I love the Governor -- "Democratic Wing of the Democratic Party" and "50 State Strategy" and "Right about Iraq when everybody else was wrong but popular" -- Dean.
But there is no particular reason to like him as Secretary of Health And Human Services, nor to think he is a good fit for the job.
For one thing, he is kind of too big for the job (maybe Senator whenever there is a Vermont retirement?). And he's too independent and has poor relations with Rahm Emanuel back when they were running the DNC and DCCC respectively. There are reasons he is not still at DNC. So it is not likely to happen.
For another, despite his being a physician (and his wife) he has not in recent years had much to do with health care or health care policy.
And, frankly, when he did have anything to say about health care policy, he was, as John Nicols at the Nation reminds us, way too dismissive of Single Payer for my taste.
As a lefty progressive policy wonk and advocate first and a Democrat second, I'd rather push for folks who with a record of fighting for change I can believe in, and leave the pre-compromising to others.
Just this last May, Dean did give a not terrible answer to the question to Time Magazine:
Question: As a former physician, what are your thoughts on the Democratic candidates’ health-care plans vs. a single-payer system?
Howard Dean: I think while someday we may end up with a single-payer system, it’s clear that we’re not going to do it all at once, so I think both candidates’ health-care plans are a big step forward. Certainly compared to Senator [John] McCain, who represents a big step backward.
But as Nicols points out:
But supporters of real health-care reform should remember that Dean long ago distanced himself from advocates for a single-payer system. Commentator John McClaughry -- a critical observer of his fellow Vermonter -- noted in a 2005 column for The Wall Street Journal that upon assuming the governorship in the early 1990s, "Gov. Dean quickly distanced himself from the single-payer idea he had supported, favoring instead something called 'regulated multipayer.' Translation: Hillarycare."
As governor of a relatively progressive state his health care reforms were very weak tea at the time. Indeed, way back then, the equivalent of the netroots "Democrat wing of the Democratic party" considered him a conservative comproming too-pro-business interest, too-Republican-like kinda guy. Sorta a blue dog Dem in a pretty blie (or should I say green mountain) state.
As Don McCanne of PNHP argues:
Let’s assume that in 2009 we will have a Democratic president, a solid Democratic majority in the House of Representatives, and sixty filibuster-proof Democrats in the Senate. We also know that, amongst Democrats, there is tremendous support for the single payer model of health care reform. That’s all we need to enact a single payer national health program. Right?
Sorry. The Democrats are already assuming that they will be in control, and the message from them is very clear. "Although single payer may be the best way to finance health care, we can never get there in one step," is the gospel (small g) as recited by the majority of veteran Democratic legislators (with the notable exception of John Conyers and the supporters of HR 676). The majority of Democrats believe that it would be impossible to skip the next step of first using our existing programs to expand coverage to (almost) everyone.
The consensus is that, above all, we must protect the vested interests if we are to achieve this next "big step forward." "Vested interests" is not code language; it is the private insurance industry (and to some extent, the pharmaceutical firms, which will not be discussed here).
In health care financing, the private insurers are not the solution to our problem; the private insurers are the problem. (I would apologize to President Reagan, except in his version he got it wrong.)
Well, obviously we are not at 60 in the Senate, and not only is Single Payer off the table, but even any form of a expanded Medicare-like public option is being considered too radical (that's what happens when they pre-compromise on Single Payer and ignore the Overton Window as a strategy; but I digress).
But we can still fight for a better choice for HHS. Nicols suggest some
prominent players in Congress--Washington's Jim McDermott, a physician and a senior member of the powerful House Ways and Means Committee; Wisconsin's Tammy Baldwin, a popular member of the House with close ties to Speaker Nancy Pelosi and experience on the healthcare subcommittee of the Commerce Committee--who have long records of advocating on behalf of a single-payer system. Both McDermott and Baldwin are able political players, with smart, flexible approaches; they understand the value of incremental reform. But they also know that the ultimate goal should be a single-payer system, not a regulatory mess of government spending and corporate profiteering along the lines proposed in the mid-1990s by then-First Lady Hillary Clinton and supported at the time by Dean. (While the Clinton's were advancing their doomed plan, McDermott was the lead sponsor of a single-payer bill that attracted more support than did the White House scheme.)
While it certainly makes sense to consider Dean--and while he would be a dramatically better HHS Secretary than Daschle -- it also makes sense to consider others, including those who have been stalwarts in the fight for real reform.
The opening for fundamental reform of a badly broken healthcare system exists. The next HHS Secretary should be someone who believes in making the most of that opening to achieve the long-deferred goal of Franklin Roosevelt and Harry Truman: the creation of a national healthcare system that provides quality care for all Americans.
I mean c'mon. If they can have the reuly awful (spelled offal) Republican Judd Gregg for Commerce, can't we have a real domestic policy progressive for Health and Human Services.
From a professional public health point of view, I like:
Dr. Tom Frieden, the activist NYC Commisioner of Health
Dr. Marcia Angell, former editor of the New England Journal of Meidicine, single payer supporter and leader in the fight to end the corrupt relationship between big Pharma and FDA and Physicians.
Dr. Carolyn Clancy, a single payer supporter and a expert in health care quality and efficiency and adminstration as a career HHS professional and Director of the grossly underfunded and neglected Agency for Healthcare Research and Quality (AHRQ)
Update - Great Minds Think Alike:
PNHP is now officially endorsing, and trying to get other progressives to coalesce around pushing for Marcia Angell. Here is a recent lay article by her on the doctor-Pharma corruption issue. Her book on the Drug Companies and her forward to Dr. Geyman's book on the corruption of the medical profession and single payer.
Here is her official biography:
Dr. Marcia Angell is a senior lecturer in the Department of Social Medicine at Harvard Medical School. A graduate of Boston University School of Medicine, she trained in both internal medicine and anatomic pathology and is a board-certified pathologist. She joined the editorial staff of the New England Journal of Medicine in 1979, became Executive Director in 1988, and Editor-in-Chief in 1999. She stepped down from her position on June 20, 2000. Dr. Angell is the author of The Truth About the Drug Companies: How They Deceive Us and What to do About It (Random House, 2004), as well as frequent articles in professional journals and the popular media on topics such as medical ethics, health policy, the nature of medical evidence, the interface of medicine and the law, and care at the end of life. She is author of the editorials "Patients' Rights Bills and Other Futile Gestures," (/NEJM/, June 1, 2000) and "How Much Will Health Care Reform Cost?" (/NEJM/, June 17, 1993) endorsing single-payer health reform. She also wrote the critically acclaimed book, Science on Trail: The Clash of Medical Evidence and the Law in the Breast Implant Case (W.W. Norton & Company, 1996). In 1997, Time magazine named Dr. Angell one of the 25 most influential Americans.