Howard Dean Should Have Been Obama's HHS Pick All Along
Now that Tom Daschle has withdrawn his name from the running to be health and human services secretary, President Obama should revisit the idea of nominating former Democratic National Chairman Howard Dean for the position, an idea he abandoned last November for all the wrong reasons.
Within a week of Obama’s winning the presidential election, Dean’s name began to circulate as a top contender for the job. Dean is a physician, a former family practitioner in fact, and during his 11-year tenure as governor of Vermont, health care and other welfare-related reforms were a priority. But within days of Dean’s name being floated, the Web site Politico reported him to be out of the running. “… [T]he chief attributes President-elect Barack Obama is seeking in his HHS secretary will be an ability to work with members of Congress and shepherd reform legislation through the House and Senate,” the site reported. “That job description has turned out to be a particularly ill-suited one for Dean, given his partisan background and lack of congressional experience, sources inside and outside the transition offices say.”
Dean became imprinted on the national consciousness when he surged to the head of the pack during his run for the 2004 Democratic presidential nomination by playing the angry anti-war candidate. His novel use of the Internet to raise funds and organize supporters produced a meteoric rise in the polls. When he failed to craft a message that appealed to a broad coalition of American voters and his campaign plunged to earth, however, many Americans were left with a low impression of Dean and his talents that was misleading and unfortunate. Dean possesses the very qualities we need in an HHS secretary at this moment in history.
I lived in Vermont for nearly all of Dean’s 11 years as governor. The 2004 presidential contender who whipped crowds of young voters into frenzies with his bracing oratory was someone we had not seen before. He governed there as a fiscal conservative whose skinflinty ways and careful long-range planning made him popular among small-government Yankees of all political affiliations, Democrat, Republican and Independent. When, in response to a mandate from the state Supreme Court, Dean led the way for Vermont’s civil union law, social conservatives, again regardless of party affiliation, turned on him. He followed up his legislative victory with dozens of visits around the state to gatherings of people who strongly disagreed with him. He listened respectfully and patiently to their grievances, argued why he believed civil unions should be equated with basic human decency and civil rights, and did not backpedal or apologize. The gambit was an extraordinary display of political courage, and savvy. In the next election he managed to hang on to his job by the slimmest of margins.
Though Dean can be famously argumentative, he is not known as a politician who holds grudges. As governor, he’d fight like mad for an initiative he believed in but on the next issue of importance could work with those who had just opposed him. Of course, Dean played the partisan as chair of the DNC, but that was his job description. He served much longer as chief executive of a state with a fixed budget and very real health and human services responsibilities, and his track record in that capacity should count for much.
In the fall of 2003, my publishing company joined with the Rutland Herald and Times Argus to produce the book “Howard Dean: A Citizen’s Guide to the Man Who Would be President,” written by nine veteran journalists who had covered Dean as governor for various news organizations or had reported on previous presidential campaigns. In his Washington Post column, David Broder wrote of our reporters’ efforts, “I could detect no personal bias in any of their individual chapters.” As the book’s publisher, I was especially proud of its prescience in assessing Dean’s strengths and weaknesses as a candidate for national office.
Here are some quotes from the book that President Obama and his advisers might find instructive:
- “When Dean left office in early 2003, most states were in dire financial shape, their revenues hammered by the collapse of the dot-com economy. Vermont, by contrast, had a comfortable surplus, thanks largely to Dean.”
- “The only real exception to rigid budget discipline was health care. … This did stretch the budget some, but those costs were offset somewhat by increased tobacco taxes.”
- Dean “for the first time pushed governmental health care coverage out beyond the welfare population to working people who did not qualify for Medicaid.”
- “Government observers in Vermont usually cite two highlights among Dean’s accomplishments in office: tight budget management of the state’s economy, and Success by Six, an effort to link early education programs to social services. … Dean, perhaps because of his medical training, demanded measured results.”
And there is one other aspect of Dean’s tenure as governor documented in our book that might interest Obama, who has become president in the midst of an economic crisis with his own party in control of both houses of Congress. “One of my most persistent activities during the early ’90s,” recalled Glenn Gershaneck, who was Dean’s press secretary before eventually heading the state Transportation Agency, “was trying to fend off the more liberal wing of the Democratic Party. The will to spend money always exceeded the resources available, and the push to spend came mostly from the left.”
I suspect that Dean’s strained relationship with Obama’s White House Chief of Staff Rahm Emanuel, with whom he famously clashed over strategy during the 2006 midterm election -- Emanuel wanted DNC money to be targeted where it could help Democratic congressional candidates win immediately while Dean was intent on a long-range plan to build party infrastructures in all 50 states -- might have had something to do with the talk of his unofficial consideration for the HHS post evaporating so quickly. Emanuel, unlike Dean, is regarded as a strident partisan who remembers transgressions and rewards fealty. But just as presidential candidate Dean paved the way for now-President Obama’s use of the Internet as a campaign tool, it was DNC Chairman Dean whose 50-state strategy helped candidate Obama keep John McCain on the defensive in traditional red states.
Obama might have ridden into office on a wave of popularity that included most swing voters and a good number of Republicans, but the Democrats in Congress, who now firmly control both houses, can claim no such appeal. Amazingly, Congress overall had lower approval ratings than George W. Bush going into the 2008 election. The danger of partisan overreach that could produce a crippling backlash against Obama a year or two from now is great.
Dean has been humbled by the challenges and realities of serving as a chief executive. In addition, he deserves credit for his successful turn as DNC chair, a post he aggressively sought and improbably won, and for which many observers did not consider him well suited. Dean was a true Washington outsider who took over a broken political machine and achieved astonishing results.
The position of HHS secretary would play to Dean’s proven strengths -- his medical training and his ability to work within budgets, to name just two. And no one could bring more passion to the job. To my mind, an old congressional hand, a Washington insider -- another nominee like Tom Daschle -- who knows how to wheedle and stroke egos and trade this for that in order to make things happen the old-fashioned way would not achieve meaningful reform on health care. There are just too many entrenched interests, and Washington insiders are congenitally incapable of making things happen with so many well-connected players trying to affect the game’s outcome. If people think insurance company paper pushers are doing more harm than good as they take decision-making powers out of doctors’ hands, imagine the damage that could result from an effort led by a career politician with no understanding of the dynamics at play in our health care system, let alone the human organism. After so many years of fruitless rhetoric by politicians, why not let a medical doctor with proven success as a political operative and a record for plain talk and common sense have a chance?
As DNC chair, Dean talked often about the need for politicians to set aside issues that divide us and focus on progressing in areas where common ground can be reached. As governor, he made advances in the area of health and welfare by gaining support for initiatives such as health insurance for children and prenatal care and other preventive wellness measures that cost relatively little and offered long-term savings and sustainability. As a candidate, Obama revealed himself to be a consummate pragmatist. Reconsidering Dean for the post of HHS secretary would be a demonstration of his intention to govern as one as well, and would reaffirm, not undermine, his commitment to work across party lines and be president to all Americans.