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Wouldn’t you know it? The same day the February issue of The Hospitalist was being shipped to the post office, former Sen. Tom Daschle—President Obama’s “chosen one” to spearhead healthcare reform— surprised us all. Embroiled in a tax and ethics scandal, Daschle up and withdrew his nomination for secretary of the Department of Health and Human Services (HHS). Considering our February cover story outlines Obama and Daschle’s plan for comprehensive healthcare reform—and the magazine cover has a nice picture of Obama with Daschle in the background—the timing couldn’t have been … better.

It’s not as if we declared Thomas Dewey the next president of the United States. If nothing else, consider the February issue a collector’s item.

In publishing circles, it’s one of those slow-motion moments. You know, the kind of moment sitcoms rewind and show from three different angles. Do they really think we need to see Cosmo Kramer trip and fall three times? I got it.

It’s not as if we declared Thomas Dewey the next president of the United States. If nothing else, consider the February issue a collector’s item. Once I’m done writing this column, I’m going to FedEx a box of February issues to Daschle’s office. I hope he hangs one on the wall—a reminder of how close he came to history.

The fact of the matter is, I’m guessing Daschle’s departure will do little to slow Obama’s push for healthcare reform. Case in point: The day after Daschle withdrew his nomination, the House of Representatives approved legislation to provide federally funded healthcare to 4 million more Americans by expanding the State Children’s Health Insurance Program, or SCHIP (see “2009: A Pivotal Year for Policy,” p. 14). The president’s first healthcare reform legislation passed Congress by a pair of two-thirds votes and will inject $35 billion into the program over the next five years. More importantly, the fact that the legislation was signed into law on Day 15 of the new administration signals Obama’s commitment to comprehensive healthcare reform.

Most in the HM community fully support the president on the idea that it’s time to change the way healthcare is delivered, revamp the way providers are paid for their services, and eliminate the term “uninsured.” Unfortunately, the president’s tidal wave of support for healthcare reform is being chipped away by a wayward economy and missteps in the confirmation process. A similar message was conveyed during a policy report to SHM’s board of directors in late January in Washington, D.C. Key HM issues, such as bundling and coordination of care, appear to be on the traditional route within the legislative process. Translation: a slower one rife with political obstacles.

At press time, Obama had not put forth a new HHS nominee. Some names thrown into the ring: Jeanne Lambrew, PhD, a deputy health adviser to Obama and Daschle’s former right hand; Rep. Rosa DeLauro (D-Conn.); and Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee. And a possibility from the other side of the aisle: Mitt Romney, former Massachusetts governor and presidential candidate. (OK, the Romney mention is a shout-out to the blogosphere. Massachusetts physicians would lay siege to the White House if Romney were nominated.)

Pundits are calling for an individual with many of Daschle’s key attributes: expertise in the healthcare system, knowledge of the inner workings of Washington, and confluence—not to mention influence—with the president in healthcare issues. From the looks of things—and knowing that Daschle’s place in the Obama cabinet was considered a slam dunk—the president will have the unenviable task of replacing the person he thought was most capable of being the “lead architect” to implement “our healthcare plan,” as he said in the Dec. 11 news conference introducing Daschle as his HHS nominee.

Although the task is great and the process delayed, it’s unlikely the healthcare debate is going to slide to the back burner. Although healthcare reform ideology spans the full spectrum—politically, philosophically, and economically—the healthcare debate is alive and kicking in this new administration.

We’ll just have to make sure the next HHS leader is confirmed before The Hospitalist shines the spotlight on them. TH

Jason Carris is editor of The Hospitalist.

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