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The case for Kitzhaber

John Kitzhaber

John Kitzhaber

UPDATE Kitzhaber is quoted as saying he wouldn’t be interested in a cabinet-level job, though he might be willing to serve as a health policy advisor in some other capacity.

Among the many names circulating to replace Tom Daschle in the key Health & Human Services/health care reform position, many are well-known (from Newt Gingrich and Mitt Romney to Howard Dean and Kathleen Sebelius). One of the lesser-known to the national audience, but mentioned repeatedly as a prospect, is former Oregon Governor John Kitzhaber.

Every candidate mentioned so far has a set of assets and liabilities. Does Kitzhaber make sense for HHS?

He might make excellent sense, if a number of conditions – some applying to him, some to the situation in D.C. – hold true. So, the case for Kitzhaber:

First, on the D.C. side. Part of the appeal (for Barack Obama at least) of Daschle is that the South Dakotan has been tight with the new president: They could work closely together. Another asset is Daschle’s experience in Washington, as a majority leader in the Senate: He knows how Washington works from deep inside, and presumably would be a power player in moving health policy. If those points are requirements for the position, then Kitzhaber isn’t a fit.

But Obama could look at it another way. His administration already has plenty of D.C. insiders. His party has solid control of the Congress – legislation could be rammed through, if need be, if it has broad support. Building that support would be at least as important, and probably more important, outside Capitol Hill than it would be on. And while having a close friend in this key spot would be a nice thing, it shouldn’t be necessary. Being president means developing a lot of relationships with a lot of people. And one other thing: Obama seems much more intent on the broad goals of health policy – such as getting everyone or nearly everyone insured – than on the details, which seem to be more negotiable. He might find it helpful to have in place someone who has worked through the implications of what’s happening, and can make effective judgements on policy from a solid knowledge base.

And: There are members of Congress who have health care ideas of their own, and probably no one is more centrally based to push them than Oregon Senator Ron Wyden, who already actually has bipartisan support for a large bill that actually would do quite a lot on health care.

Looked at that way, how might Kitzhaber fit?

First, let’s start with the preconditions: That Kitzhaber would accept if offered, that he and Obama conclude they could work comfortably together, and that he would fully clear the sure-to-be-intensive vetting. None of those conditions are certain; but let’s assume for a moment they’re surmounted.

Kitzhaber would not go in as a lobbyist extraordinaire, but he would have plenty of help from the White House and others. He would, however, bring a batch of other assets.

For one thing, Obama is starting to field complaints that his operation is slipping into the same old loose-ethics, Washington-insider environment he ran against only months ago. Daschle has suddenly become the poster boy for those complaints. An announcement of Kitzhaber would be sharp reversal: A non-Washington guy (and not another close Friend of Barack) who just recently declined to run for a Senate seat he could easily have won, so that he could work on his life’s work, his topic of consuming interest . . . health care reform. This is a guy working on the issue, not in pursuit of job titles. He could say his job will be to get health reform enacted, and then he’s outta there, and people would actually believe it.

He would shake things up from the current downer environment simply by virtue of who he is. His qualifications – popular two-term state governor, experienced executive, emergency room physician deeply steeped in health care policy, for which he’s been an advocate not just in the Northwest but nationwide – would be beyond realistic question: He has the resume for the job, and then some. But no less significant in this media age is the image, the blunt but charismatic (television would love him) boots-jeans-and-belt buckle git-er-done guy from the far end of the country, who not only knows the subject matter but has learned (somewhat like Al Gore) to explain it in clear and compelling ways. Because of the image he would cut – a far from bureaucratic or insiderish image – he would be hard to dismiss politically. He could be a powerful leadership figure on health care. And he is a very strong personality.

He also has his own very definite ideas on how health care ought to be done, and Kitzhaber can be (as any number of legislators will attest) a stubborn guy. But he has shown signs of willingness to negotiate, as he did on the Oregon health finance policy proposal. From his standpoint, this could be the best opportunity he could ever hope for to personally push through the ideas he believes in. On top of which, he has substantial experience working with Wyden, whose ideas would in many ways complement Kitzhaber’s. The two could prospectively be a powerful team.

Now. None of this is in any sense a prediction, and the cautionary notes are real: For various reasons, none of this might happen.

But on the surface, Kitzhaber could make for a hell of a choice.

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