Ezra is probably right. There isn't much more to infer from this other than that Obama views the Surgeon General's office as a Commincations position and little more. I doubt it means he's abandoning healthcare.

Really, who else would you pick given the realities of this position? A good looking, fairly young doctor who Americans already have a level of trust and familiarity with is a good idea.

Ezra,

I think you're right on with Obama's intent with this pick, and I think the folks getting fired up about Moore are missing the larger point. A good one.

That said, I think its a stretch to suggest that this pick is the culmination of an ongoing evolution of Surgeon General. I'm by no means an expert on Surgeons General, but my sense is that you've captured the key inflection points-- Koop, Elders-- which until Gupta are more outliers on a trend line of traditional Surgeons General rather than a trend line suggesting an evolution towards being a public face for health care. In other words, I think Obama deserves a little more credit than you given him-- he's looked at the outliers and made a decision to make a significant shift in the role of Surgeon General. Whether it will work-- thats TBD-- but its a very interesting action, one that I think you've nailed in terms of Obama's intent.

Ezra, you're wrong about Koop in that clip; he didn't "just happen" - it was the fact that, by timing, he was in the job when talking about AIDS became more necesaary. And, like Joycelyn Elders, who was [icked specifically for that reason, Koop was a traditional public health guy who felt that the public, informed with the proper information, could make the right health choices. Koop spoke up, in no small part, because silence, literally was death at that moment. That he became something of a cultural touchstone, I think, goes to the fact that he preseted himself seriously, and credibly, as a knowledgeable expert. Elders, too.

That, I think, is why Gupta is an interesting, but not slam dunk pick. His cred as a doc is overshadowed by the fact that, as a CNN "medical expert" he's been as likely to discuss flu season as he has been more serious issues. He's a credible expert; he does his homework, he's a smart doc. But he's telegenic and more than a little smooth, which can undermine his ability to seem authoritative. As a spokesman for Obama's health plan, I'd point out, Gupta will be fulfilling a political, not a healthcare role, principally. Can he sell it? Sure. But he'll be trading, as at CNN, on hid doctor cred to achieve another goal. Koop and Elders were trusted, in part, because they were willing to go wherever the medical evidence led them, and to where the public needed the right information for better health. Will Gupta? Will he when it means contradicting Daschle, or Obama himself, or criticizing their policies? (That, after all, was how Koop had to approach AIDS policy in the Reagan era, or Elders on sex education when it challenged Clinton's more soft approach to the religious right.) We don't know with Gupta, and I'd say that's where his "corporate" nature troubles more than heartens me. I think Gupta will be Surgeon General... but whether he'll be a great one, really, will be about the next medical and public health crisis we have and how he handles it, not about whether he can sell Obama's health plan.

Nice job, Ezra, but I kind of miss the scruff.

Ezra, you made some good points on countdown. However if the only reward is gratitude and his post, will Gupta really sell the Obama health plan like he now supports Big Pharma. And isn't the Surgeon General's job bigger than that? Koop led the gov on Aids and Elders led on sex ed, will a health care plan be the only public health crisis. Now I would feel better if Gupta would get out in front fighting or at least questioning Obama's faith-based initatives about welfare or any other challenge to the status quo.

sanjay gupta...."whatever his other faults"

sanjay gupta presented his wife with a long poem that he wrote for her, and the last line contained his proposal of marriage.
they had an exquisite, traditional, indian wedding in a quaint shell house and they have named their little girls, sage and skye.
also, we have a lot of bad news these days, and sanjay has a gentle and non~scary manner.
that is good.

i hope as soon as he becomes surgeon-general, he starts to educate americans on the virtues of ayurveda...and help us to become a more peaceable and calm.
also~~~~~~~~~~~~michael moore should take better care of himself, as one who is an advocate of health care.
he should be a living , credible example of preventive medicine and healthy living if he is going to champion health care.

No, this is the evolving criterion: celebrity. That was what was behing the Rick Warren choice, as it is behind this. Rule by celebrity, rule by the famous: get used to it, live it.

