Vetting Daschle’s Replacement

And the wisdom of the crowd

Call it citizen journalism or citizen participation, but the Internet has been full of stories about Tom Daschle’s would-be replacement as Secretary of Health and Human Services. Daschle withdrew as President Obama’s choice after revelations surfaced that he didn’t pay all his income taxes. His financial disclosures also raised questions about his connections to health care interests, which might have hindered his credibility as the president’s point man in charge of reform. The wide variety of names being discussed underscores the different priorities people have for health reform—and the difficulties any HHS secretary will face in trying to address them all.

The Washington Post published an interesting feature—sort of a lengthy Q and A that asked the question: “Who Should Replace Tom Daschle? Ten people, mostly mainstreamers—or “Beltway observers”, as the Post called them—suggested names ranging from Kansas Governor Kathleen Sebelius and former Massachusetts Governor Mitt Romney to Tennessee Governor Phil Bredesen and former vice president Al Gore. Georges Benjamin, executive director of the American Public Health Association, declined to name names, but instead offered his thoughts on qualifications for the job. The Beltway observers were all over the place.

Not so when it came to Facebook. Here, Howard Dean was the winner. One Facebook group, “Appoint Howard Dean to HHS,” attracted 4000 members; another, “Howard Dean for HHS Secretary,” courted some 1,600. Dean, who recently stepped down as chairman of the Democratic National Committee, was once governor of Vermont, where he expanded childhood health care and mandated equal insurance coverage for mental health diagnoses and substance abuse. Dean is also a physician. A Dean supporter explained that the governor expanded health coverage to 99 percent of the state’s children: “That’s the kind of results oriented leadership President Obama has been looking for in his cabinet.”

In Tennessee, the Tennessee Health Care Campaign, a grassroots organization, has organized an e-mail, letter writing, and fax campaign opposing Gov. Bredesen. The group worked hard a few years ago to stop cuts in TennCare, the health plan that expanded coverage for lots of poor and sick Tennesseans at least for a few years, but then ran into serious money troubles. The governor took a knife to the program, and the Tennessee Health Campaign’s campaign to restore the coverage was not successful. People lost their health insurance. Many died from lack of medical care.

Tony Garr, who heads the group, is urging Tennesseans to contact the president. “You need to do this for your country,” Garr’s mass e-mail says. “Governor Bredesen has caused serious harm to thousands of people. We don’t want him doing this to the country.”

As you can see, popular opinion on Daschle’s replacement is mixed. Perhaps that’s what we can expect—after all, the masses don’t have to weigh political considerations when making their ideal Cabinet choice. Still, crowd wisdom can help guide the presidential selection committee. It’s clear the public has something to say about the President’s choice for health reform chief, and new forms of communication are making it possible to move the decision making process out of the back room. Who would say that is not a good thing?

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Trudy Lieberman is 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. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.