect of that plan.” Hopefully this newly formed Office of Health Reform will be used to formulate strategy and inject continuity and integration into a process—legislative policy-making—which by its very nature is incremental and piece-mill. I believe such coordination and systems thinking is essential to the successful reform of health care in America.

The Obama brain-trust for health policy also includes Daschle staff alumni Mark Childress and Bill Corr each formerly having served as Cheif Counsel and bring a wealth of legislative experience to this endeavor. Experience that will be highly valuable in shepherding reform legislation through Congress. Subject matter experts include Dr. David Cutler, a health economist, Dr. Nicole Lurie, a physician-scientist noted for her research in the areas of health care disparities and public health preparedness and Dr. Jonathan Moreno, a bioethicist. Together with Dr. Lambrew, these experts have proposed linking medical payment to improved health care outcomes (and not simply the medical intervention), emphasis on prevention, and coordinating care through disease management programs as key goals for health care reform. Each of which is difficult to attain in the absence of an integrated health care delivery system. (More on the details of the Obama health plan and further integration of the system to follow in Part II of this post).

Watch the press conference

Read a transcript of the press conference

Additional Sources:

Change.gov:

Department of Health and Human Services Team Leads

Health Policy Working Group

Lembrew, J. “Dear 44: Take a Pragmatic Approach” Politico.com posted July 7, 2008.

Lowenstein, R. “The Quality Cure” in The New York Times Magazine. March 13, 2005.

UPDATE February 3, 2009: Former Senator Tom Daschle removed his name from further consideration for confirmation as Secretary of Health and Human Services amid criticism surrounding delayed payment of taxes in excess of $100,000.00 and the perception of ethical impropriety due to his former work with health care industry clients at the firm Alston & Bird, LLP.