Before I joined HealthLeaders Media, I was a reporter for seven years in Nashville, TN, where I covered state politics, including Democratic Gov. Phil Bredesen and his efforts to reform TennCare, the state's monstrously large Medicaid waiver program. So, I've been closely watching this media speculation about his chances to become the next HHS secretary. The criticism of Bredesen from healthcare coverage advocates is fair—but only if you believe that the sole responsibility of a governor is to provide healthcare for the poor. Bredesen understands that he has to fund public education, public safety, and several other basic and vital programs that all state governments are charged with providing. He also has to provide for a balanced budget in a state with one of the lowest tax burdens in the nation. Yes, he cut TennCare, but only because the run-away program he inherited was growing by double digits annually when he took office and threatened to consume the state's budget.
Can he do the job at HHS? Of course! He's usually the smartest guy in the room and he is very much a problem-solver. Bredesen's biggest obstacle, however, is that he is the polar opposite of Tom Daschle, who was the front-running candidate at HHS until he flunked driver's ed. Daschle is the ultimate insider, the guy who knows how to stroke egos, the guy who knows what buttons to push, and where the bodies are buried. Bredesen would come to Washington, DC, very much the outsider. He couldn't even count on the home-state support of Tennessee Republican Sens. Bob Corker and Lamar Alexander.
Beyond that, there is the question of temperament. Simply put, Bredesen doesn't suffer fools gladly, and there are simply too many fools in Washington. I have a hard time believing he could mask his contempt for the do-nothing ideologues and obstructionists who have no idea what it's like to run a large bureaucracy, and who don't know what a balanced budget looks like. On another front, Ron Pollack with Families USA—the consumer group that has aggressively rapped Bredesen—is reporting today that Kansas Democratic Gov. Kathleen Sebelius, considered the top candidate, would take the HHS job if it was offered. [Read More]