It seems the issue used to be: How many times will progressives believe that Obama's so-called bipartisanship is merely to keep up appearances? I mean, Obama doesn't personally believe in Gregg/Bredesen/whoever! He is in control and will use bipartisanship for cover in doing liberal things. Or something.

That concern doesn't mean much anymore. Now the question's turned into: Is his obsessive focus on keeping up bipartisan appearances preventing any sort of legislative action -- bipartisan or not?

Where the eff is Rahm Emanuel? Did progressives work for a decade to have Obama focus on making Republicans feel good?

I cannot wait until all these Conservatives appoitned to cabinet posts turn into an army of Zell Millers in 2010/12.

"What many learned in the aftermath was that reform should be run by a personality that seeks consensus rather than seeks to advocate a certain set of ideas and theories."

This is precisely why losing Daschle was such a huge deal, and why progressives who have been smugly patting their backs over the moral superiority his withdrawal from consideration gives us over the Bush Admin will very likely regret it.

Do ANY of the Dems floated as possible names fit this consensus-based model? Who else has credibility with all sides without having prior commitments to a given ideological solution?

Although I've lived in New York for twenty years, I'm a native of Tennessee, and followed the whole TennCare debacle closely. Please, not Bredesen.

"What many learned in the aftermath was that reform should be run by a personality that seeks consensus rather than seeks to advocate a certain set of ideas and theories."

I actually believe this is the wrong core lesson learned.

Magaziner was almost comically incompetent in his public persona.

In other words, reform should be run by a personality that plays well on TV.

And frankly, in a situation where we can pass healthcare reform with 50 votes if necessary, in a situation where everyone already agrees on the basic outlines of the bill, the ability to advocate a certain set of ideas really would be a nice ability to have in a front person...

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"This is precisely why losing Daschle was such a huge deal, and why progressives who have been smugly patting their backs ... will very likely regret it."

I was pleased that Daschle went down for many, many reasons.

One of the important ones was that I thought Daschle isn't a particularly good public spokesman, and would become an attractive focal point for opposition to reform.

There are other reasons I was pleased, but there aren't enough pixels in the internet to list them all...

Ezra,

I'll be clear upfront-- I'm not defending Bredesen as a good pick. But this really is off-base:

typical of the top figures in the health industry I've met over the years: Self-made entrepreneurs a bit too convinced of their own brilliance, completely unaware that the strategies for making private insurers profitable don't help--and often hurt--the sicker, poorer people whom insurance should ideally protect. Their biggest fans are often people who know a ton about health care at the macro level, but haven't spent much time observing it on the ground--where reality is often messier than the statistics suggest.

I'm completely amazed that Cohn so easily writes off people who are actually on the ground. To be blunt, the comment of people "who know a ton about health care at the macro level, but haven't spent much time observing it on the ground" refers directly to Cohn, you, and frankly most "policy wonks" around DC. The same is true for most of the academic economists-- Hacker, Gruber and the like. None of the people have spent any time "on the ground." To hear Cohn dismiss Bredesen, who's been in the trenches in some fashion, because "his fans" haven't been on the ground, is particularly galling. People in industry may have their biases, but their "on the ground" experience is completely what separates them from the pay-to-play DC elites like Daschle-- at least Bredesen's opinions are based on his own actual experiences, and thus can potentially be informed by others' experience-- you know, real knowledge sharing. The lobbyists running around town don't know crap-- they are mouthpieces who give the appearance of expertise. Let's be real clear not to mix up the two. Maybe we should try health care reform with people that actual experience in the industry. Bredesen may not be the right guy, but I'm honestly angered to see you and Cohn, neither of which has any business judging other people's health care expertise, to dismiss people so easily. Industry experience should be valued, not tossed away.

"I'm completely amazed that Cohn so easily writes off people who are actually on the ground."

Excellent point, wisewon.

A few more potential appointees who have the merit of having been "on the ground" in their fields of expertise in the way that Bredesen has with healthcare:

SEC - Bernie Madoff
Treasury - John Thain
EPA - CEO of any oil company

But as far as HHS goes, I have an even better suggestion than Bredesen. How about appointing the Ebola Virus to head HHS?

I will be the last person to defend the state of Tennessee as a whole in terms of its approach to health care. My state is a backward state, without question, not just on the issue of health care but on practically any issue that a progressive person like myself cares about. This is the reality. It was true when Don Sundquist was the governor and tried to institute an income tax in Tennessee, and it was true when Phil Bredesen entered office and faced the TennCare crisis. No one would argue that Bredesen handled the TennCare crisis perfectly, but Jon Cohn's and Ezra Klein's easy dismissals of Bredesen ignore the complexities of Tennessee politics. Try spending some time here as a liberal Democrat and see how easy it is to a)run for office; b)win an election; or c)govern in a progressive manner. Frankly, it's damn near impossible to do any of those things. Tennessee, as it proved in the 2008 presidential election, is allergic to change. That's not Phil Bredesen's fault. That's just the way it is. It's just slightly difficult to be the governor of a state that insists on clinging to a tax policy more appropriate to the 19th century than the 21st. Though I wouldn't necessarily support Bredesen's nomination for HHS, I'd suggest that you consider the context before passing judgment on him.

wisewon- I've been writing about health care for a decade. In that time, I've interviewed literally hundreds of people who have first-hand experience dealing with the health care system, as patients, providers, or administrators. And I've spent countless days in clinics, emergency rooms, hospital wards, rehab clinics, outreach centers, etc. Trust me when I tell you that Bredesen and many (although not all) folks like him have lots of experience in their corner of the health care world, but very little on what I would call the front lines. And I think that shows in their policy moves.