Further anticipated celebrity appontments: Bob Villa (host of This Old House) as secretary of Housing and Urban Development, Kirk Douglas (he played artist Vincent Van Gogh) as head of National Endowment of the Arts, Brad Pitt, undersecretary of defense

anonymous

nothing for angelina jolie or george clooney?

actually, sanjay gupta is a practicing neurosurgeon and a clinical professor who attended excellent schools and has great communications skills and a global understanding of political events, health and social issues.
i dont think this is simply a "celebrity" appointment. in fact...so far, i think this is one of the better appointments.

"actually, sanjay gupta is a practicing neurosurgeon and a clinical professor who attended excellent schools and has great communications skills and a global understanding of political events, health and social issues."

All the more reason not to lie and shill. I love Obama, but ... no.

Ezra,

You really need to read up on why C. Everett Koop was appointed by President Ronald Reagan. As the other poster commented, he didn't "just happen."

Among other reasons, he was appointed for his views on the right to life and his opposition to abortion.

Yet, when it came to public education efforts about HIV/AIDS, Dr. Koop was at the forefront--displeasing many social conservatives.

The Surgeon General position is important, but it has only been seen of late as a factotum of Bush-carrying, science-undermining placeholders. I wrote about health policy, professional nursing and patient advocacy for several years, but I was and am still dismissed out of hand. The audacity of a nurse having an informed and legitimate opinion!

Very few progressives read substantive posts about policy and the decimation of government functions and the public well-being.

I wrote specifically about former Surgeon General Rich Carmona and what he offered during Congressional testimony. It was hair-raising, but it didn't garner a ripple from progressives. Carmona has excellent emergency preparedness expertise and experience. He testified that he requested to be sent to New Orleans as a Katrina first responder and that he was denied. Gupta never mentioned that.

Gupta, on the other hand, reports advertiser, commercial pharma crap as unbiased health reportage. He stays to a Wall Street Journal, free market, traditional corporate model of healthcare messaging. He is a commercial sell-out, and he also has many undisclosed conflicts of interest, just as you documented.

Moreover, there is a growing body of evidence that commissioned officers of the USPHS working in the DIHS - the branch that Gupta would be attached to - have been used as agents of abuse and torture on immigrant detainees. The Surgeon General would certainly be obligated to investigate that and report, but no one has. Sec HHS Leavitt has methodically weaponized HHS and used it against the health of the citizenry. DIHS, which was accountable to the USPHS somehow magically migrated to ICA and DHS, and no one is investigating or stopping abusive practices. So not unsurprisingly, people are suffering and dying and no one is doing anything about it.

Gupta has never investigated any Bush/Leavitt/HHS policy or. He's remained silent while the FDA and CDC abdicated their oversight and regulatory responsibilities and imperiled the public safety. For the past eight years, Gupta has never questioned a single thing that the Bush Admin has done.

CNN has even proudly announced that they have repressed all coverage of health policy and health reform since Obama contacted Gupta. The public can not be informed by media who deliberately and willfully withhold vital information.

Isn't anyone concerned about that?

Lastly, Gupta has no public health credentials, and the SG position is one where those credentials and expertise count. Healthcare reportage is so distorted, and it uses hospitals, physicians, pharma and commerical insurers as the four stakeholders to the exclusion of all ambulatory care settings, where the majority of care is delivered, of professional nurses, who provide over 95% of all reimbursed healthcare services, and of patients - as patients and not as consumers. The Surgeono General has an obligation to report accurately, in context and with adequate understanding of public health mechanisms, policy and program. Gupta has never demonstrated any of this, and Obama's selection of him undermines any notion of healthcare reform. It's just glossy salesmanship behind white toothy veneers.

I'm quite disappointed, Mr. Klein, that you haven't consulted with the public health community since the SG appointment is a public health position.

Ezra's patronizing remark is quite a turnoff and also exposes his lack of knowledge required to speak authoritatively on this issue of the USAG: "But the position was still hired for as if it called for simple expertise: Richard Carmona, Bush's surgeon general, was simply the next guy in line for the job."

Many months back I happened to view a CSPAN program featuring Richard Carmona (a Nat'l Press Club event, I think it was) and was impressed and tentatively heartened by Carmona's background and current priorities as AG at the time. He spoke of growing up poor in NYC, going into the service as a way out (as many youth raised in poverty do, having grossly limited opportunities made available to them in our society). He became a medic in the service, and later used the service benefits to become an RN, then eventually attended med school. Now that takes commitment to the health care profession!

