Weekly Pulse: Czar 44, Where Are You?


The Obama administration may be about to pull the plug on the health
czar. The position has gone unfilled since Obama’s appointee-apparent,
former Sen. Tom Daschle, withdrew his name from consideration for both
czar and Secretary of Health and Human Services (HHS) in early
February. Several serious candidates are emerging in the unofficial
race to lead HHS, but there’s no corresponding shortlist for health
czar.

The czar and his Office of Health Reform were initially touted as
proof that Obama was really serious about shepherding a health reform
package through Congress. But the Obama team may ultimately decide that
the Office of Health Reform is an obstacle instead of an asset without
Daschle and ditch it altogether.

As Erza Klein explains in the American Prospect, the position was created especially for Daschle and any other candidate might be worse than nothing as far as passing a healthcare reform package goes. Steve Benen of the Washington Monthly agrees, and says that nixing the health czar doesn’t necessarily indicate that the Obama administration is any less committed to healthcare reform.

The purpose of the health czar was to create a single emissary to
represent President Obama’s healthcare agenda to Congress. When the
Clintons tried to reform healthcare in 1993, they discovered that
various powerful administration officials were claiming to speak for
the president.

The health czar was supposed to prevent future confusion as the
president’s spokesperson. Many senior healthcare officials are already
close to Obama and a similar situation could arise. Daschle would have
been a credible health czar because he’s closer to the president than
any of them, and a former congressional heavyweight to boot. Gov. Kathleen Sebelius
is a front-runner for HHS secretary and she has a very good
relationship with Obama. But Gov. Sebelius is a Washington outsider who
has never served in the U.S. Congress, which might make her a less
compelling candidate for czar.

Ezra Klein, linked above, argues that if nobody can fill Daschle’s
shoes, appointing a less compelling czar might just add to the din of
executive branch officials vying for the attention of key Congressional
leaders.

Maybe it’s a good idea to send as many Obama health officials to
Congress as possible. If nothing else, they might cut into time the
reps are currently spending with health insurance industry lobbyists, as Talking Points Memo reports.

Speaking of contenders for Secretary of Health and Human Services, Gov. Howard Dean recently published an article on AlterNet
defending Obama’s comparative effectiveness research (CER) agenda
against right wing critics like Rush Limbaugh. Dean draws on his
experience as a doctor and a healthcare policy-maker to argue that CER
is a way to put more scientific evidence in the hands of doctors, so
they can choose the very best treatment for the money. Right wingers
don’t like the idea. They’re literally afraid that if science
determines that a treatment is bogus, the government will stop paying
for it. Right wingers calls this “rationing.” Taxpayers might call it
evidence-based policy. Last we checked, Medicare and Medicaid were not
faith-based programs.

As Dean points out, the CER to be funded by the new economic
stimulus bill is officially for doctors, not legislators. “Mr. Limbaugh
and his cohorts would have you believe that this research will be used
to deny needed care to your great Aunt May and be run by the politburo.
But the Bill passed by Congress states right up front that the
Government can not make coverage decisions based on this research,”
Dean wrote. Realistically, though, that’s kind of a hollow assurance.
Once the research is done, there’s no way to stop legislators from
using publicly available research findings to make healthcare decisions.

In another corner of the healthcare reform-o-sphere, Katrina vanden
Heuvel says that time is right to reform New York’s draconian Rockefeller Drug Laws in The Nation.
These laws have been on the books 35 years. The laws essentially force
judges to send drug possessors to jail based on the weight of the drugs
they were caught with, whether the judge thinks imprisonment would be a
good idea or not. New York’s budget crisis might be a blessing in
disguise for drug reform, vanden Heuvel argues, because policy-makers
are sick of paying to keep drug offenders locked up whether they need
it or not.

And finally, some good news from RH Reality Check. Many
people just wouldn’t feel right stepping out without a spritz of
perfume, a blast of breath-freshener, or regrettably, a head-to-toe
shellacking with Axe Body Spray. As Joe Veix reports for RH, another spray-on product may one day be added to the essential equipment list: contraceptive.
An Australian company is currently testing a hormone spritz for women.
The product is applied to the forearm. Like the contraceptive patch,
the spray is designed to deliver hormones through the skin. Researchers
hope that through-the-skin delivery can produce the same results as pills, but with lower doses of hormones and fewer side effects.

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