"But as far as HHS goes, I have an even better suggestion than Bredesen. How about appointing the Ebola Virus to head HHS?"

I mean, seriously, wisewon, the Ebola Virus has a lot of experience "on the ground" in the healthcare field.

Why wouldn't the Ebola Virus be perfect to head up HHS? Being a virus, I'll bet it doesn't have an income tax problem...

He's also got a horrible reputation in the community of folks with disabilities. Say you get hurt in an accident and need a little home health care to stay independent. Folks in the know say Tennessee is NOT the place to be. ADAPT calls him "the Grim Reaper."

The sentiment is that Bredesen would seemingly rather dump folks into an institution and pay for scads of institutionalized care than make a wise (and moral) investment in the independence and potential capabilities of Tennessee citizens.

Governor Bredesen has described the dismantling of the TennCare program and the resulting loss of insurance to 170,000 Tennesseans as a regrettable necessity forced upon him by budget shortfalls and costly court orders. The reporting of the cuts by Tennessee media largely repeated the Governor’s version of events and shaped public perceptions in a manner favorable to Bredesen.

Court documents tell a different story. In 2004, TennCare, like all Medicaid programs, was under financial pressure because of rising costs. Unlike other states, however, TennCare had enough reserves to carry through to 2006. Reforms were available that would have made cuts in enrollment and benefits unnecessary. But those reforms involved cracking down on well-connected HMO contractors that were wasting enormous sums, especially for prescription drugs. Internal Bredesen Administration documents, filed as exhibits in federal litigation, show that Bredesen decided against those reforms, in favor of cutting off the sickest people on the program.

Apart from influence by the HMOs, two political considerations appear to have factored into the decision. At a state level, Bredesen faced re-election in 2006 and wanted to have “solved’ the TennCare crisis well before then, in fulfillment of the main campaign promise made when he was initially elected in 2002. Staff warned the Governor that the state contractors might not effectively execute management reforms, whereas disenrollments would decisively and swiftly generate savings. The secret plan was to “overcut” well in advance of the election, incur any political costs in 2005, then “do addbacks” as the election approached in 2006. The Governor would get credit for being a courageous fiscal conservative willing to make hard choices. Limited restoration of benefits in 2006 would demonstrate his compassion. The Governor’s lobbyist was ordered to block all legislative efforts to find additional revenues, including a tobacco tax increase, that might obviate the cuts. The “messaging:” plan was to blame the cuts on advocates and the federal courts.

The Governor’s national aspirations also appear to have been a factor. At that time, President Bush had just been re-elected, the Democrats were in disarray, and Bredesen was discussed as a blue dog candidate in 2008. In a series of national policy addresses and flattering press profiles, Bredesen made his attack on Medicaid a signature issue. He upbraided Nancy Pelosi, Harry Reid and the Democratic establishment for their loyalty to a program he disparaged as “socialist” and “a dead dictator in a glass coffin”. Cutting TennCare won accolades in the Wall Street Journal and The Economist. Simply balancing the TennCare budget with managerial reforms already in place in other states would have done nothing to burnish Bredesen’s national credentials.

"In a series of national policy addresses and flattering press profiles, Bredesen made his attack on Medicaid a signature issue."

Yup. That's the disqualifier.

It's not just what he did, it was the enthusiasm with which he did it.

All that said, beware. A cynic would assume the administration is floating a non-starter like Bredesen merely so they can nominate a slightly less puke-worthy candidate and have us all sign with relief...

Trust me when I tell you that Bredesen and many (although not all) folks like him have lots of experience in their corner of the health care world, but very little on what I would call the front lines. And I think that shows in their policy moves.

Most of the people driving the current reform package have experience in no corners of the health care field. So I'm just not clear how if you're comfortable with their complete lack of "on the ground experience" you have issues with folks that only have "one corner." Its makes no sense.

More importantly, what's clearly preferable is policy being driven a group of people with experience from different parts of the system, rather than none. The Obama team is lacking in these folks. They've got a lot of DC lifers and academics. That ain't a lot to be impressed about.

I've been writing about health care for a decade. In that time, I've interviewed literally hundreds of people who have first-hand experience dealing with the health care system, as patients, providers, or administrators. And I've spent countless days in clinics, emergency rooms, hospital wards, rehab clinics, outreach centers, etc.

I admire your desire to pursue health care as your field of journalism, that isn't that compelling in terms of experience, Jon. I'm not really into chest-thumping, but suffice to say that there are plenty of health care professionals that have significantly more experience than you've "observed" in your journalism career of one decade. Countless days? Try countless years. And I mean actually doing, not interviewing. So forgive me if I'm just a little ticked off when you write people off who don't have broad enough experience when you've got none. You want me to "trust you" that you've got it right? Trust me-- you don't even know what you don't know.

Bernie's got an idea!

"Sanders urged President Obama to name Howard Dean to head the Health and Human Services Department. The physician and former Vermont governor is “eminently qualified,” Sanders said. Read about it in The Nation."

http//sanders.senate.gov

Toodles,cg

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