Pros and cons of Sebelius as Health and Human Services Secretary

President Barack Obama formally announced on Monday that he is nominating Kathleen Sebelius to serve as Health and Human Services Secretary in his cabinet. She should be confirmed with little trouble, as various Republicans have already praised her nomination.

After the jump I’ve posted my initial thoughts on the pluses and minuses of this appointment.

1. Sebelius is smart and highly capable by all accounts. You want this in a cabinet secretary.

2. She has extensive knowledge of the health care system, having served as insurance commissioner of Kansas before being elected to two terms as governor.

3. She is not a late convert to the idea of universal health insurance coverage, having advocated for it long before she was under consideration for this job.

4. According to CQ Politics,

She already has fought one major battle with the health insurance industry, at the state level, conducted during her gubernatorial election campaign. In 2001, Indiana-based health insurer Anthem announced it would buy Blue Cross Blue Shield of Kansas. Unlike private, for-profit health insurers, Blue Cross Blue Shield of Kansas is owned by its state policy holders.

Though Blue Cross Blue Shield of Kansas’ members approved the sale to Anthem, Sebelius used her power as insurance commissioner to block the move, taking the fight all the way to the state supreme court, where she eventually prevailed.

5. She has tried to maintain adequate funding for health care as governor, which is one reason Popular Progressive is pleased with Obama’s choice. He notes that Sebelius just signed a budget bill that reduced spending but mostly spared health care programs.

6. She may have higher political ambitions. While most cabinet secretaries will never run for office, Sebelius may seek the presidency someday. Consequently, she has a lot riding on Obama’s health care reform efforts. If Obama manages to reshape our health care system the way Lyndon Johnson did with Medicare and Medicaid, it would be a huge asset for Sebelius to be able to say she helped make that happen.

Conversely, if Obama fails to improve access to health care and reduce the crushing cost of health insurance, Sebelius’s role in his administration will not be a selling point for her as a possible presidential nominee or running mate.

Here are the drawbacks of the Sebelius nomination, as I see it:

1. As far as I know, Sebelius has never advocated for a public health insurance plan that any American could buy into as part of health care reform. A mandate to purchase individual health insurance will not solve our current health care problems or control costs.

I give President Obama credit for framing health care reform as a “fiscal imperative,” most recently at the press conference announcing the Sebelius nomination. But he has taken the least costly approach to universal health care off the table. A public option is also missing from the health reform principles outlined in the budget blueprint that Obama submitted to Congress last week.

I’d feel better about Sebelius as Health and Human Services Secretary if I thought she would fight within the administration for a public option to be part of comprehensive health care reform.

2. She may have higher political ambitions. If Sebelius wants to run for president, universal health care reform would be a great resume item. On the other hand, any good health care plan will have powerful enemies, not just in the corporate world but also within the Democratic Party. Perhaps it would be better if Obama’s cabinet secretary had no reason to fear upsetting powerful interest groups.

3. We lose our only hope of making the U.S. Senate race in Kansas competitive in 2010. If she turns out to be an exceptional Health and Human Services Secretary, this is well worth the trade, but if she muddles through in the cabinet, I’d rather have seen her make the Republicans defend that Senate seat.

4. Her successor as governor of Kansas is barely a Democrat.

Speaking of health care, Obama announced on Monday that thanks to the stimulus bill Congress recently approved, the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) has already released $155 million to support 126 new health centers. From a White House press release:  

These health centers will help people in need – many with no health insurance – obtain access to comprehensive primary and preventive health care services.

“We have acted quickly to put Recovery Act dollars to good use in communities across America,” said President Obama. “The construction and expansion of health centers will create thousands of new jobs, help provide health care to an estimated 750,000 Americans across the country who wouldn’t have access to care without these centers, and take another step toward an affordable, accessible health care system.”

The White House estimates that this $155 million will help create 5,500 jobs at the new health centers.

I received a separate press release noting that Iowa’s share in this program will be $1.3 million for the River Hills Community Health Center in Ottumwa, which will create an estimated 60 jobs.

During last year’s campaign in the second district, Ottumwa resident Dr. Mariannette Miller-Meeks depicted Congressman Dave Loebsack as ineffective. If she wants a rematch in 2010, the stimulus spending that is about to flow into the district won’t help her cause.

This thread is for any opinions about Kathleen Sebelius, prospects for health care reform, or health spending in the stimulus.

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