THE TREATMENT FEBRUARY 6, 2009
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Howard Dean is probably not going to be the next Secretary of Health and Human Services.*
As best as I can tell, White House Chief of Staff Rahm Emanuel is not about to let Dean in the same zip code, let alone the same branch of government. That is the political reality.
Still, writers should do more than reflect the political reality. They should try to change it--or, at least, explain why it's flawed. With that in mind, here are two very key assets that Dean would bring to the job--the job, I know, he'll never have.
The first is management ability. Ever since Tom Daschle withdrew his name from consideration for HHS Secretary, most of the discussion hs focused on what it meant for the president's health reform agenda. Daschle was a gifted communicator and deft political operator. Everybody wants to find a replacement who has those skills. Dean doens't have them.
But it's not essential that the HHS secretary be one of the key players, privately or publicly, on health reform. Other advisers and officials can take up that role, as can the president himself.
On the other hand, it is essential that the HHS secretary take charge of an agency with wide-ranging responsibilities, a vast bureacracy, and a recent history of neglect. Head Start is part of HHS. So are the Centers for Disease Control along with the Food and Drug Administration, two agencies that represent our first line of defense against disease. For the last eight years, they've struggled under an administration that, at best, ignored them and, at worst, used them to advance a socially conservative agenda.
The next HHS Secretary must do better. And one way (albeit not the only way) to guarantee that is to find somebody with a proven track record of managing organizations that work on health care. As the five-term governor of Vermont, Dean did exactly that. And while Vermont is a tiny state, the record he complied there was exemplary, not just on health insurance but on the whole range of issues dealing with human welfare.
Don't forget, too, that Dean showed pretty good management skills--not to mention judgment--at the Democratic National Commitee. With virtually no support from the political establishment, which held him in nearly universal disdain, Dean was true to his vision and--because of that--helped build a grassroots network that's paying real political dividends today. (Anybody laughing about the 50-state strategy now?)
To be sure, even if the HHS Secretary isn't the point person on health reform, he or she will have a seat at the table. But Dean would add something here, too--something that might be in relatively short supply now that Daschle is gone.
Dean speaks his mind. And, when he does, he speaks up for the little guy. In the context of health reform, he'd be a consistent voice for coverage and access--for making sure that health reform focused, as it should, on protecting everybody from the financial vulnerability so many now feel because they can't pay their medical bills.
Of course, there's always the danger that Dean's abrasive style would alienate more people than it would win over. I love the guy. I count myself as a charter member of the Howard Dean club, as some readers of this publication (not to mention my Dean-o-phobic colleague Jonathan Chait) will recall. But Dean is not always the most persuasive.
So perhaps the political reality is as it should be; Dean doesn't belong on the short list. But as long as people are thinking about names, it's worth thinking of what he might have brought to the administration--and which of the more realistic candidates might do the same.
*Update: I inserted the "probably" after the initial posting. As I do not have a crystal ball, I should not have been so definitive.
--Jonathan Cohn

5 comments
I wish someone would write the definitive account of the horrible relationship between Emanuel and Dean. I don't entirely understand it. I mean, I know the background, but clearly Emanuel's distaste for Dean (and vice versa, I can only assume) goes beyond the purely political or professional realm. It seems to me, though I have no evidence other than my own observations to support this assertion, that it's a case of two guys with huge egos and poor social skills who simply aren't capable of getting along. That's a shame for the country and for the health care reform movement because Dean, whatever his flaws, is a rarity in politics. He is someone who thinks about and talks about which actions and which policies will be most effective in the long run.
- amcarey
February 6, 2009 at 2:53pm
"I wish someone would write the definitive account of the horrible relationship between Emanuel and Dean. I don't entirely understand it...two guys with huge egos and poor social skills who simply aren't capable of getting along. "
I think its most an elitist insider vs. uncouth outsider thing. Emanuel's also uncouth, but he's a big shot. Dean wasn't tapped for Skull and Bones, figuratively speaking. There is also the idea that Dean is not competent or politically astute. I don't know that that is really the case, although I think it is clear that he's had a learning curve sharp in learning how to do business, Washington style.
I think he would be great to run HHS itself, put someone else in charge of the health care reform effort.
- gurdjieff66
February 6, 2009 at 5:05pm
Hmm, since Dean became DNC chair, the Democrats gained the White House and also regained Congress. His 50 state strategy worked and worked well.
Rahmbo's first task was getting the stimulus bill the President wanted passed and passed the way the President wanted. He's failing miserably.
Dean is the difficult one who can't get things done? Yeah, right. Obama is a fool to not pick Dean as HHS Secretary.
- tnmats
February 6, 2009 at 10:29pm
Dean has shown he is far more effective politically and administratively than the conventional wisdom ever credits him for - his failure in the 2004 nomination contest notwithstanding. He had no business being at the top of polls going into Iowa, other than as a result of his political savvy, and it's unfortunate that that is now seen as the proof of his shortcomings. His campaign had never come up with the strategy to win Iowa (unlike Obama) for the very reason that they hadn't expected Dean's straight talk strategy to work in the first place - in the past it only worked for Republicans. Unfortunate for the Democrats, who clearly have benefited from his superior abilities.
Why doesn't Emanuel like him - because he can't compete. Not on long-term strategy. Not on honesty. Not on passion for the substance of health care reform.
- fwslusser
February 7, 2009 at 1:32am
Mr. Cohn is absolutely right. I regret I'm an atheist. Otherwise I'd be praying for Mr. Obama to listen to him. Dr. Dean is the best choice for HHS.
- eddie2003
February 8, 2009 at 12:31am