President Biden’s healthcare team

The new President’s success in confronting and solving problems depends on his choice of capable leaders to assist and guide him.

An incoming President always faces serious challenges. Some years they take on wars, economic downturns, civil unrest, corruption, terrorist acts, natural disasters, unstable foreign affairs, or environmental accidents.

But 2020 beat all expectations with a viral pandemic that the world has not faced for over a hundred years. Add to that

  • a contentious presidential election
  • peaceful protests and raucous riots
  • racism confrontations and reconciliation attempts
  • health inequities battles and health reform initiatives
post updated January 25, 2021
The Biden-Harris Administration

The Electoral College met and voted on December 14, 2020, affirming the election of President-elect Joe Biden and Vice President-elect Kamala Harris. They were inaugurated on January 20, 2021.

They inherit a country divided in many ways-politically, economically, racially, and even in regards to health and medical care. The new President’s success in confronting and solving problems depends on his choice of capable leaders to assist and guide him.

Our health team will be ready on day one to combat our most pressing health challenges. They will lead with science, expertise, and integrity.

President-elect Joe Biden

In this post I review some of the key government positions that manage the “health and welfare” of the United States and will be critical to getting us through the pandemic and beyond. As more positions are filled, I will update this information.

The Presidential Oval Office at the Reagan Library
a replica of the White House Oval Office at the Ronald Reagan Presidential Library , by Dr. Aletha
Office of Science and Technology Policy (OSTP)

The US Office of Science and Technology Policy (OSTP) assists the President on science and technology issues and coordinates science initiatives among other government agencies. Its leader serves as science adviser to the president but President Biden elevated this position to cabinet level.

He appointed Eric Lander, a geneticist, to this job. Mr. Lander studied and earned degrees in mathematics, economics, and molecular biology and participated in the Human Genome Project.

Addressing the COVID-19 CRISIS

President-elect Biden named Jeff Zients as the White House coordinator of the coronavirus reponse. In this role, Mr. Zients will oversee vaccine distribution and direct and troubleshoot supply chain issues.

In a new position, Dr. Marcella Nunez-Smith will direct a task force to identify and address disparities in preventing, diagnosing, and treating COVID-19.

David Kessler, M.D. , Chief Science Officer of COVID Response, serves as a co-chair of the COVID-19 Task Force. He was the Commissioner of the Food and Drug Administration from 1990 to 1997.Mr. Biden wants Dr. Kessler to lead efforts to develop and distribute Covid-19 drugs and vaccines.

Department of Health and Human Services

Most of the health care activities of the federal government fall under the agencies of the Department of Health and Human Services or HHS. The Secretary of HHS serves in the President’s Cabinet.

President-elect Biden has chosen Xavier Becerra, currently the Attorney General of California, as the head of HHS.

Due to the COVID-19 pandemic, we’ve heard more about the HHS in the news than usual; maybe you’ve never heard of these agencies. Generally, management of a pandemic or other public health emergency falls within the work of the CDC, a sub-agency of HHS.

For fiscal year 2020, HHS budgeted $ 1.293 trillion for its services.

public health service

The Public Health Service, PHS, is a division of HHS concerned with, public health, obviously. Within the PHS is the Commissioned Corps, which is one of the uniformed services, like the military. Thus it’s head is known as the Surgeon General.

Assuming this role will be Dr. Vivek Murthy who previously served as Surgeon General under President Obama. Prior to the pandemic, Dr.Murthy authored a book on loneliness and the value of human connection, little imagining how important a topic it would be this year.

Together: The Healing Power of Human Connection in a Sometimes Lonely World

The lessons in Together have immediate relevance and application. These four key strategies will help us not only to weather this crisis, but also to heal our social world far into the future. They are

  • Spend time each day with those you love.
  • Focus on each other .
  • Embrace solitude.
  • Help and be helped.

This is an affiliate link.

Centers for Disease Control and Prevention

The CDC’s mission is simple but encompasses many facets of health

“to work 24/7 to protect America from health, safety and security threats, both foreign and in the U.S.”

