February 21, 2009
The Office of Health Reform - Still Happening?
Ezra Klein contemplates whether President Obama will still pursue the creation of the Office of Health Reform. He writes,
To calm my e-mailers down: The fact that the White House might dump the Office of Health Reform does not mean they're dumping health reform. Quite the opposite, in fact.
The White House Office of Health Reform was an agency created at Tom Daschle's request to carry out Tom Daschle's vision of health reform. . . . .
That vision, crucially, relied on the authority vested in him by the President of the United States. The health czar only matters if he's understood to have Obama's ear on the issue. And Daschle did have Obama's ear. Obama trusted Daschle. He trusted him to be the administration's point of contact with the Senate, he trusted his knowledge and instincts on the issue, he trusted his ability to manage a large bureaucracy. But the administration has not found a suitable replacement. Daschle has not -- and will not -- be replaced. And if he's not replaced, then the structure built around his person has to change.
Indeed, there's a strong argument that filling that spot with someone else would actually undermine the original intent of the office. Daschle presided over the early conversations on health reform. His authority on the issue was understood and respected by the other players in the room. But his withdrawal did not derail the administration's internal health policy process. The room simply changed. Other players stepped into larger roles. Peter Orszag and his health deputy Zeke Emanuel emerged as key participants. Jason Furman and Diana Farrell at the National Economic Council. Jeanne Lambrew and Mark Childress retain significant roles. Larry Summers, of course, has influence, though it's not clear if he's directly involved at this juncture. . . .
Which calls into question the need for a new agency called the Office of Health Reform: No one wants a department that was supposed to streamline the process to instead add to the clutter. If they decide to dump the Office of Health Reform, it's not because they've abandoned health care reform. It's because they haven't, and they're building a post-Daschle strategy.
February 21, 2009 | Permalink
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