Second choice will fill HHS post

Tom Daschle’s (D-S.D.) withdrawal as nominee to be secretary of Health and Human Services has some speculating whether or not healthcare reform will be derailed.

Daschle withdrew after saying that his failure to pay more than $120,000 in taxes could be a “distraction.”

“Conventional wisdom, Obama popularity and inside-the-Beltway decision making are not always in full sync,” says F. Randy Vogenberg, senior scholar, Thomas Jefferson University School of Population Health, and principal of the Institute for Integrated Healthcare. “Clearly the political constituency losses and reputation damage-to himself, Obama and the Democratic party-were too great to overcome and successfully spearhead any significant health reform through Congress this year. “It appears that everyone cut their losses quickly so a second-choice secretary could be made rapidly and be able to continue the healthcare change agenda on a fast track, most likely now primarily led by Ted Kennedy [D-Mass.].”

“One group is the healthcare-savvy politicos, such Kansas Governor Kathleen Sebelius or Senator Tom Harkin [D-Iowa],” he says. “Another group of prospects are healthcare wonks, such as Harvard Economist David Cutler, Georgetown’s [University Professor] Judy Feder, and Jeanne Lambrew, deputy director of the White House Office of Health Reform. Given the Daschle experience, the administration may need to focus on sitting officials or high profile academics.”

Reportedly, other contenders for the HHS secretary post may also include former Oregon Gov. John Kitzhaber; ex-Democratic National Committee Chairman Howard Dean; and President Obama’s transition chief, John Podesta.Meanwhile, Daschle’s withdrawal could delay the new FDA Commissioner pick. For FDA Commissioner, the administration will need new blood to rebuild the agency’s internal morale and external reputation, according to Piper. “Ideally, it’ll need to be a research-savvy physician with a visible profile and strong leadership and management skills. That’s a rare combination,” he says. Robert M. Califf, MD, vice chancellor for clinical research at Duke, professor of medicine in the Division of Cardiology at Duke, and longtime advisor to the FDA and the Institute of Medicine, is an obvious choice, says Piper. Baltimore’s Health Commissioner, Joshua Sharfstein, is the short list because he would bring high energy to the job.

Additionally, Robert Kolodner, MD, the national coordinator for health information technology, says that he is not confirming a published report that he will remain in the position under the Obama administration.The White House would be wise to retain Kolodner as head of Office of the National Coordinator, according to Piper.

“He has an excellent record of HIT reform at the VA. The administration’s HIT agenda is a cornerstone of health reform and the HIT provisions of the stimulus bill are very ambitious,” he says. “They need to hit the ground running.”Kolodner became the interim head of the Office of National Coordinator in mid-2006, replacing David Brailer.