On CSPAN Carmona spoke of his priorities to improve health promotion and disease prevention in the U.S. as the Surgeon General. Reducing exposure to second hand smoke was a top policy goal among other promotion and prevention measures under his tenure. After seeing Carmona on CSPAN I loosely followed his tenure and was not surprised to learn that Bush and Co. shut Carmona down on these public health efforts and he eventually resigned.

So, Ezra, pull back on the patronizing attitude, will ya. I'm also referring to your grandiose and WAY OFF THE MARK statement: "Choosing Sanjay Gupta is recognizing and codifying the change in the position. It is now as much about media as medicine."

That statement exposes how little you actually know about--and value--sound health care and health policy in general and public health in particular. (Please note: these are not to be confused with health care politics, which certainly exists, too). And not to trivialize the role of media, but pahleeez!!! One of the country's preeminent experienced experts on health care and the media, Gary Schwitzer at UMN, also nixes the Gupta choice. See Schwitzers' health news blog http://blog.lib.umn.edu/schwitz/healthnews

I wish I'd read Annie's comment before I posted mine but since my blogging was done in spurts between picking up one son at school and then his younger brother at daycare, cooking dinner, paging my public health nurse husband to go straight to our son's public school for a parents meeting with the principal about upcoming deep budget cuts, then getting the kids thru their tubs, then finally finishing my blog comment after that, I seem to have missed Annie's important contributions that I would have referenced, or at least thanked her for. So, "Thanks, Annie!" I agree with you wholeheartedly.

Hillary Clinton is also a celebrity appointment, without any expertise whatsoever in foreign policy. That is why I am recommending Brad Pitt for undersecretary of defense. He played a warrior in the movie Troy, and he looks good on tv.

I am recommending Caroline Kennedy's oldest daughter for special envoy to the middle east. The Kennedys have public service in their DNA. Let Chelsea Clinton head up the SEC. She has apparently worked for a hedge fund. If Leon Panetta doesn't get confirmed, I am recommending George Clooney. His veneers are superb, and he has played CIA types now in several movies, notably Syriana, which gave him knowledge about the middle east as well.

Department of Homeland Security: John Walsh

Department of Commerce: Trader Joe

Ruth Bader Ginsburg's seat on the court when she steps down next year as expected: Judge Wapner

Ezra, good points on Countdown. However, I don't think it's right to assume that because Sanjay Gupta is both a medicine guy and a media man, that he is uniquely qualified for this job.

There are a number of other physicians who Obama could have chosen, who would be qualified and excel at being medicine people and media people.

And who have spent part of their career working at ALL in public health.

And who do not have the numerous conflicts of interest that Gupta has. Gupta has, in his work as CNN's health guy and as the head doc at Accent (the company that advertises pharmaceutical and other products to patients as they wait in the waiting room RIGHT BEFORE they go in to their doctor and ask their doctor about this new med they saw on TV).

And who do not claim to be health journalists while lambasting the factual accuracy of what Moore provides in "Sicko" without doing real fact-checking (that was a CLEAR example of CNN's advertisers telling Dr Gupta what to report as fact).

THIS, precisely, is what makes Dr Gupta uniquely adorned with conflicts-of-interest jewelry (tarnishing his appeal and the trust of the public in him).

Hey Ezra,
Nice appearance! I am a relatively new reader of yours and have to offer a compliment.
I read Sullivan, Greenwald, Douthat, and a whole slew of other blogs, but one thing that comes across about you: humility. As in, authentic humility. Keep it up.
(And write stuff in your comments section. It's a good thing to do....)

In general, the main concern of the government is the benefits of the patients and they are worming for limiting the expenses of this medical practitioners. Well, this is a great program for the Americans to up build a good Health for everybody.A payday loan won’t be necessary to get Dr. Sanjay Gupta through the doors of the new administration. It has been reported that President-elect Barack Obama has chosen the respectable, 36 year-old doctors to become the next Surgeon General. There has not been a final decision made, however. Dr. Gupta has served as the chief medical correspondent for CNN for almost a decade. During the Clinton administration, he served as a special adviser to then-first lady Hillary Clinton. He has accomplished many things in his lifetime – from a mountain of education degrees to winning an impressive number of honors and awards for his research accomplishments. This man clearly does not need a payday loan, more so if he takes up the offer to become the nation’s next Surgeon General.