With Daschle out, Obama should make Romney the healthcare-reform czar

Picture the scene: a dignified Ted Kennedy stands beside President Barack Obama on a brisk, late winter day in the Rose Garden.

Mr. Obama laments the events that caused him to withdraw the nomination of his anointed healthcare-reform czar, former Senate majority leader Tom Daschle, as Health and Human Services Secretary. Reaching back to the lofty rhetoric of his campaign, he implores his audience to look past his own lapse in judgment and seize the opportunity to implement sweeping national reform that puts health insurance within reach for the millions already uninsured – and the millions more whose coverage is jeopardized by the nation's economic crisis.

Then Senator Kennedy ambles to the microphone. He thanks Obama for his attention to what has been a more than 40-year personal crusade. He reemphasizes that now is the time to rise above partisan politics and address this central policy issue of our time.

"I've seen such an approach work," Kennedy declares, "in my own home state, where in just two years we've seen 500,000 people who were uninsured gain access to quality healthcare as a result of an agreement among Republicans, Democrats, hospitals, insurers, and the voters. They came together because they understood this issue was too important to remain bogged down in politics any longer. Now I am here to introduce my partner in that process; a man whose life experience spans the heights of the public, private and nonprofit sectors; a man whose commitment to the goal of seeing every American receive quality, affordable healthcare is every bit as strong as my own; the man who I believe can work with the president, the Congress and the entire healthcare system to reach this goal; my friend, my former governor, Mitt Romney."

With that dramatic introduction, Mr. Romney strides gracefully to Kennedy's side, embraces the senator, shakes the hand of the president and accepts the most daunting assignment in an audaciously ambitious administration.

Putting Romney forward as the face of reform would be extraordinary, controversial, and risky. But, then again, so would anything resembling meaningful healthcare reform. It would require sacrifice on both sides of the political aisle – far beyond any of the halting, symbolic bows at bipartisanship exchanged thus far in the Obama era. And it may be the last, best opportunity to salvage the effort in the wake of Daschle's fall.

In his favor, Romney brings unimpeachable credentials as a healthcare reformer, including the ability to bring together unconventional allies and utilize every bit of leverage available to get a deal done. While reluctant to claim full credit for all aspects of the Massachusetts initiative during his 2008 presidential campaign, Romney almost singlehandedly drove the process, with Kennedy's approval and assistance where necessary.

He leveraged the potential loss of $385 million in federal Medicaid funding to force the extremely powerful Massachusetts hospital lobby to the table and secure their support for a market-based reform that relied on (mandatory) private health insurance as the primary source of coverage for those receiving subsidies under the plan. As a result, nearly half of the newly insured acquired private, unsubsidized coverage, mostly through their employers. In the process, he convinced a wary Bush administration to maintain their full financial commitment to the state's Medicaid program by selling the Massachusetts plan as a potential model for universal access without a single-payer mechanism.

Of course, the former governor also brings several liabilities to the table, many resulting from his 2008 campaign. Romney geared his message to the GOP's more strident conservatives in his run, ceding any pretense of bridge-building and bipartisanship to Sen. John McCain. Nor did he go easy on then-candidate Obama's proposals.

Just before the election, Romney said, "I think a lot of [Obama's] policies are inspired by the pathway [that] Europe took. I think the idea of having the government take over healthcare and raise taxes on employers is the wrong direction for the country."

Still, as much as any president in recent memory, Obama has shown an admirable willingness to let campaign trail bygones be bygones – witness Secretary of State Hillary Clinton, who flatly questioned the foreign-policy policies she is now being asked to implement. The harder sell will be to liberal Democrats, who have already chafed at the lack of high-profile appointments for authentic progressives. This is where Kennedy's imprimatur would be invaluable.

At almost any other time, the thought of Obama appealing to Romney for such a mission – and of Romney accepting the task – would not even be worth entertaining. But in the face of crises and opportunities on a scale not seen in generations, these strangest of bedfellows may yet be the answer to real healthcare reform.

• Frank Micciche is the managing director of the Next Social Contract Initiative at the New America Foundation.