The Magazine

Dr. Daschle's Dubious Cure

Get ready for health care activism.

Dec 15, 2008, Vol. 14, No. 13 • By DAVE GERSHON and HENRY I. MILLER
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As the long-time leader of Senate Democrats, Daschle may be well suited to shepherding legislation through Congress and directing its implementation by his department, but he lacks the scientific and medical background to oversee the scientific issues that will arise in the research-intensive components of his vast HHS empire. The department encompasses critical public health agencies, including the National Institutes of Health and Centers for Disease Control and Prevention, as well as the FDA, and dispenses about $30 billion in grants annually, more than the rest of the U.S. government combined. Tommy Thompson, who served as HHS secretary during much of the past eight years and who was also an old political pro from his days as Wisconsin's governor, presided over a series of public health policy debacles because he was not conversant with medical science and economics. A contributing factor was the Clinton administration's decision to remove the assistant secretary of health--traditionally a public health policy-oriented physician--from line authority over HHS's public health agencies. The assistant secretary is now little more than an observer.

Daschle, then, will need strong advisers and agency heads who will bring genuine expertise to complex issues. He would do well to include a few who understand the power of free markets and competition.

Henry I. Miller, a physician and fellow at the Hoover Institution and the Competitive Enterprise Institute, was an official at the FDA from 1979 to 1994. Dave Gershon, a physician and attorney, is chairman of the National Institute for Healthcare Economics and Regulatory Policy and a visiting lecturer at the Harvard University Health Science and Technology Program/MIT Sloan School of Management.