The CDC website devotes an entire section now to information, guidelines, and news about the SARS-CoV-2 virus and COVID-19.

illustration showing the coronavirus which causes COVID-19

The goal of public health is to avoid or prevent health threats from becoming public health emergencies, like the COVID-19 pandemic. If they accomplish the mission, we hardly notice. But when an outbreak occurs, their work suddenly becomes visible, scrutinized, and debated.

Dr. Rochelle Walensky will take over as Director of the CDC. She is chief of Infectious Disease at Massachusetts General Hospital and teaches at Harvard Medical School.

National Institutes of HealthNIH

The National Institutes of Health, part of the Public Health Service,

  • supports biomedical and behavioral research with the United States and abroad,
  • conducts research in its own laboratories and clinics,
  • trains promising young researchers, and
  • promotes collecting and sharing medical knowledge.

And within the NIH is the NIAID– the National Institutes of Allergy and Infectious Diseases, which has been an invaluable source of guidance as the United States and the world works to understand and manage this new infectious disease.

Dr. Anthony Fauci, who has worked at the NIAID for 50 years and directs it now, will serve the new President as Chief Medical Adviser.

 Fauci: the first-ever audio biography of Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases and one of the most prominent voices in the US response to the COVID-19 pandemic.

Written and narrated by New Yorker staff writer Michael Specter, Fauci combines Specter’s unparalleled reporting with exclusive new interviews and archival audio of Dr. Fauci; his wife, Christine Grady, RN, PhD; key colleagues; and peers. Listeners will hear Dr. Fauci speak firsthand about the harassment and death threats he has received as a result of his leadership and about the stress of simultaneously combating the COVID-19 pandemic and an information war waged by his boss, the president of the United States. 

Specter has covered Dr. Fauci – and global public health – for more than three decades. In Fauci, Specter traces the doctor’s life from his childhood as a basketball-loving kid in Brooklyn through his leadership during the AIDS epidemic in the 1980s to today, when the response to the COVID-19 pandemic and the future of viral research are shaping humanity. With its chorus of voices, archival recordings, and original score, Fauci brings the immediacy and energy of the best documentary podcasts to the audiobook format.(review from Amazon for this affiliate link)

Novel Coronavirus SARS-CoV-2
This scanning electron microscope image shows SARS-CoV-2 (orange)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (green) cultured in the lab.
 
Credit: National Institute of Allergy and Infectious Diseases-Rocky Mountain Laboratories, NIH

Dr. Francis Collins , Director of the NIH, will serve on President Biden’s Science team.

NIH director Dr. Francis Collins speaks with Dr. Idowu Aimola of Nigeria, one of 10 fellows participating in a new program, the African Postdoctoral Training Initiative (APTI). Fellows spend 2 years in the lab of an NIH senior investigator, learning cutting-edge science while working on a research project of mutual interest. The immersion is intended to give the fellows the expertise to become research leaders when they return home and to foster collaborations between NIH scientists and institutions in Africa.

Credit: National Institutes of Health, public domain

centers for Medicare and Medicaid services(CMS)

This sub-agency of HHS administers three government healthcare programs- Medicare , Medicaid , and the Health Insurance Exchanges. President Biden will appoint a new CMS administrator.

Medicaid provides insurance coverage for adults and children who are unemployed or low income.  

Medicare covers disabled children and adults and persons 65 years and older.

The Health Insurance Exchanges work with the states to provide health insurance as established by the Affordable Care Act.

Food and Drug Administration– FDA

The FDA joined the pandemic response by

  • reviewing and approving diagnostic tests for the coronavirus
  • protecting consumers from fraudulent products for COVID-19.
  • issuing Emergency Use Authorizations (EUAs) for ventilators
  • sampling and testing of respirators for importation

The FDA’S current challenge is to review, and ultimately approve a safe and effective SARS-CoV-2 vaccine to the American people.

Mr. Biden will name a new FDA Commissioner to replace Dr. Stephen Hahn; the Senate must approve his choice.

