Thursday, January 8, 2009

Gupta as Surgeon-General: Vice President of Health

The Surgeon General is a position not unlike the vice presidency. It has prestige and profile, but not much power – beyond that of the bully pulpit.

In that light, appointing CNN correspondent/neurosurgeon Sanjay Gupta would be an interesting move. It is obviously an effort to revive the role as a spokesperson on national health issues, a la C. Everett Koop. Gupta, as a TV journalist already has the skills for this role. He also has a dash of Washington experience, having done some writing for Hillary as a White House Fellow. No doubt Gupta hopes to play a substantive policy role as well, he is supposed to sit on the Daschle led healthcare reform commission.

Gupta, having risen to the top of two very difficult professions, is obviously blazingly smart, focused, and capable. But will that translate into his being an effective policy player – as opposed to primarily being a spokesman? Being smart often is not enough, Bill Frist, a Harvard and Princeton-educated cardiac surgeon was less effective as Senate Majority Leader than former Ole Miss cheerleader Trent Lott.

More important to playing a substantive role, is the reality that the Surgeon General has no institutional base. His role is symbolic rather than administrative. (He heads the Public Health Service Commission Corps, which employs over 6000 medical professionals that perform duties in various federal agencies but is not really an agency in its own right.) On a panel with heavyweights like HHS Secretary Tom Daschle (who is also technically his boss) he might not be able to play much of a role. Gupta’s high public recognition might give him some base of influence, but that has to be wielded carefully. Floating trial balloons and advocating inside positions via the media can be effective strategies – but insiders who play those cards too often will soon find themselves outsiders.

Or, like most Vice Presidents, could Gupta use the Surgeon General position as a steppingstone? There isn’t much upward mobility for a neurosurgeon-TV star (astronaut maybe?) But if he catches the politics bug, Gupta is young enough, and capable enough that a political career is possible and he could conceivably go far. John Adams said about the Vice Presidency, “In this I am nothing, but I may be everything.” For a Surgeon-General Gupta a more apt line might be, “In this I’m not much, but I could become anything.”

Tuesday, January 6, 2009

Teddy Roosevelt Meets his Match

Ninety years ago today, Teddy Roosevelt died at his home in Oyster Bay. He was sixty. Besides the grim reaper, there were few forces that could contain TR's energy. As VP he came face to face with two of them.

Theodore Rex did many tremendous things in his fascinating life. He authored dozens of books, was a war hero in the Spanish-American War, governor of New York, and he was an able President who won the Nobel Peace Prize while in office (for negotiating the end of the Russo-Japanese War). With all of this on his resume, it is easy to forget that he was also vice president. He didn't really want to be, he had said,
I would a great deal rather be anything, say professor of history, than Vice-President.
Still, Roosevelt took the job figuring it would set him up for the Presidency (his plans came to fruition early when President McKinley was assassinated in September 1901.) But the Vice Presidency, boring to most politicians, was absolutely painful to a man of Teddy Roosevelt's energies. So he took a vacation during which, according to the Senate Historical Office's invaluable Vice Presidents of the United States, 1789-1993:
The lack of pressing business as vice president allowed Theodore to spend time playing football with his sons and sparring with his tempestuous older daughter, Alice.
It is unclear if these were verbal jousts or actual fisticuffs Teddy would have preferred the latter, especially since Alice became Alice Roosevelt Longworth, the Washington society figure who famously said,
If you haven't got anything nice to say about anybody, come sit next to me.
Alice clearly had her father's number, once remarking
My father always wanted to be the corpse at every funeral, the bride at every wedding and the baby at every christening.
When he became President, TR stated,
I can be President of the United States, or I can attend to Alice. I can't do both.
Fathers of daughters, from King Lear to the present can no doubt relate.

Saturday, January 3, 2009

Enough Veep

At a New Year's Eve party I was talking to a few friends in the kitchen. I saw my wife standing in the doorway, about to come in. Then she heard me say, "Vice President" and she turned around and walked out.