The Leavitt alone approach

President Bush's appointment of Michael Leavitt as secretary of HHS reflects the administration's enthusiasm for avoiding political risk, rather than an interest in promoting specific agendas. The decision to pass over CMS Administrator Mark McClellan for the top HHS post suggests that the industry's concerns are not likely to be high on the agenda of the second Bush administration. It also amplifies the consequences of the leadership vacuum at FDA.

There is a strong sense among biotech executives that the failure to appoint McClellan to HHS represents an enormous missed opportunity. The hope was that he would integrate the HHS components and focus them on his strong passion for promoting medical innovation while resisting pressures to impose arbitrary cost-containment policies. His interest in both economics and health make him particularly well suited to develop policies that would determine which health interventions are of the most value and to reward them...