Cabinet Choices Might Suggest Direction of Obama Administration

The announcements of two major choices for the cabinet provided opportunity for speculation about the nature of an Obama administration. Cabinet members will ultimately wind up promoting the policies of the president they serve under, and legislation from Congress might alter all the intentions of the executive branch, but it is reasonable to wonder about the type of advice that cabinet members will be offering to the president.

Glenn Greenwald has reviewed some information on Eric Holder, Obama’s choice for Attorney General. It will be important for the next Attorney General to reverse the course of the Bush administration to return to the rule of law and to reverse the politicalization of the Justice Department. Greenwald provides evidence to suggest Holder might be a good candidate to promote these goals, along with showing promise on human rights issues:

The bulk of what I’ve read about and from Holder suggests, with a couple of ultimately marginal exceptions, that this appointment would be a very positive step.  Digby yesterday quoted at length from an impassioned speech Holder gave in June of this year in which he condemned Guantanamo as an “international embarrassment”; charged that “for the last 6 years the position of leader of the Free World has been largely vacant”; complained that “we authorized torture and we let fear take precedence over the rule of law“; and called for an absolute end both to rendition and warrantless eavesdropping.  He proclaimed that “the next president must move immediately to reclaim America’s standing in the world as a nation that cherishes and protects individual freedom and basic human rights.”

One major disappointment is in his position on the drug war as reported by Reason:

Barack Obama’s selection of Eric Holder as his attorney general is a very discouraging sign for anyone who hoped the new administration would de-escalate the war on drugs. As Dave Weigel noted earlier today, Holder pushed for stiffer marijuana penalties when he was the U.S. attorney for the District of Columbia, and the details are strikingly at odds not only with Obama’s signals regarding marijuana but with his opposition to long sentences for nonviolent drug offenders. According to a December 1996 report in The Washington Times excerpted at TalkLeft, Holder wanted “minimum sentences of 18 months for first-time convicted drug dealers, 36 months for the second time and 72 months for every conviction thereafter.” He also wanted to “make the penalty for distribution and possession with intent to distribute marijuana a felony, punishable with up to a five-year sentence.” The D.C. Council made the latter Holder-endorsed change in 2000. Holder thought New York City’s irrational, unjust crackdown on pot smokers was a fine idea and worth emulating, saying “we have too long taken the view that what we would term to be minor crimes are not important.” His rhetoric on the seriousness of marijuana offenses was indistinguishable from that of the most zealous Republican drug warrior.

I had hoped during the campaign that Obama would go even further than he has stated in the past in changing drug policy but was avoiding this topic while campaigning for political reasons. The appointment of Holder is discouraging on drug issues, but this could be an area where the underlying beliefs of the president trumps those of the AG.

The other major cabinet position announced was Tom Daschle for Secretary of Health and Human Services. Upon hearing the news I placed an order for his book Critical: What We Can Do About the Health-Care Crisis and hope to obtain more specific information on his views than is currently available on line.

An overview of Daschle’s thoughts on health care can be seen in an article he wrote at Huffington Post back in March. He does call for comprehensive reform as opposed to incremental change, but even before the financial crisis I suspected that economic and political realities will result in incremental change, even if more significant than seen in recent years, as opposed to an immediate plan for universal health care. The appointment of Daschle might indicate that Obama does see a push towards universal health care as part of an immediate economic package, along with seeing the value in having Daschle to push a plan in Congress.

Daschle’s ideas on health care reform center around creating a Federal Health Board:

The time is now for us to take this challenge head-on. What we need is a change in approach. In my book, Critical: What We Can Do About the American Health-Care Crisis, I have proposed a Federal Health Board that would be a foundation from which we could address all three problems. In many ways, the Federal Health Board would resemble our current Federal Reserve Board for the banking industry. Just as the Federal Reserve ensures certain standards, transparency and performance for our banking industry, the Fed Health would ensure harmonization across public programs of health-care protocols, benefits, and transparency. Ultimately, the Fed Health would offer a public framework within which a private health-care system could operate more effectively and efficiently.

