Biden’s health team offers glimpse of his COVID-19 response strategy
WASHINGTON >> Presidentelect Joe Biden’s choices for his health care team point to a stronger federal role in the nation’s COVID-19 strategy, restoration of a guiding stress on science and an emphasis on equitable distribution of vaccines and treatments.
W it h Mond ay ’ s a nnouncement of California Attorney General Xavier Becerra as his health secretary and a half dozen other key appointments, Biden aims to leave behind the personality dramas that sometimes flourished under President Donald Trump. He hopes to return the federal response to a more methodical approach, seeking results by applying scientific knowledge in what he says will be a transparent and disciplined manner.
“We are still going to have a federal, state and local partnership,” commented Dr. Georges Benjamin, executive director of the nonprofit American Public Health Association. “I just think there is going to be better guidance from the federal government and they are going to work more collaboratively 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 already been working together as members of Biden’s coronavirus advisory board. Others will have to suit up quickly.
By announcing most of the key positions in one package, Biden is signaling that he expects his appointees to work together, and not as lords of their own bureaucratic fiefdoms.
Here’s what Biden’s health care picks say about the policies his administration is likely 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 sometimes left to figure things out themselves, as when the White House initially called on states to test all nursing home residents without providing an infrastructure, only to have to rectify that omission later.
Zients has made a name for himself rescuing government programs that went off course, such as the “Obamacare” HealthCare.gov website. Becerra has experience managing California’s attorney general’s office, which is bigger than some state governments.
Former Health and Human Services Secretary Kathleen Sebelius knows both men from her service in the Obama administration and says she does not see them working at cross purposes.
A Secretary Becerra “can’t get up every morning and think only COVID,” she said. He’ll “work on COVID and coordinate the assets of the FDA, CDC and NIH, but he’ll have lots of other things to do.” Meanwhile “Zients will be the railroad engineer making sure the trains run on time.”
Science at the forefront
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.
“It means that the response plan will be grounded in health science,” said Dr. Nadine Gracia, executive vice president of the Trust for America’s Health, a nonprofit that works to promote public health.
A focus on equity
Even more than the nomination of a Latino politician for health secretary, Biden’s selection of Yale University’s Dr. Marcella Nunez- Smith is being read as a sign that his administration will work 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 minorities that the health care system has their best interests in mind.
Early indications are that the vaccines are highly effective, said Altman of the Kaiser Foundation. But polling indicates a strong undertow of doubts, especially among African Americans.