If Grijalva wasn’t writing the obituary, Secretary of Health and Human Services Secretary Kathleen Sebelius might have been. Way back in August, Sebelius said that the president could live without the public plan, and it turned out she was right. Last week, the secretary told the Senate Finance Committee: “I am not a principal in the negotiations. Nor is my staff.” What kind of administration would be negotiating major health reform bills without its Secretary for Health and Human Services in the thick of it?

Historical footnote: During the negotiations for Medicare, officials from the Department of Health, Education, and Welfare (as the agency was then called) were heavily involved, particularly Wilbur Cohen, who was once called The Man Who Built Medicare. Politico and the AP have done a jolly good job bringing to light the ambiguity (and absurdity) of this phase of reform.

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.