In remarks that have been broadcast over and over this past week, President Obama said that he "screwed up" in nominating former South Dakota Senator Tom Daschle to be secretary of health and human services. Why? Because his vetting team failed to identify a problem with unpaid taxes on a car and driver provided by a Democratic contributor. The demise of the Daschle nomination, which was expected to breeze through confirmation, made quite a story: the rise and fall, the unexpected revelations, the president's admission of responsibility. But, although we should expect our public servants to pay their taxes, all the discussion drew attention away from the overall objective of appointing a secretary who can fix our health system. When it comes to health care, Americans, and women in particular, cannot afford to lose focus.
Our next Secretary of Health and Human Services should be able to lead the United States through much-needed health care reform and bridge gaping inequalities in health services. Here are some issues the new secretary will need to take on.
Throughout his election campaign, President Obama stated his intention to take on the United States' faltering health care system. Quality health care remains out of reach for millions of people in the United States, and the current economic crisis threatens to force many more to go without critical services. According to the latest numbers available from the Centers for Disease Control, 15.3 percent of people in the US were uninsured in 2007, which translates into more than 45 million people, including 8 million children, going without coverage. Among the insured, most had health insurance coverage that is tied to an employer, and thus susceptible to termination as the economic crisis leads to job losses.
But the problems are even greater when it comes to women's health needs. Women face discrimination in obtaining coverage through the private insurance market, and insurance policies often leave out women's core health needs, such as access to contraception and prenatal services. Furthermore, as demonstrated by the recent withdrawal of contraceptive funding from the economic stimulus package, women's reproductive health continues to be a political bargaining chip. In this environment, the secretary must be a determined advocate for women's right to control their own bodies and lives. This will include pushing for the restoration of subsidies for birth control pills to clinics serving low-income and college women, and undoing the harm caused by the Bush administration's last-minute regulations on "conscientious objection" for health care providers. These regulations are formulated in such a broad and ambiguous manner that they seriously jeopardize women's access to abortion and contraception.
In addition to serious sex equality issues in access to health care, this country has stark racial disparities in disease prevalence and health outcomes. Nationally, the rate of AIDS cases for African-American women is 21 times that for white women; for Latina women the rate is five times that for white women. African-American women have the highest rates of death related to HIV, with HIV ranking as the third leading cause of death among African-American women ages 25 to 44. These numbers demand the development of a national action plan, and the nomination of a leader who will see it through.
And here is another task for the new secretary. During the past eight years, policies and programs that should have been based on scientific evidence were instead determined by ideological considerations. Most notoriously, the Bush administration's Department of Health and Human Services promoted manifestly ineffective abstinence-until-marriage sex education. In another example, despite medical evidence about the safety of the drug, the Food and Drug Administration refused to approve Plan B (a form of emergency contraception) for over-the-counter sale until pressured to do so by grassroots activism and a still-pending lawsuit. In both cases, the Department's resources and stature were commandeered in the service of an ideological agenda at the cost of Americans' health. The nation must be able to trust that the next Secretary of Health and Human Services will make policy based on medical evidence and scientific findings rather than politics.
President Obama, in looking for a new nominee for this crucial post needs to find someone who can show leadership on these issues and come up with a better, and far fairer, way to serve the country's health needs.
