Analysis: McClellan obvious choice for CMS

By ELLEN BECK, United Press International

WASHINGTON, Feb. 20 (UPI) -- Dr. Mark McClellan, a politically savvy physician and economist with White House experience, is viewed by analysts, consumer advocates and healthcare industry officials as the right guy in the right place at the right time to be the new Centers for Medicare and Medicaid administrator.

A board-certified internist and the current Food and Drug Administration commissioner, McClellan, whose brother Scott McClellan is White House press secretary, was an associate professor of economics and medicine at Stanford University. He earned his medical degree from Harvard and a doctorate in economics from the Massachusetts Institute of Technology.


Taking a leave from Stanford in 2001, he became a member of the President's Council of Economic Advisers on domestic economic issues and also was the senior policy director for healthcare and related economic issues. In 2002 he was tapped by President Bush to head up the FDA.


Friday's announcement by Bush, therefore, was no surprise but is interesting on both political and healthcare policy levels.

His nomination to replace Tom Scully, who resigned in December to return to the private healthcare sector, must be approved by the U.S. Senate but that should not be a problem since he already won the Senate's approval for his FDA nomination.

McClellan also is politically viewed as being able to work with both Republicans and Democrats -- an important aspect to consider as Medicare launches a controversial $395 billion prescription drug and Medicare reform plan in the upcoming years. A year's worth of FDA experience dealing with pharmaceutical companies -- their pricing structures, research, development and patent issues -- also will help him in developing the drug benefit.

He'll have to oversee the writing of regulations to implement the new Medicare law, which has rankled members of both parties. Conservative Republicans are unhappy with the high price tag and almost no controls on spending.

Democrats are upset over a lack of controls on drug prices pharmaceutical companies charge, billions of dollars in perks destined to insurance companies and what they see as a skimpy drug benefit for seniors.

"It's a terrific appointment," said Gail Wilensky, a senior fellow at Project Hope and a former administrator of the Health Care Financing Administration -- now CMS.


"He is an extremely capable individual who understands Washington, knows the Department of Health and Human Services and has a very good rapport with members of Congress, and knows the Medicare program," she told United Press International.

"He's probably the most competent and qualified person available," John Rother, policy director for the seniors' group AARP, told UPI. "He has the confidence, clearly, of the president and the White House. He's widely acknowledged to be an expert on some of the issues that CMS faces -- especially those that involve competition. And he has good relations on both sides of the Hill."

"He is an MVP of this administration because he combines the ability to analyze very complicated information, to speak plainly and understandably -- with one of the nicest personalities in the city," said Karen Ignagni, president of the American Association of Health Plans/Health Insurance Association of America.

McClellan, however, would step into the role in an election year. The fact he already is in the administration and would be an easy approval -- coupled with the immediate need to push through the Medicare drug discount cards and begin regulation writing for the new law -- also played to his favor because it is unusual for a president to make such an important permanent political appointment so late in his administration.


Should Bush not win re-election, however, a Democratic White House would bring in its own CMS administrator -- which could change the tenor if not the course of the Medicare law implementation.

Add into the political mix the fact that Health and Human Services Secretary Tommy Thompson early on indicated he would not be returning for a second Bush administration.

"He's coming to the program at a critical time because there is so much that has to be done, so quickly, to implement the new Medicare drug benefit," Rother said.

McClellan also got high marks for his efforts at FDA. The Generic Pharmaceutical Association called him "knowledgeable, thoughtful, pragmatic and fair."

Biotechnology Industry Organization President Carl B. Feldbaum issued a statement that said McClellan, during his FDA tenure, "wasted no time in setting a new course for the FDA, one which is committed to new drug innovation by removing unnecessary regulatory barriers."

Filling in at FDA would be Lester Crawford, the deputy commissioner, and it is expected that the commissioner's position will remain open until after the November election.

"They are fortunate to have an experienced deputy on hand whose name had been raised earlier as a potential nominee (for FDA commissioner), so they clearly have someone who can run the agency well for a period," Wilensky said. "The administration will have to decide whether to proceed that way until the second term begins."


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