What good is a VP anyway? The five ps about the V.P. - policy, process, politics, the Presidency, and my PhD

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.”

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