18 November 2008

Parlor Games

I've never been much interested in playing the breathless speculation "Who's going to be Secretary of xxxxxxx," games that so consume the Beltway types.  But for what it's worth, Obama could do worse than former Governor John Kitzhaber of Oregon for Secretary of Health and Human Services.  He's an Emergency Physician who developed and implemented a universal health care plan in his state, and since leaving office has advocated tirelessly for national health care reform.

I've attended a few speaking engagements with Dr Kitzhaber, and have come away impressed at his knowledge of health policy and his pragmatic and value-driven approach to reform.   He'd be a good guy to have on the team.


  1. I agree wholeheartedly. Dr. Kitzhaber, aside from being an excellent physician, is a pragmatic, consensus-builder who worked well in a state divided between rural and urban interests. He is candid, intelligent and has a really amazing "big picture" grasp.

    The Oregon Health Plan has not been a total success (I think enrollment is now down to 8,000 in the non-Medicaid-eligible component), and the promised small business reforms have largely been eroded over time (weak insurance commissioner's office, consolidation, etc), but it was a start, and more importantly, it was a start from a place where the operating reality was "We cannot fund everything for everyone" - the entire effort sprung from a decision to deny soft tissue transplants to Medicaid patients. Governor Kitzhaber is uniquely qualified to address de facto rationing from a position of experience.

    I'm not sure he'd take the job, though. He's an extremely avid fisherman, and I don't think you can even get a license to catch avid anywhere near Washington, DC.

    ps - He's the only governor of *any* state that has ever seen me naked.


  2. ps - He's the only governor of *any* state that has ever seen me naked.

    Thank you for this, Eric the Pragmatic Caregiver!

  3. Hmmm, isn't there some scuttlebutt going around about a mmm, is it Michael Copass, being selected?


  4. This choice won't make anyone with two brain cells think Obama isn't angling for a socialist-style health care system.

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  6. I agree also about Dr. Kitzhaber. He is visionary and a real leader. He may not be enough of a policy-wonk for that position but it would be a great start. The new administration will be a breath of fresh air for the world.

  7. Also, he's got the crazy-mountain-man look going for him.

    He'll fit right in the Obama administration

  8. It's mostly great how much he looks like Sam Elliot.


  9. Bastiat's Ghost11/19/2008 10:19 AM

    This would be the same universal health care plan that will pay for suicide drugs but not Chemo?

  10. That's disingenuous.

    The case in question was that of highly advanced lung cancer, to use a last-chance therapy with a chance of success virtually indistinguishable from zero. I'm not aware of *any* lung cancer therapy with curative intent. It's all palliative at that point, and I'm sorry - if your "insurance" is publicly-funded "insurance" of last resort, maybe, just maybe, you're not going to get the Iressa or the Avastin or the Sutent when your expected lifespan, with or without it, is measured in weeks.

    As horrifying as it can sound, less sometimes *is* more in late-stage cancers, and if you can provide a citation to a peer-reviewed RCT that would show a median survival benefit of, say, six months, in a case like hers, I will eat my words.

    Ugly reality: any baseline universal coverage solution is not going to cover last-ditch attempts at letting terminally ill patients see their green bananas ripen.



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