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The Nation

Is Dean the Best Replacement for Daschle?

With the exit of the atrocious Tom Daschle as President Obama's nominee to serve as Secretary of Health and Human Services, there is now much talk about nominating former Vermont Governor and Democratic National Committee chair Howard Dean for the position.

Dean is appealing. He is a physician with record of working at the state level to expand access to healthcare for children and low-income families. His 2004 presidential candidacy rallied opposition to the Bush-Cheney administration at a critical point and laid the communications and grassroots-political groundwork for Barack Obama's successful 2008 drive -- as did Dean's leadership of the DNC. And Dean is an independent player, who has tangled with the likes of White House Chief of Staff Rahm Emanuel in the past, and could be counted on to do so as a high-profile member of a "team of rivals" Cabinet.

But supporters of real health-care reform should remember that Dean long ago distanced himself from advocates for a single-payer system. Commentator John McClaughry -- a critical observer of his fellow Vermonter -- noted in a 2005 column for The Wall Street Journal that upon assuming the governorship in the early 1990s, "Gov. Dean quickly distanced himself from the single-payer idea he had supported, favoring instead something called 'regulated multipayer.' Translation: Hillarycare."

Dean's statements about healthcare reform continue to stir concern among single-payer advocates, including the doctors who are involved with a group the Vermonter should have aligned himself with, Physicians for a National Health Care Plan.

The point here is not to condemn Dean, who this writer has interviewed often and generally written about positively.


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Rather, it is to suggest that those who are serious about reform should go into the discussion with regard to who will be Obama's point person on healthcare reform with eyes wide open.

There are prominent players in Congress--Washington's Jim McDermott, a physician and a senior member of the powerful House Ways and Means Committee; Wisconsin's Tammy Baldwin, a popular member of the House with close ties to Speaker Nancy Pelosi and experience on the healthcare subcommittee of the Commerce Committee--who have long records of advocating on behalf of a single-payer system. Both McDermott and Baldwin are able political players, with smart, flexible approaches; they understand the value of incremental reform. But they also know that the ultimate goal should be a single-payer system, not a regulatory mess of government spending and corporate profiteering along the lines proposed in the mid-1990s by then-First Lady Hillary Clinton and supported at the time by Dean. (While the Clinton's were advancing their doomed plan, McDermott was the lead sponsor of a single-payer bill that attracted more support than did the White House scheme.)

While it certainly makes sense to consider Dean--and while he would be a dramatically better HHS Secretary than Daschle -- it also makes sense to consider others, including those who have been stalwarts in the fight for real reform.

The opening for fundamental reform of a badly broken healthcare system exists. The next HHS Secretary should be someone who believes in making the most of that opening to achieve the long-deferred goal of Franklin Roosevelt and Harry Truman: the creation of a national healthcare system that provides quality care for all Americans.

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