We are committed to expediting the development of COVID-19 vaccines, but not at the expense of sound science and decision making. We will not jeopardize the public’s trust in our science-based, independent review of these or any vaccines. There’s too much at stake.”

Stephen M. Hahn, M.D., FDA Commissioner, and Peter Marks, M.D., Ph.D., Director, Center for Biologics Evaluation and Research
COVID-19 Diagnostic Test Attire
FDA Commissioned Corps officer RADM Estella Jones, DVM, OCET Deputy Director and Co-Chair of the FDA Animal Welfare Council, oversees Commissioned Corps officers as they practice proper fitting of protective items. Healthcare workers testing patients for COVID-19 novel coronavirus infection must wear specific protective gowns, gloves, ventilation masks, and full facial shields as shown, and must replace these items after each patient is tested. credit FDA, public domain

investing in healthy communities

Besides the ones I’ve already mentioned, other executive departments’ roles contribute to our health and welfare-Education, Homeland Security, Energy, and Transportation.

Social determinants of health are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes. We broadly characterize these as

  • economic stability
  • education access and quality
  • healthcare access and quality
  • neighborhood and built environment
  • social and community context
Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved [date graphic was accessed], from https://health.gov/healthypeople/objectives-and-data/social-determinants-health

The President-elect has selected one of his opponents for the Democratic presidential nomination to be Secretary of Transportation. Former mayor of South Bend, Indiana Pete Buttigieg, a veteran, made infrastructure and internet access a focus during his campaign for the nomination.

Mr. Biden plans to appoint Ohio Representative Marcia Fudge as Secretary of HUD. She was elected to Congress in 2008 and has served on several committees focusing on agriculture, education, nutrition, civil rights, health, and employment.

US government photo

Biden’s choice for Energy Secretary is former Michigan Governor Jennifer Granholm. She served two terms as the first female governor of Michigan.

For Agriculture Secretary, Biden’s choice is Former Iowa Governor Tom Vilsack. Mr. Vilsack served as Agriculture Secretary from 2009-2017.

Keep an appliance thermometer in your refrigerator to check the temperature. The temperature in the refrigerator should be set at 40 °F or below. USDA Photo. public domain

The President-elect will name Miguel Cardona for Secretary of Education. Mr. Cardona became the top education official in Connecticut in 2019 after being an assistant superintendent in Meriden, Conn., which serves nearly 9,000 students. Cardona attended school and taught elementary education there. Serving as a principal for 10 years, he was named the state’s principal of the year in 2012.

These appointees require Senate confirmation.

Occupational Safety and Health administration-OSHA

OSHA is part of the United States Department of Labor. OSHA’s administrator answers to the Secretary of Labor, also a cabinet member. Mr. Biden has chosen the Mayor of Boston, Martin Walsh, for this job.

Congress created the Occupational Safety and Health Administration (OSHA) in 1970 to

ensure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.

For the pandemic response, OSHA offers guidance on

  • returning to work
  • preparing workplaces for COVID-19
  • worker exposure risk to COVID-19
  • for specific industries including airlines, farms, retail, corrections
  • use of respiratory protection equipment

caring for Veterans and the Military

The two largest healthcare systems in the United States are the Department of Defense Military Health System and the Veterans Administration Healthcare .

Military healthcare serves more than 9.6 million active duty personnel, military retirees and their families. The VA is responsible for caring for some 9 million veterans nationwide, including some 800,000 aging Vietnam War veterans, as well as some dependents.

Mr. Biden intends to nominate retired general Lloyd Austin to head the DOD and Denis McDonough for the VA position.

Welcome Home Heroes- military sign at a VA medical
at a VA medical clinic , photo by Dr. Aletha

The other Cabinet positions, though less directly involved with health issues, can impact health through policies and actions. The appointees are 

  • State-Anthony Blinken 
  • Treasury-Janet Yellen
  • Commerce- Gina Raimondo
  • Justice (Attorney General)- Merrick Garland 
  • Homeland Security-Alejando Mayorkas 
  • Interior- Deb Haaland
  •  Energy -Jennifer Granholm 
Read more about the Biden-Harris healthcare team at this link

Health Nominees and Appointees

Public vs Private-not a perfect Union

The United States government invests heavily in its citizens health, both directly and indirectly. Congress, the legislative branch, makes laws and approves funding for the services delivered by the executive branch. Here is a link to help you understand exactly the responsibilities of the executive departments.

the executive branch

The United States’ healthcare system combines public health efforts with mostly private delivery of health care. Usually they coexist side by side with some but infrequent interaction.

