Two Governors Are the Top Candidates to Head HHS

Would a Former Health Care Slasher Governor Make a Good Choice to Lead the Reform Effort?

After the resignation of Tom Daschle from consideration to head the Department of Health and Human Services, there has been a bit of a stampede by new candidates for the post.

Chief among these, are the candidacies of Tennessee Governor Phil Bredesen, and Kathleen Sebelius, the Governor of Kansas and a rising star in the Democratic party.

While the recent trend of choosing "executive" Governors for cabinet posts would continue regardless of which of the candidates is picked, the differences between the two can be stark.

Ms. Sebelius, a former Kansas Insurance Commissioner before becoming governor, was once named one of the "100 Most Powerful People in Health Care" by Modern Healthcare magazine; she was instrumental in preventing private take over of the state's Blue Cross/Blue Shield program by out-of-state private interests, as well as in some other initiatives, including increased prescription coverage for seniors, and an innovative program which allows Kansans to purchase less-costly prescriptions from Canada and Europe.

She has also been lauded for initiatives that crossed ideological lines in trying to lower health care costs across the whole spectrum of service.

From KSGovernor.com

In an effort to rein in skyrocketing health care costs, Governor Sebelius organized a Cost Containment Commission of business leaders, health care providers, private insurers, and patient advocates. The Commission has recommended ways to increase modern health care technology such as a transition to electronic medical records, which would reduce the cost of copying forms, as well as promote consistency in care and reduce the burdensome administrative costs that currently eat up more than thirty cents of every health care dollar.

The Slasher

Governor Bredesen, on the other hand, a former managed care executive, is reviled in many reform-minded circles for his slashing of the Tennessee Medicaid program, known as TennCare, in 2005.

At the time, the state had the highest percentage of any state's population on its Medicaid rolls. The costs, spiraling out of control, were seriously hampering the state government's ability to provide other basic services.

After some tough fights in the legislature, Gov. Bredesen cut 170,000 Tennesseans from the rolls, and reduced the benefits for countless others.

These may sound like draconian measures, more likely to be attributed to a conservative governor (and in fact, many conservatives love his candidacy for HHS), but this should not disqualify him from consideration by reform-minded progressives, seeing as he was able to bring a bloated monster of a health care system under control in his state, when inaction would have been fatal to the it.

Gov. Sebelius appeals to many for her ability to work within the system, bringing insurers, doctors, and even drug companies and hospitals together to figure out solutions. She's an excellent candidate. But I have feeling that Bredesen would not be the disaster at HHS that MoveOn and the like claim he would be. Some times, you need decisive action, even if that action is painful.