Fron­trun­ners in the race for Hil­lary Clin­ton’s top health posts

Modern Healthcare - - NEWS - By Har­ris Meyer

With polls show­ing Hil­lary Clin­ton with a big lead in the Nov. 8 elec­tion, Demo­cratic political in­sid­ers are look­ing ahead. They say she will quickly name peo­ple to top health pol­icy po­si­tions who are di­verse in gen­der, race, and eth­nic­ity, have sharp ad­min­is­tra­tive skills, and can work in a bi­par­ti­san way.

“If there are op­por­tu­ni­ties for bi­par­ti­san­ship, Hil­lary would be well-served to think through whether her key ap­point­ments in health­care would help pro­mote that bi­par­ti­san­ship,” said Ron Pol­lack, ex­ec­u­tive di­rec­tor of Fam­i­lies USA, a lib­eral ad­vo­cacy group.

Names floated as likely con­tenders for HHS sec­re­tary, CMS ad­min­is­tra­tor and other key posts in­clude former Ken­tucky Gov. Steve Bes­hear, former Mas­sachusetts Gov. De­val Pa­trick, Neera Tan­den,

Chris Jen­nings, Clin­ton pol­icy ad­viser Ann O’Leary, sur­geon and au­thor Dr. Atul Gawande, and out­go­ing Robert Wood John­son Foun­da­tion CEO Dr. Risa Lav­izzo- Mourey. While some hope Sylvia

Mathews Bur­well will con­tinue on as HHS sec­re­tary, that’s con­sid­ered un­likely.

Sta­bi­liz­ing the Af­ford­able Care Act’s strug­gling in­surance ex­changes will top the list of chal­lenges Clin­ton’s health­care team will need to tackle quickly. They’ll also have to lead the tricky im­ple­men­ta­tion of the new Medi­care physi­cian pay­ment sys­tem, ac­cel­er­ate the use of val­ue­based pay­ment, man­age Med­i­caid ex­pan­sion and re­forms through ne­go­ti­a­tions with states, find ways to con­trol ris­ing pre­scrip­tion drug costs, and guide the im­ple- men­ta­tion of the Pre­ci­sion Medicine Ini­tia­tive and Can­cer Moon­shot.

With Clin­ton’s odds of win­ning the pres­i­dency grow­ing in the wake of Repub­li­can pres­i­den­tial candidate Don­ald Trump’s scan­dal-driven melt­down, spec­u­la­tion is mount­ing about who she will se­lect to ad­min­is­ter health pol­icy. Clin­ton and her tran­si­tion team, headed by former In­te­rior Sec­re­tary Ken Salazar, have made it a goal to in­crease the num­ber of women and mi­nori­ties who are hired.

Any of Clin­ton’s picks would have to be pre­pared to do bat­tle with Repub­li­cans and health­care in­dus­try stake­hold­ers. A num­ber of them may be re­luc­tant to jump back into the fray af­ter gru­el­ing years of prior public

Sta­bi­liz­ing the Af­ford­able Care Act’s strug­gling in­surance ex­changes will top the list of chal­lenges Clin­ton’s health­care team will need to quickly tackle.

ser­vice or be­cause they pre­fer to con­tinue more lu­cra­tive pri­vate-sec­tor ca­reers.

“Do these folks re­ally want to wade back into the wars?” asked Jim Man­ley, a former top aide to Demo­cratic Se­nate Leader Harry Reid who’s now a com­mu­ni­ca­tions strate­gist in Wash­ing­ton.

Two names that came up were former Se­nate Ma­jor­ity Leader Tom Daschle and

Michael Leav­itt, who was HHS sec­re­tary un­der Ge­orge W. Bush. But Daschle, who was nom­i­nated for the post by Pres­i­dent Barack Obama but with­drew over con­cerns about un­paid taxes, ruled out an­other bid. “Been there … tried to do that!” Daschle quipped in an email re­sponse. Leav­itt, who now heads the prom­i­nent health­care con­sult­ing firm Leav­itt Part­ners, like­wise said he’s not in­ter­ested. “Serv­ing at HHS was a high­light for me, but not an ex­pe­ri­ence I am in­ter­ested in re­peat­ing,” he said in an email.

There is less spec­u­la­tion about Trump’s health picks be­cause his chance of win­ning is seen as small. In­deed, it’s not clear who Trump’s health pol­icy ad­vis­ers are. A num­ber of vet­eran Repub­li­can health pol­icy ex­perts and former health of­fi­cials say they have not been in con­tact with the Trump cam­paign or else that they do not wish to serve in a Trump ad­min­is­tra­tion.

Guess­ing who the new pres­i­dent’s choices will be is a fa­vorite Wash­ing­ton par­lor game ev­ery four years. Mod­ern Health­care sur­veyed seven vet­eran Demo­cratic-af­fil­i­ated health pol­icy ex­perts, most of whom spoke on back­ground, to find out who the lead­ing con­tenders are.

