- Dr. Vivek Murthy, 43, has been one of the most influential players helping President-elect Joe Biden craft a healthcare and coronavirus agenda.
- The former surgeon general created a doctor group in 2008 to help elect Barack Obama to the White House. Murthy and his group later pushed for the passage of the Affordable Care Act.
- Allies describe him as a "bridge-builder" who knows how to assemble a team of experts, but others are concerned he lacks enough experience to join the Biden Cabinet as the next secretary at the Department of Health and Human Services.
- "One of my concerns, when he was nominated to be surgeon general, was basically based on his youth and inexperience," Sen. John Barrasso, the Senate's third-ranking Republican, told Insider.
- "Vivek has never had to do big policy," said a former Obama administration official.
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President-elect Joe Biden has leaned a lot on former Surgeon General Vivek Murthy for his healthcare and coronavirus planning.
Now the 43-year-old doctor is on the short list to lead the Department of Health and Human Services in a Biden administration, eight people close to the Democrat's transition team told Insider.
Three of those sources said they'd been surprised Biden's team is considering Murthy for the job, given his lack of experience crafting policy or overseeing a major organization.
Despite his soft-spoken nature, Murthy has tangled with political controversies over the last decade — including with the nation's most powerful gun lobby — that could come back to haunt him.
Murthy, who has described himself as the "grandson of a poor farmer from India," founded the group Doctors for Obama in 2008 to help elect Barack Obama to the White House.
After Obama's win, Doctors for Obama rebranded as Doctors for America and worked closely with the influential Democratic-aligned group Center for American Progress to push for the passage of the Affordable Care Act in 2010.
Murthy also irked Republicans and red-state Democrats when he tweeted in 2012 that "guns are a health care issue" and in 2013 after Doctors for America proposed a list of gun-control policies to Congress.
When Obama nominated him as surgeon general at 36, his youth, relative lack of experience, and his position on guns became flashpoints on his path to the job. His nomination languished in the Senate for more than a year, largely due to opposition from the National Rifle Association, until his confirmation in December 2014.
Three Democrats, including Sen. Joe Manchin of West Virginia, voted against him.
Ultimately, Murthy only completed a little more than half his four-year term as surgeon general before President Donald Trump asked him to resign shortly after taking office in 2017.
But new opportunities emerged for Murthy in the 2020 election cycle. The Biden campaign's healthcare teams tapped him for his political and medical acumen even before Election Day. Now that Biden is headed to the White House, Murthy is one of the three people leading the president-elect's COVID-19 Transition Council.
His nomination — if it happens — is certain to revive the old controversies that delayed his confirmation six years ago, including questions about his ability to lead a major federal agency in the midst of a deadly pandemic that shows no signs of slowing. Several sources told Insider that New Mexico Gov. Michelle Lujan Grisham, who previously oversaw her state's health agency, is also high on the HHS secretary short list.
Since leaving the surgeon general post in April 2017, Murthy, a Yale medical and MBA graduate, has written a book on how loneliness is a public health issue. He steered clear of talking about gun violence when he was surgeon general and instead used his perch to focus on addiction and the importance of physical activity.
People who have worked close to or alongside Murthy tell Insider that he's a committed and compassionate physician whose healthcare positions shouldn't be viewed as political. They cite the fact that several medical associations advocate for gun control measures as a way to reduce injury and death. Still, that view could make it harder for Murthy to get past pro-gun Senate Republicans if they retain their control of the chamber after Georgia's January 5 runoffs.
"He's open-minded and a learner," said Donald Berwick, the former administrator for the Centers for Medicare and Medicaid Services during the Obama administration. "He knows he doesn't know everything and that he needs to listen carefully, and that's what he does."
Berwick, a medical doctor and lecturer at Harvard Medical School, said that Murthy has the key traits of a good leader, including the ability to bring opposing views together and knowing who to turn to for answers to complex problems. Berwick worked with Murthy on Biden's healthcare unity task force to help iron out deeply held differences between centrists and progressives. He described Murthy as a "bridge-builder."
When Biden is sworn in on January 20, his healthcare team will have to hit the ground running in its efforts to control the coronavirus and distribute a vaccine.
As Biden builds his White House and his dream Cabinet, insiders say he has some tough choices to make: pick people with significant policy and executive experience or go with longtime loyalists like Murthy, who may have never led a major agency but know how to sell the administration's message to the public. The latter group would have to lead a team of deputies who know more than they do.
"No leader needs to know it all," Berwick said. "You need to be a team player. You lead best by building a team of people who have skills and knowledge you don't have."
'A massive bureaucracy'
Leading the Health Department is no easy task. The $1.3 trillion agency includes 11 other health bodies such as the Food and Drug Administration and the Centers for Disease Control and Prevention and has about 80,000 employees.
"HHS is a massive bureaucracy," Sen. John Barrasso of Wyoming, the third-ranking Republican in the Senate, told Insider when asked about Murthy's prospects.