The Fed Health could help reduce administrative costs. Roughly 30 cents of every dollar in health care is spent on administration rather than health benefits. Our administrative costs, on a per capita basis, are seven times higher than that of our peer nations. Each state has their own system for Medicaid and insurance regulation. We have different health-care systems for active duty military members versus veterans. And private insurers spend billions trying to enroll the healthy and avoid the sick. A Federal Health Board that sets evidence-based standards for benefits and quality for federal programs and insurance will lower this complexity and thus costs.

The Fed Health could also promote quality and save money by making the health-care system more transparent. Today, the lack of transparency in the system makes it virtually impossible for people to grasp what they are paying for and who provides them with the best care. This shroud of secrecy allows for wildly different prices for similar quality care. For example, a Pennsylvania report on heart surgery found hospitals with similar outcomes charge from $20,000 to $100,000. The Board, by ensuring transparency, would increase competition based on price and quality rather than cream skimming and cost sharing.

Additionally, the Fed Health could set standards for quality and coverage, promoting best practices and identifying the trade-offs on services. It would use information on the comparative clinical and cost effectiveness of different treatment options to set standards for Federal programs. The Congressional Budget Office recently credited this idea with the potential to produce substantial system-wide savings.

Such a board may or may not be incorporated in Obama’s health care plan. Regardless of its value, this does not really tell either health care professionals or consumers how he envisions changing the health care field when providing universal coverage. The devil is in the details of any health care plan considering how directly such details affect large numbers of people. These details are far more important than structures in Washington such as a Health Board, and failure to understand this quickly doomed Hillary Clinton’s attempts at changing health care.

There is still speculation that Hillary Clinton might become Secretary of State, provided that the problems with Bill’s associations can be resolved. The major advantages in having Clinton in this position would be to remove her from domestic policy, and limit the chances of her opposing Obama from a separate power base in the Senate. David Broder presented some arguments as to why Clinton is the wrong person for Secretary of State, primarily because “What Obama needs in the person running the State Department is a diplomat who will carry out his foreign policy.” I agree with his reservations about Clinton as Secretary of State but we disagree on the value in keeping Clinton away from domestic policy. Thomas Friedman has also pointed out the problems of having a Secretary of State whose views differ from the president.

Despite the excellent arguments made against the appointment of Clinton by Broder and Friedman, the need for Obama to keep his enemies close might outweigh these considerations. The choice of Clinton would certainly mean that the advice of the Secretary of State would be worthless and generally should be ignored. This dilemma makes me glad to hear that John Kerry is expected to be named Chairman of the Senate Foreign Relations Committee, assuming he does not wind up becoming Secretary of State. Kerry’s advice would be of value from either position, and there is a certain satisfaction in seeing John Kerry advance over the years from a young veteran protesting the Vietnam War before this committee to becoming its chairman.

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1 Comment

  1. 1
    BENJAMIN says:

    PRESIDENT ELECT OBAMA
    AS A BLACK MAN, AND A MOVIE PRODUCER LIVING IN THE STATE OF NEW MEXICO, I HAVE TO SAY, I WOULD FEEL VERY BETRAYED BY YOU, IF YOU SELECTED HILLARY CLINTON OVER GOVERNOR BILL RICHARDSON FOR SEC.
    OF STATE!!!
    GOVERNOR RICHARDSON WAS THE PIVOT THAT CAUSE YOU TO WIN THE HISPANIC VOTE! HE TURNED HIS BACK ON THE CLINTON’S TO SUPPORT A MAN WITH A VISION FOR THE FUTURE.

    PLEASE DON’T TURN THAT VISION INTO POLITICAL FAVORS TO PLEASE THE POWERS THAT BE!!!! NO ONE HAS MORE EXPERIENCE IN FOREIGN AFFAIRS THAN BILL RICHARDSON; FORMER “U.S. AMBASSADOR”, NEGOTIATING TO FREE AMERICANS UNJUSTLY HELD IN PRISONS AROUND THE GLOBE.

    NOT TO OFFER HIM THAT POSITION WOULD BE A DISSERVICE TO THE COUNTRY, TO HIM, AND TO YOURSELF!!!! DO THE RIGHT THING!!!!!
    IF WE WANTED A 3RD.
    CLINTON ADMINASTRATION, WE WOULD HAVE VOTED IN HILLARY!!!!
    “CHANGE, NOT ASSIMILATION ”
    BENJAMIN
     
     

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