Secretary Xavier Beccera,
Congratulations on your confirmation to lead the Health and Human Services Department! Your tenure in Congress and experience serving the large and diverse citizenry of California make you an ideal steward of America’s health care system.
What I offer here is not a road map for navigating politics and bureaucracy, but some practical advice from a former governor who has partnered with presidents and Cabinet secretaries to turn health policy into real-world assistance for sick and endangered Americans.
Make friends with governors
It’s a tip that is as simple as it is ambitious. Much of your success at HHS will depend on your ability to work with governors and local health officials who turn policy into action. I urge you to travel as much as possible, to meet with and really listen to people on the ground. One of your predecessors (and my good friend), Kathleen Sebelius, learned this early and well when she effectively partnered with states like Kentucky as early laboratories of the Affordable Care Act. Together we made mistakes, learned, adapted and created life-saving coverage for a lot of people.
Embrace the private sector and put it to work
For all its good intentions, government is often a slow and cumbersome instrument. We’d all like to forget that initial stumble on the Affordable Care Act when crashing government software inhibited enrollment. Companies aren’t perfect, but forging partnerships with private enterprise can be a force multiplier, offering you access to tools, technology and expertise that simply can’t be matched in government. In Kentucky, our partnership with a top IT company was key to the success of our rollout of the ACA. I find that when the private sector has its own money on the line, it tends to get it right.
Recognize and resolve interagency conflicts that handicap results
Shortly after President Barack Obama was sworn into office in 2009, Kentucky was hit by an ice storm that crippled power and communication networks, putting thousands of people at risk. (Attn: Gov Abbott!) The White House was quick to declare a disaster and send FEMA and the Army Corp of Engineers. The start of that engagement gave us a harsh lesson in the difficulty of coordinating multiple state and federal agencies.
Fortunately, it was quickly resolved by Homeland Security Secretary Janet Napolitano, who got on the phone with federal team leaders and, with some very direct language, got everyone aligned. Rapid deployment of experts is essential in an emergency, but don’t underestimate the ongoing need for your active and direct leadership and detailed management of federal resources.
Don’t let D.C. acrimony overshadow the optimism and spirit of cooperation in the states
This is the best advice I can offer. Most every American has a family member who is dependent on your stewardship of our health care system. All of us — most every governor, administrator, doctor, nurse and parent — are ready to help. Please do not hesitate to call on us early and often. We trust your good judgment and we want you to succeed!
Steve Beshear, a Democrat, is a former governor of Kentucky, where he successfully implemented the first successful ACA state exchange. He currently serves as chairman of the eHealth Public Policy Advisory Committee.