"One of my concerns when he was nominated to be surgeon general was basically based on his youth and inexperience," added Barrasso, who was an orthopedic surgeon for almost 25 years before he went into politics.
The role of surgeon general is generally about communicating with the public on how people can live healthier lives. Over time it has morphed into a politically charged position.
It's unclear whether Republicans now believe Murthy has gained enough experience or if their bar has dropped considering they voted for many of Trump's nominees who were highly political or lacked experience for the roles they were moving into.
"I'll make an assessment of that when he makes the nomination," North Carolina Republican Sen. Richard Burr, who's next in line to lead the Health, Education, Labor, and Pensions Committee under a Republican-controlled Senate, told Insider when asked about the possibility of Biden picking Murthy.
The committee would be the first stop for healthcare nominees before a full Senate confirmation vote.
If Democrats are in charge, Washington Sen. Patty Murray would become the panel's chairwoman. She didn't directly address questions about Murthy but told Insider that the nominee for HHS should be someone willing to work with Congress to expand affordable healthcare and reduce health disparities.
"We need someone who is experienced and is committed to putting public health and science first — someone who will fight for families and work with us to stand up [for] a science-driven response to the COVID-19 pandemic," she said. "We haven't had that in four years, and we need it now more than ever."
Biden allies say it would be hypocritical for Republicans to argue about qualifications after they pushed through unqualified Trump nominees.
Leslie Dach, the chairman of the Democrat-aligned healthcare advocacy group Protect Our Care, said any GOP opposition to Biden's Cabinet nominees would be political rather than based on their qualifications.
Dach was a senior counselor at HHS during the Obama administration and also worked as an advisor to Hillary Clinton's 2016 presidential campaign.
"This Republican Senate approved a bunch of know-nothings — who didn't even care about doing a job — into the Trump administration on a regular basis, so let's not take any of that seriously," he told Insider. "The refusal to confirm Biden nominees would be nothing but obstruction in politics."
Florida Rep. Donna Shalala, who was HHS secretary for eight years under President Bill Clinton, said she's certain Biden will make a "thoughtful decision" when he picks his person for the job.
"The big challenge is going to be to get someone confirmed," she told Insider on Tuesday at the Capitol.
Should Murthy's nomination be politically insurmountable, Biden could still place him in other high-level roles that don't require Senate approval.
Murthy declined an interview request through a spokeswoman and the Biden transition team would not comment on its Cabinet nomination plans.
'Wonderful, smart…but inexperienced'
Republicans aren't the only ones who question Murthy's qualifications, whether for HHS or even in his current role as a leader on the Biden coronavirus task force.
"Vivek has never had to do big policy," said a former Obama official who asked to remain anonymous in order to speak candidly.
Another former federal health official who's a Democrat expressed concern about Murthy's qualifications and lack of experience in national and global crisis management, including on pandemics, and warned that those kinds of questions could trip him up during confirmation proceedings if he's nominated.
Still, the Democrat, who knows Murthy and asked not to be named, described him as "wonderful, smart, caring, compassionate — but inexperienced."
Rear Adm. Boris Lushniak, Murthy's former deputy surgeon general who was also acting surgeon general while the Senate held up Murthy's nomination, was more supportive. He said that having relationships with the White House is an added advantage for anyone who takes on a leadership role in an administration.
He pointed out that Murthy would already have a relationship with Ron Klain, who will be Biden's chief of staff. The two worked together when Ebola hit the US in 2014.
Now that Murthy has been surgeon general, he'd come in with an understanding of HHS operations, said Lushniak, who's now the dean at the University of Maryland's School of Public Health.
"The reality is there is no one set formula for being successful at HHS," Lushniak said.
Rebuilding public trust in HHS
The coronavirus pandemic adds even more importance to the job of HHS secretary, especially as the government gears up for a monumental coronavirus vaccination effort.
Murthy's role is more publicly visible now that he's co-chairing the 13-member coronavirus task force that's advising Biden on health and economic steps the federal government should take.
One week after the election, it was Murthy who briefed Senate Democrats about the coronavirus crisis during their caucus lunch. He also talked to House Democrats at the invitation of Speaker Nancy Pelosi, a Biden transition spokesperson told Insider.
According to Sen. Tim Kaine of Virginia, Murthy's Senate briefing lasted an hour and included conversations about vaccine development and distribution.
"He took every question that was asked, so it was really thorough," Kaine said.
Whoever takes charge of the Health Department is also going to have to oversee the creation of an emergency response plan to prepare for the next pandemic, and must rebuild the agency's credibility with the public, said Shalala who recently lost her re-election bid.
She wouldn't comment directly on Murthy or any potential Biden nominees, but said the person picked to lead the agency should have experience "managing complex organizations."
Shalala was the chancellor of the University of Wisconsin-Madison and president of Hunter College at the City University of New York before she led the nation's top healthcare agency in the 1990s.
"It's the one department, like Defense, where you can't be a rookie," she said.
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