THE TREATMENT FEBRUARY 6, 2009
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.