Will Obama Pull the Plug on His Own Health Czar Position?

Posted by Lindsay Beyerstein, Media Consortium at 6:43 AM on February 25, 2009.

The Obama administration may be about to pull the plug on the health czar. The position has gone unfilled since Obama’s appointee-apparent, former Sen. Tom Daschle, withdrew his name from consideration for both czar and Secretary of Health and Human Services (HHS) in early February. Several serious candidates are emerging in the unofficial race to lead HHS, but there’s no corresponding shortlist for health czar.

The czar and his Office of Health Reform were initially touted as proof that Obama was really serious about shepherding a health reform package through Congress. But the Obama team may ultimately decide that the Office of Health Reform is an obstacle instead of an asset without Daschle and ditch it altogether.

As Erza Klein explains in the American Prospect, the position was created especially for Daschle and any other candidate might be worse than nothing as far as passing a healthcare reform package goes. Steve Benen of the Washington Monthly agrees, and says that nixing the health czar doesn’t necessarily indicate that the Obama administration is any less committed to healthcare reform.

The purpose of the health czar was to create a single emissary to represent President Obama’s healthcare agenda to Congress. When the Clintons tried to reform healthcare in 1993, they discovered that various powerful administration officials were claiming to speak for the president.

The health czar was supposed to prevent future confusion as the president’s spokesperson. Many senior healthcare officials are already close to Obama and a similar situation could arise. Daschle would have been a credible health czar because he’s closer to the president than any of them, and a former congressional heavyweight to boot. Gov. Kathleen Sebelius is a front-runner for HHS secretary and she has a very good relationship with Obama. But Gov. Sebelius is a Washington outsider who has never served in the U.S. Congress, which might make her a less compelling candidate for czar.

Ezra Klein, linked above, argues that if nobody can fill Daschle’s shoes, appointing a less compelling czar might just add to the din of executive branch officials vying for the attention of key Congressional leaders.

Maybe it’s a good idea to send as many Obama health officials to Congress as possible. If nothing else, they might cut into time the reps are currently spending with health insurance industry lobbyists, as Talking Points Memo reports.

Speaking of contenders for Secretary of Health and Human Services, Gov. Howard Dean recently published an article on AlterNet defending Obama’s comparative effectiveness research (CER) agenda against right wing critics like Rush Limbaugh. Dean draws on his experience as a doctor and a healthcare policy-maker to argue that CER is a way to put more scientific evidence in the hands of doctors, so they can choose the very best treatment for the money. Right wingers don’t like the idea. They’re literally afraid that if science determines that a treatment is bogus, the government will stop paying for it. Right wingers calls this “rationing.” Taxpayers might call it evidence-based policy. Last we checked, Medicare and Medicaid were not faith-based programs.

As Dean points out, the CER to be funded by the new economic stimulus bill is officially for doctors, not legislators. “Mr. Limbaugh and his cohorts would have you believe that this research will be used to deny needed care to your great Aunt May and be run by the politburo. But the Bill passed by Congress states right up front that the Government can not make coverage decisions based on this research,” Dean wrote. Realistically, though, that’s kind of a hollow assurance. Once the research is done, there’s no way to stop legislators from using publicly available research findings to make healthcare decisions.

In another corner of the healthcare reform-o-sphere, Katrina vanden Heuvel says that time is right to reform New York’s draconian Rockefeller Drug Laws in The Nation. These laws have been on the books 35 years. The laws essentially force judges to send drug possessors to jail based on the weight of the drugs they were caught with, whether the judge thinks imprisonment would be a good idea or not. New York’s budget crisis might be a blessing in disguise for drug reform, vanden Heuvel argues, because policy-makers are sick of paying to keep drug offenders locked up whether they need it or not.

And finally, some good news from RH Reality Check. Many people just wouldn’t feel right stepping out without a spritz of perfume, a blast of breath-freshener, or regrettably, a head-to-toe shellacking with Axe Body Spray. As Joe Veix reports for RH, another spray-on product may one day be added to the essential equipment list: contraceptive. An Australian company is currently testing a hormone spritz for women. The product is applied to the forearm. Like the contraceptive patch, the spray is designed to deliver hormones through the skin. Researchers hope that through-the-skin delivery can produce the same results as pills, but with lower doses of hormones and fewer side effects.

Lindsay Beyerstein a New York writer blogging at Majikthise.