The public health emergency created by the pandemic forced them into a “union” that quickly became politicized, and unfortunately diminished the effectiveness of the response.

But despite the lack of coordination and cooperation between all levels of government and private citizens, our health care professionals, in both public health and private medical practice stayed true to their calling.

Many risked their own lives to care for COVID-19 victims. Others sacrificed time and finances to lead the pandemic response in their communities and on social media- maybe not perfectly, but definitely UNITED in resolve to lead, help, and heal their fellow citizens through this unprecedented health emergency.

exploring the HEART of healthcare

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Dr. Aletha 

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Mark Twain’s loves and losses

Twain, whose real name was Samuel Langhorne Clemens, pursued wealth but never permanently achieved it, much like his father, who died when he was young. Later in his life a series of tragic, unexpected illnesses in his family gradually wore down his energy and emotions, leaving him despondent and broken; nevertheless he left a legacy in literature that continues to influence readers today.

Mark Twain will always be remembered first and foremost as a humorist, but he was a great deal more—a public moralist, popular entertainer, political philosopher, travel writer, and novelist.

britannica.com

But like most of us, finances and family shaped Mark Twain’s life. As we’ve seen during the viral pandemic and resulting economic collapse of 2020, blows to our financial stability and family relationships, especially illness and death, cause upheaval that we are ill prepared for and change our lives forever.

Samuel Langhorne Clemens, aka Mark Twain

Twain, whose real name was Samuel Langhorne Clemens, pursued wealth but never permanently achieved it, much like his father, who died when he was young. Later in his life a series of tragic, unexpected illnesses in his family gradually wore down his energy and emotions, leaving him despondent and broken; nevertheless he left a legacy in literature that continues to influence readers today.

Twain is remembered as a great chronicler of American life in the 19th and early 20th centuries. Writing grand tales about Sawyer, Finn and the mighty Mississippi River, Twain explored the American soul with wit, buoyancy and a sharp eye for truth.  

biography.com
20 years from now you will be disappointed by the things you didn't do
graphic with Mark Twain quote from Lightstock, source for stock photos and graphics, affiliate link

milestones in Mark Twain’s career and family

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1835

Samuel Clemens was born prematurely to John and Jane Clemens, and was “sickly” most of his childhood.

1847

John Clemens died of pneumonia. Samuel was 12 years old, and he soon quit school and started working to support his family.

The Innocents Abroad, published 1869

1870

Samuel married Olivia(Livy) Langdon, who was from a financially secure family. Later that year they had a son, Langdon.

1872

Langdon died of diphtheria, a throat infection. Diphtheria is now preventable by vaccination, given as the DPT-diphtheria, pertussis, tetanus-injection.

The Clemens had three more children, all girls.

  • 1972-Susy
  • 1874-Clara
  • 1880-Jean

1874-1891

While living in Hartford Connecticut, Mark Twain wrote and published some of his most famous books.

1896

Daughter Susy died of meningitis, an infection of the brain lining. Many causes of meningitis are now also preventable by vaccination. Twain was out of the country on a lecture tour, trying to recover from bankruptcy due to failed investments. He was distraught at her loss.

1904

Olivia, Samuel’s beloved wife, died after a long illness.

1909

His daughter Jean had been diagnosed of epilepsy. She died of an apparent heart attack, having suffered a seizure. Today, epilepsy can usually be controlled with medications.

1910

After years of increasing despondency and depression, Samuel Clemens, better known as Mark Twain, died of a presumed heart condition at age 74. He had outlived his wife and three of his four children.

1962

His last surviving child, Clara, died this year at 88 years old. She had married a famous Russian musician.

