Tuesday, March 3, 2009

Kathleen Sebelius as Secretary of HHS

As a citizen of Kansas, I probably know more than the average American about the new nominee for Secretary of HHS, Governor Kathleen Sebelius. On the whole, I think that she is a good choice who will be effective as well as honest, without the baggage ($128K tax and close relationships with lobbyists) that Sen. Daschle had. However, Sen. Daschle gave a great speech at his confirmation hearing, pointing out that every other country with decent health outcomes starts from a base of primary care, moving up through secondary and tertiary care if they can afford it. The US, on the other hand, starts with funding tertiary care, and runs out of money before providing comprehensive primary care (see picture; this is an unstable format!)

I hope that Governor Sebelius can be as articulate at her confirmation hearing, but hope much more that she will press for such important change as Secretary. While she is not a single-payer advocate, she has advocated coverage for all, which is a good start; indeed, “Cover Everybody!” should be our mantra, although there is a lot of bad and overpriced coverage out there – so Rep. Conyers’ assertion that “what we want is access to high quality health care for everybody” is really the goal.

While Gov. Sebelius, the daughter of former Democratic governor of Ohio John Gilligan and daughter-in-law of a prominent long-time Republican congressman from Kansas, was early in her career Executive Director of the Kansas Trial Lawyers Association, and as such not popular with physicians, her subsequent tenure as a legislator, state Insurance Commissioner, and Governor has been very positive regarding health care, and even healed many of the wounds with physicians. Her most important decision as insurance commissioner was blocking the sale of Blue Cross/Blue Shield of Kansas to a private company, Anthem, in 2002, saying it would raise costs for Kansans. This was a good decision, occurring during a time when the insurance industry was, across the country, consolidating its hold on health care. It gained her great popularity and was a major reason she was elected Governor later that year.

She is seen as a Democrat who is able to work across party lines, a necessary characteristic in a very “red” state, where both houses of the legislature have become increasingly dominated by the what is known as the “conservative” wing of the Republican party; whether “conservative” or not, they are ideologically driven in much the same way as the increasingly marginalized national GOP is, except here in Kansas they are in control.

I would also add, if we want to know the kind of person she is, that in 2005 I was headed down to New Orleans for a conference. Waiting at SW Airlines, I looked up from my book and saw her sitting across from me. Someone else recognized her and razzed her for not taking her state "jet". She replied, "First, it's not a jet, and second, this is not state business. I'm taking a few days to meet my husband down in New Orleans for the Jazz and Heritage Festival".
So she waited in line with everyone else, and as I helped her put her bag in the overhead rack, remember thinking "I can't imagine Arnold Schwarzenegger or George Pataki (then Gov of NY) doing this - flying with the hoi polloi on SW, personal business or not." Or, for that matter, Tom Daschle.

She has some excellent health advisors in Kansas, and if they accompany her to DC, I would be optimistic about effective change.

1 comment:

Lady.Dr. said...

I was wondering what you would think of this appointment and I'm happy to hear your opinion. I want to be able to be hopeful about as much as possible.

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