"You think I'm kidding, don't you?"

I heard about this last night, and when I went to read the quote on the WSJ site, I literally did a spit take. Wine all over the carpet.

If Obama appoints this guy to any position, Obama deserves to be impeached, convicted, and possibly deported.

But of course Daschle had these ties too, albeit not nearly so tight.

I mean maybe Obama sees a reform lieutenant that has an in with these industries as being far more strategically important than cultivating further ties with the health reform community (which he almost automatically does just by dint of being a Democrat).

On the other hand, maybe the OHR just doesn't make sense without Daschle, and it's time to just go with a straight hybrid. Throw Bredesen and Pete Stark onto a commission together and maybe you'll get something a little more acceptable?

we learn that as a further hedge against criticism, Bredesen's staff gave Rahm Emanuel "letters of support...from the president of the Tennessee Hospital Association and from a half dozen pediatricians in the state." This belief that industry support is the highest form of flattery isn't surprising. Bredesen himself comes from a health industry background. And, arguably, that gives him unique insight into their incentives and vulnerabilities. But he's presenting himself as the candidate of the health care industry rather than the candidate of those who think they need a secretary with the credibility to stand against the health care industry.

I think you're misunderstanding his point-- he isn't providing letters pf support from his part of the industry. As we've said previously, cutting costs is hard-- and will require taking on physician and hospital groups. The point of his letters is to show that while he's make some touch decisions (TennCare) he still maintained support from key constituencies that can make reform near impossible. He's offering a pretty clear package to Obama: he's been in the trenches as an HMO CEO and cut back benefits significantly in TennCare, all while keeping his oppositional interest groups in line. So he's done it in the private and public sectors. If you're Obama, you may not like what he cut-- but Obama's the president, so Bredesen will execute Obama's vision, not his own. In short, Bredesen has demonstrated an ability to navigate the messy maze of health care and still have (influential) friends at his side. Isn't that pretty much the profile you want if you are serious about successfully reforming health care costs?

Ask nearly anyone who knows anything about Tennessee politics and health care and they will tell you the biggest disappointment of the Bredesen administration was his failure to come up with ANY creative solution to the high TennCare costs other than cutting recipients. There's even more consensus around Bredesen's role in contributing to Obama's loss of Tennessee in the election. There's also some question about the actual extent of his health care administrative experience. Why was he ever on the list?

The fight of TennCare was over who you cut: Advocates wanted cuts to, well, doctors, hospitals, and insurers. Bredesen refused that approach entirely. He didn't keep the industry in line. He simply agreed with them. That's true whether you support Bredesen's position or not.

The relevant stakeholder for your analogy -- keeping the reformed or regulated in line even as you force them to bear new burdens -- would have been if patient advocates felt like they were dealt with fairly, which they don't.

The fight of TennCare was over who you cut: Advocates wanted cuts to, well, doctors, hospitals, and insurers. Bredesen refused that approach entirely. He didn't keep the industry in line. He simply agreed with them. That's true whether you support Bredesen's position or not.

The relevant stakeholder for your analogy -- keeping the reformed or regulated in line even as you force them to bear new burdens -- would have been if patient advocates felt like they were dealt with fairly, which they don't.

Fair enough. I actually was going to caveat my above post to say that if the TennCare cuts were exactly as you suggest, then docs/hospital support isn't that meaningful. I hadn't followed TennCare closely, so I'll take your word for it.

In any case, the actual reality was probably more gray than black and white as you described, and I think that is what Bredesen is offering up to Obama. We can debate about the degree that its true-- but he unquestionably has better qualifications on this score than the others Obama is reportedely considering. I don't think any of them haven't ever really dealt with these stakeholders, in the trenches, in their past experience. That's the angle that Bredesen is playing.