1966

Nina Gabrilowitsch‚ Clara’s daughter and his only grandchild‚ died at age 55. She had no children‚ so there are no direct descendants of Samuel L. Clemens.

quote from Mark Twain about the Bible
graphic with Mark Twain quote from Lightstock, source for stock photos, videos, and graphics

What Mark Twain wrote about racial relationships

Mark Twain lived through the American Civil War, which saw the official end of slavery although not the end of racial tensions and discrimination in the United States. Two of his famous works, Tom Sawyer and Huckleberry Finn, portray Black characters in a manner typical for pre-Civil War society, and used terms now considered inappropriate and racist. This has prompted some to call Twain himself a racist.

We cannot… overlook the works of Twain that do address the issues of race and stereotype. Clearly, Twain used his writing to work through issues of race for himself and his society, Despite the culture surrounding him, Twain understood deeply that racism is wrong.

For Twain to have depicted in Adventures of Huckleberry Finn a young hero who questioned racial inequality and an African American who was caring, compassionate, and strongly committed to his freedom was revolutionary indeed.

Why Huck Finn Belongs in Classrooms
by JOCELYN CHADWICK

Whether Twain was or was not racist is beyond the intent of this post to argue, so I suggest you consider these two quotes and follow up the sources if you want to research it further.

Mark Twain mirrored the complex racial changes of the American nineteenth century. His father owned slaves, and he grew up in a slaveholding community, , endorsed by the government and the church. His exposure to the slaves on his Uncle Quarles’s farm had a lifelong effect on him and on his work.

In his young life, he wrote some letters that show the racist attitudes he was exposed to in the pre-Civil War south, but as he matured, his racism gave way to empathy and understanding of the black experience…. culminating in antislavery novels like Adventures of Huckleberry Finn and Puddn’head Wilson.

… he secretly paid a black man’s tuition to Yale Law School, …. He was a friend and supporter of Frederick Douglass as well as Booker T. Washington.

Fishkin, S. (2020). Race and Ethnicity: African Americans. In J. Bird (Ed.), Mark Twain in Context (Literature in Context, pp. 192-202). Cambridge: Cambridge University Press. doi:10.1017/9781108617208.021

The Mark Twain House and Museum

In 1873 Sam (Mark) and Olivia (Livy) Clemens contracted New York architect Edward Tuckerman Potter to design a house in Hartford, Connecticut.

Construction began in August of that year‚ while Sam and Livy were abroad. Although it was not complete, the family moved into their house on September 19‚ 1874. Construction delays and the ever-increasing costs of building the home frustrated Sam.

Their home measures 11‚500 square feet‚ and has 25 rooms distributed through three floors. It displayed the latest in modern innovations for that time.

The couple spent $45‚000 building their new home‚ keeping the interior simple. The Clemens family enjoyed what the author would later call the happiest and most productive years of his life in their Hartford home.

Financial problems forced Sam and Livy to move the family to Europe in 1891. The family never lived in Hartford again. Susy’s death in 1896 made it too hard for Livy to return there‚ and they sold the property in 1903.

Fortunately, the historical value of the home was wisely recognized by The Friends of Hartford, led by Katharine Seymour Day, who purchased the house in 1929.

That April, a group called The Mark Twain Memorial and Library Commission was chartered, with the purpose of saving and restoring Mark Twain’s House on Farmington Avenue. Now the house is preserved for tours with an associated museum offering many local and virtual educational resources.

A YouTube channel called Catching Up With The Clemenses offers kids, and adults, a fun glimpse at what it was like living in the house. This episode titled Where’s the Toilet Paper? brings to mind the toilet

exploring the HEART of life in literature

I’m glad you joined me to learn a little about one of America’s famous authors. I hope you’ll read some of his books if you haven’t, or find new ones you may have missed.

The cover image for this post depicts a bridge over the Mississippi River in Missouri. Photographed by Reed Hewitt for Lightstock.com, an affiliate link. Consider them when you need a stock photo, video, graphic, or other media.

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .