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To further the point that you don't tap a former Senate majority leader to simply run the Health and Human Services bureaucracy, Mike Allen reports:
Daschle, who was developing a passion for health care, did not want to be HHS secretary – or at least was lukewarm on it – unless he was given a health-czar role. HHS is a monstrous bureaucracy (NIH, FDA, etc.) and is not a place to effect health-care reform. Although you won’t hear them making the analogy, Obama aides want to use the Cheney-energy-task-force model of using the White House as a place to hash out issues before they got to the Hill and Cabinet. So the Office of Health Reform will be like a special-projects arm of the White House. By adding that role to his spot in the Cabinet, HE’S ALIGNING THE PLANETS TO ALLOW HIM TO PUSH FOR SIGNIFICANT CHANGES – TO TRY FOR HEALTH REFORM MORE AMBITIOUS THAN PEOPLE ARE THINKING. A few other factors will help with that:This is why Daschle got two jobs: Secretary of Health and Human Services and director of the White House's Office of Health Reform. The fact that the Office of Health Reform is in the White House, rather than the Health and Human Services agency, is important, too. In politics, and particularly in the executive branch, proximity matters. But the Office of Health Reform also has implications for the strategy the administration means to pursue. The department will have its own high profile director and, with Jeanne Lambrew and her team, its own analytical staff. That suggests that the White House means to hash out much of its policy in-house, rather than turning most of it over to Congress, as many have speculated. That's not to say there won't be involvement from congressional players in that process, but the effort will be centered at 1600 Pennsylvania. It's a somewhat surprising strategic choice, and the next big question is how the OHR will interact with the Congress.
