The Treatment

Sebelius, Romney, Arnold...yes, No, Maybe

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Lots and lots and lots of speculation out there about who should succeed Tom Daschle. A few things to keep in mind.

1. It's not a given that Obama will appoint one person to oversee both the White House health reform office and the Department of Health and Human Services. Daschle was uniquely equipped to handle both jobs simultaneously (and was not, to be perfectly honest, necessarily ideal for HHS). As I wrote earlier today, it seems more likely to me that Obama will divide the job and appoint separate replacements for the separate posts.

2 . When thinking up names for the White House reform office, do not underestimate the difficulty of integrating a new person into a planning process that's already very far along. If it's not going to be Jeanne Lambrew, who's the current deputy and who has the respect of her peers, it's going to have to be somebody who's far and away the better candidate. 

3. HHS is a place where you can get a little more creative. The post has a large managerial component. Governors make particularly attractive candidates because governors inevitably spend a great deal of time managing Medicaid, just as the secretary of HHS must do. But the person who holds that job can be a prominent spokesperson for the administration and/or an emissary to Capitol Hill. 

Of the names in circulation, Kansas Governor Kathleen Sebelius is the one that seems increasingly logical to me. People marvel about her managerial abilities and there's no question about having the relevant experience. She was the state insurance commissioner before she became governor; over the yeras, she's fought to stamp out fraudlent carriers, block dangerous industry mergers, and overcome lawmakers opposed to expansions of government health insurance for kids. She's well-known and well-liked by the health care advocacy community. And while she's not steeped in the ways of Washington, she'd have plenty of advisors to help--not to mention a strong relationship with Obama, based in part on her bipartisan touch.

If she doesn't want the job--I gather she's turned down spots already--I'd then look at other governors. The trouble with Howard Dean and John Kitzhaber, two physicians, are that they don't fit in with the No Drama mold. (I say this as a well-known Dean fanboy.) Jennifer Granholm, again, might be worth a look. 

My friends Marc Ambinder and Karen Tumulty have been proposing Mitt Romney for the post. I like what he did with health care in Massachusetts and have huge respect for his managmeent skills. But I don't see that one happening. Even if he wasn't fixated on capturing the 2012 Republican presidential nomination, he's said too many unambiguously harsh things--about the auto bailout, about the stimulus, and about Democrats in general--to serve credibly in this administration.

Also don't forget that HHS's jursidction frequently intersects areas like abortion and contraception. Putting an opponent of abortion rights in that post seems unthinkable. 

If you're looking for a fun choice from across the aisle, a better bet would the pro-choice and barely Republican Arnold Schwarzenegger, who's also known to support universal health insurance (at least in theory) and might actually help sell the idea nationally, making it safe even for all the non-girly-men out there. I haven't followed his career that closely--this book by Joe Matthews is perhaps the place to start, if you're interested--but I gather he's a decent manager of state services and has a genuine interest in health care. 

Of course, Schwarzenegger's odds are really steep, too. Among other things, I'm sure he's too toxic on the left. And, with Daschle gone, it's important to pick somebody liberal advocates of reform can trust. But if you want to be creative...

--Jonathan Cohn 

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