Monday, April 14, 2014

Running for Sheriff and Obamacare

As Washington DC lurches from one partisan skirmish to another, it's only natural that pundits are pining for the good old days of larger than life politicians like Lyndon Johnson.  Despite a recalcitrant Congress dominated by southern conservatives, our 36th President's big-government ideas ultimately prevailed.  

So, while we're looking for ways to ease our national discontent, it's only fair to ask: what would the wily LBJ have done about a vacancy over at Health and Human Services?

The Population Health Blog doubts he would have nominated Sylvia Mathews Burwell.

The PHB recalls the story of the newly minted Vice President soliciting the input of then-Speaker Sam Rayburn about all the brilliant persons that had been tapped to serve the Kennedy's White House.  Mr. Rayburn was less impressed, saying "Well, Lyndon, everything you say may be true, but I'd feel a whole lot better if one of them had ever run for sheriff."

The PHB recalls reading that Mr. Johnson considered that advice when it was his turn to dole out Presidential appointments. As pointed out here, there's something about running for office that instills a better appreciation for the diversity of opinion, the ability to compromise, keeping promises and the risks of public duty.

While Ms. Sebelius was no friend of physicians, the PHB wonders if her past successes in running for public office in Kansas may have partly helped - outside of the debacle - in getting Obamacare passed and implemented.

Despite her Rhodes Scholar and Harvard brainiac chops, Ms. Burwell brings no such experience.  While she's participated in some retail politics, her credentials are essentially that of a high functioning bureaucrat with some worthy, if largely corporate, philanthropic experience.  She's never faced voters.

Combined with her lack of healthcare credentials, the PHB doesn't think Ms. Burwell's Senate nomination process is going to be a slam dunk.  Assuming she prevails and does eventually become HHS Secretary, the PHB doubts her considerable skill set is going to be enough to convince the elected members of Congress to change their minds about Obamacare.

The games will continue.

No comments: