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Biden’s picks for key health positions in his cabinet indicate a stronger federal role in the response to the pandemic.
United States President-elect Joe Biden’s healthcare team's choices point to a stronger federal role in the nation’s COVID-19 strategy, restoration of a guiding focus on science, and an emphasis on equitable distribution of vaccines and treatments among ethnic groups and those at a disadvantage.
It is a shift from President Donald Trump’s strategy where states were largely left to gather resources, acquire protective equipment, build a strategy, and implement restrictions often without clear direction from the federal government.
With Monday’s announcement of California Attorney General Xavier Becerra as his health secretary and other key appointments, Biden aims to leave behind the personality dramas that sometimes flourished under Trump. He hopes to return the federal response to a more methodical approach, seeking results by applying scientific knowledge in what he described as a transparent and disciplined manner.
“We are still going to have a federal, state, and local partnership,” said Dr. Georges Benjamin, executive director of the nonprofit American Public Health Association. “I just think there is going to be better guidance from the federal government and they are going to work more collaboratively with the states.”
By announcing most of the key positions in one package, Biden is signaling that he expects his appointees to work together, and not as lords of their own bureaucratic fiefdoms.
Even if he is working with a cooperative Congress, the larger and more ambitious features of President-elect Biden’s health care plan may prove more difficult to achieve. Here's what to expect from health care policy under a Biden administration. https://t.co/j6KgY8mxcw
Here is what Biden’s healthcare picks say about the policies his administration is likely to follow:
Stronger federal management Becerra's selection as health secretary and businessman Jeff Zients as White House coronavirus coordinator point to a more assertive federal coronavirus role.
Under Trump, states were sometimes left to figure things out themselves, as when the White House initially called on states to test all nursing home residents without providing an infrastructure, only to have to rectify that omission later.
Zients has made a name for himself rescuing government programs that went off course, such as the Affordable Care Act – also known as Obamacare. Becerra has experience managing California’s attorney general’s office, which is bigger than some state governments.
Science at the forefront Biden’s selection of infectious disease expert Dr. Rochelle Walensky to head the Centers for Disease Control and Prevention, the elevation of Dr. Anthony Fauci to medical adviser, and the return of Dr. Vivek Murthy as surgeon general are being read in the medical community as a restoration of the traditionally important role of science in public health emergencies.
“It means that the response plan will be grounded in health science,” said Dr. Nadine Gracia, executive vice president of the Trust for America’s Health, a nonprofit that works to promote public health.
Under Trump, “those of us who practice in medicine today have been dismayed,” said Dr. Wendy Armstrong, an infectious disease specialist at Emory University medical school. “The individuals with the greatest expertise have not had the voice many of us wish they would have had … This to me signals that the government is ready to put expertise in place that can guide its plan.”
Walensky, a widely recognized HIV/AIDS expert, got her coronavirus experience first hand as chief of infectious diseases at Massachusetts General Hospital in Boston during the first wave this spring.
Focus on equity Even more than the nomination of a Latino politician for health secretary, Biden’s selection of Yale University’s Dr. Marcella Nunez-Smith is being read as a sign that his administration will work for equitable distribution of vaccines and treatments among racial and ethnic minorities, who have suffered a disproportionately high toll of COVID-19 deaths.
That challenge faces widespread skepticism among minorities that the healthcare system has their best interests in mind.
Early indications are that the vaccines are highly effective, said Altman of the Kaiser Foundation. But polling indicates a strong undertow of doubts, especially among African Americans.