Two do­mes­tic pol­icy wonks who are widely ex­pected to serve in top po­si­tions in a Clin­ton ad­min­is­tra­tion are Tan­den, a long-time Clin­ton aide who now heads the Cen­ter for Amer­i­can Progress, a lib­eral think tank; and O’Leary, a se­nior pol­icy ad­viser to the Clin­ton cam­paign. Both are serv­ing on the cam­paign’s tran­si­tion team.

Tan­den pre­vi­ously served as a health­care re­form ad­viser in the Obama White House. Be­fore that, she over­saw pol­icy is­sues for Clin­ton when she served in the Se­nate. O’Leary worked with then-Sen. Clin­ton on the Medi­care pre­scrip­tion drug ben­e­fit leg­is­la­tion and other pol­icy is­sues as her leg­isla­tive di­rec­tor.

An­other key Clin­ton ad­viser on health pol­icy will cer­tainly be Chris Jen­nings, of health­care con­sul­tancy Jen­nings Pol­icy Strate­gies, who worked with the Bill Clin­ton and Obama ad­min­is­tra­tions on health­care re­form is­sues. “Even though I think he’s not likely to seek or even ac­cept a po­si­tion, he will be the most in­flu­en­tial per­son on health­care in a Clin­ton ad­min­is­tra­tion,” Pol­lack said.

Ob­servers say Bur­well likely could stay on as HHS sec­re­tary if she wanted, since she’s widely seen as do­ing an excellent job and is pop­u­lar among both Repub­li­cans and Democrats. But some say she seeks fresh chal­lenges, and that she could be Clin­ton’s pick for Trea­sury sec­re­tary.

“One can only hope Bur­well will move to an­other cabi­net po­si­tion; she’s fan­tas­tic,” Man­ley said. “We don’t know what she wants to do.” Other fre­quently men­tioned names are:

Nancy-Ann DeParle, a key health pol­icy of­fi­cial in the Bill Clin­ton and Obama ad­min­is­tra­tions.

David Cut­ler, a Har­vard Univer­sity eco­nom­ics pro­fes­sor who served in the Bill Clin­ton ad­min­is­tra­tion and ad­vised the Obama White House on health pol­icy.

Dr. Kavita Pa­tel, a Johns Hop­kins Medicine in­ternist who served as a se­nior aide in the Obama White House.

Dr. Ju­lian Har­ris, who served as as­so­ci­ate di­rec­tor for health at the Of­fice of Man­age­ment and Bud­get in the Obama ad­min­is­tra­tion and pre­vi­ously served as Med­i­caid di­rec­tor in Mas­sachusetts.

Dr. Ezekiel Emanuel, a Univer­sity of Penn­syl­va­nia pro­fes­sor of med­i­cal ethics who served as health pol­icy ad­viser to the Obama ad­min­is­tra­tion.

Peter Lee, ex­ec­u­tive di­rec­tor of the Cal­i­for­nia Health Ben­e­fit Ex­change and a former HHS of­fi­cial in the Obama ad­min­is­tra­tion.

Andy Slavitt, the act­ing CMS ad­min­is­tra­tor who played a key role in fix­ing the por­tal Health­Care.gov af­ter its dis­as­trous launch.

Dr. Pa­trick Con­way, the CMS chief med­i­cal of­fi­cer who also heads the CMS In­no­va­tion Cen­ter.

Liz Fowler, a former top Se­nate staffer who was a key drafter of the Af­ford­able Care Act.

Pol­lack pre­dicted that Clin­ton and her tran­si­tion team will give pref­er­ence to some­one with strong ad­min­is­tra­tive skills to lead HHS, given the early lead­er­ship prob­lems in rolling out the Af­ford­able Care Act. That’s why he thinks Clin­ton will pick some­one like Bes­hear or former Michigan Gov. Jennifer Gran­holm, who is serv­ing on the tran­si­tion team.

“My guess is the in­cli­na­tion will be to se­lect a gov­er­nor be­cause as we’ve seen it’s not just im­por­tant to have some­one strong on sub­stance and pol­icy, but it’s also crit­i­cally im­por­tant to have some­one sound on ad­min­is­tra­tion,” he said.

Any of Clin­ton’s picks would have to be pre­pared to do bat­tle with Repub­li­cans and health­care in­dus­try stake­hold­ers. A num­ber of them may be re­luc­tant to jump back into the fray af­ter gru­el­ing years of prior public ser­vice or be­cause they pre­fer to con­tinue more lu­cra­tive pri­vate-sec­tor ca­reers.

GETTY IM­AGES

Tan­den

Gawande

Bes­hear

Bur­well

Lav­izzo-Mourey

DeParle

Pa­tel

Emanuel

Cut­ler

Har­ris

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.