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It's big, if sort of obscure, news that Ted Kennedy has tapped Massachusetts' John McDonough to be his chief health adviser. McDonough was a longtime legislator in the Massachusetts House who went on to become the state's leading health care advocate. As the executive director, and even chief blogger(!), of Health Care For All, McDonough and his organization exerted most of the pressure from the left that led to the Massachusetts health reforms. Right about now, many of you will point out that what Massachusetts passed wasn't perfect. And that's correct. But they were actually able to navigate the tricky currents of health reform and pass a major bill that stands as a significant improvement. It was, at the very least, an immense political accomplishment. And that's what's interesting about Kennedy's choice of McDonough. Most Senate health advisers are policy wonks with Hill experience. McDonough is a politician with health care experience. He's even written a book about the problems of political reform in legislatures (a book that received a glowing review from, yes, Ted Kennedy). This suggests that Kennedy's focus is much, much more on getting something passed than creating some new set of policy innovations. And given that Kennedy is going to be an absolute key player in the next reform battle, that's a meaningful signal.