Biden’s health teamoffers glimpse of his strategy
Presi - WASHINGTON — dent-elect JoeBiden’s choices forhis health care teampoint toastrongerfederalroleinthe nation’sCOVID-19strategy, restorationof a guiding stresson science and an emphasis on equitable distribution of vaccines and treatments. WithMonday’s announcementofCaliforniaAttorneyGeneral Xavier Becerra as his health secretary and other key appointments, Biden aims to l e av e behind the personality dramas that sometimes flourished under President Donald Trump. He hopes to return the federal response to amoremethodicalapproach, seekingresultsbyapplyingscientific knowledge inwhat he says will be a transparentand disciplined manner.
“We are still going to have a federal, stateandlocal partnership,” said Dr. Georges Benjamin, executive directorof thenonprofitAmerican Public Health Association. “I just think there is going to be better guidance fromthe federal governmentandtheyare goingtoworkmorecollaboratively with the states.”
In a sense, what Biden has is not quite yet a team, but a collection of players drafted for key positions. Some have alreadybeenworkingtogether as members of Biden’s coronavirus advisory board. Otherswillhavetosuitupquickly.
Byannouncingmostof the key positions in one package, Biden is signaling that he expects his appointees to worktogether,andnotaslords of theirownbureaucratic fiefdoms.
“Thesearenotturf-conscious people,” said Drew Altman, CEOofthenonpartisanKaiser FamilyFoundation, aclearinghouseforhealthcareinformation and analysis. But “it’s up to the (Biden) administration to make it an effective team.”
AWashingtonsaying,sometimes attributed to the late President Ronald Reagan, holds that “personnel is policy.”Here’swhatBiden’shealth care picks say about the policieshisadministrationislikely to follow:
Stronger federal management
The selection of Becerra as health secretary and businessman Jeff Zients as White House coronavirus coordinator point to a more assertive federal coronavirus role.
Under Trump, states were sometimeslefttofigurethings out themselves, as when the WhiteHouseinitiallycalledon states totest allnursinghome residentswithoutprovidingan infrastructure, only to have to rectify that omission later.
Zientshasmadeanamefor himself rescuing government programsthatwentoffcourse, such as the “Obamacare” HealthCare.govwebsite. Becerra has experience managing California’s attorney general’s office, which is bigger thansomestategovernments.
Science attheforefront
Biden’s selection of infectious disease expert Dr. Rochelle Walensky to head the Centers for Disease Control and Prevention, the elevation of Dr. Anthony Fauci to medical adviser, and the return of Dr. Vivek Murthy as surgeon general are being read in the medical community as a restoration of the traditionally important role of science in public health emergencies.
“Itmeansthattheresponse planwillbegroundedinhealth science,” saidDr. NadineGracia, executive vice president of the Trust for America’s Health, a nonprofit that works to promote public health.
Walensky, arecognized HIV/AIDSexpert, gothercoronavirus experience firsthand as chief of infectious diseases atMassachusettsGeneralHospital inBostonduring the first wave this spring.
“Shewasarealleaderwhen it came to COVID,” said Dr. Rajesh Gandhi, an infectious diseasephysicianatMassGeneral.“controlpolicieswithinthehospital, sheorganizedtreatment studies, she was organizing testing and leading testing.”
A focus on equity
Even more than the nomination of a Latino politician for health secretary, Biden’s selection of YaleUniversity’sDr. Marcella Nunez-Smith is being read as a sign that his administration willwork for equitable distribution of vaccines and treatments among racial and ethnic minorities, who have suffered a disproportionately high toll of COVID-19 deaths.
That challenge faces widespread skepticism among minoritiesthatthehealthcare system has their best interests in mind.
Early indications are that the vaccines are highly effective.But polling indicates an strong undertowofdoubts,especially among African Americans.
“While states will be able tomake the finaldecisionson whogetsthevaccine,therehas to be guidance around those decisions so that they are fair andequitableacrossthecountry,” Altmansaid. “You don’t wanttohavethekindofvariationsthatpeoplewilllookand say, ‘This just wasn’t fair.’”