Two More Pieces to the Healthcare Puzzle

After one major false start, the health policy team for the Obama administration is finally in place. Kansas Gov. Kathleen Sebelius (D) will head the sprawling Department of Health and Human Services (HHS), while former Centers for Medicare and Medicaid Services (CMS) director Nancy-Ann DeParle will lead the newly created office of Health Reform.

The sheer size of HHS, with its plethora of responsibilities, makes it ideally suited for a governor (the last three secretaries were former governors). The secretary has administrative responsibilities for not only two of the biggest entitlement programs (Medicare and Medicaid), but also the National Institutes of Health, with its enormous research budget.

Conversely, the Office of Health Reform is likely to have a staff smaller than a college basketball roster. As this profile indicates, DeParle is an undisputed healthcare policy expert and competent manager. Daschle might have been one of the biggest political heavyweights in politics, but even he didn’t have DeParle’s knowledge and background of the healthcare system.

The relationship between Sebelius and DeParle might not be unlike the Geithner-Summers dynamic profiled in yesterday’s New York Times, where the two form a close partnership that reaches across the Cabinet and into the West Wing. Such a relationship would likely be beneficial given that Sebelius and DeParle join an administration already filled with staffers likely to have large influence over health policy, including Jeanne Lambrew, Peter Orszag,and Ezekeil Emanuel. Additionally, Sens. Edward Kennedy (D-Mass.) and Max Baucus (D-Mont.) are likely to have large rolls in the drafting of health reform — to say nothing of Republicans and nearly every registered lobbyist in town.

Healthcare, more than any other issue, attracts the kind of competing and varied interests that would make the authors of the Federalist Papers blush. Despite the considerable risks, there may never be another time when the conditions for reform are so favorable.


The views expressed in this blog do not represent the views or opinions of Generations United.

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