The Obama Administration's organizational chart is rapidly filling up (click here for a list of appointments made thus far, although unfortunately it's not set up like one of the tree diagrams that police use to identify Mafia leaders in the movies). In fact, after a flurry of appointments over the last few days, the only Cabinet-level post that has not been filled is Director of the Office of National Drug Control Policy (ONDCP), more commonly known as the Drug Czar.
There are 15 Cabinet posts--14 Secretaries (of State, of Labor, of Defense, etc.) who lead executive departments, plus the Attorney General who heads the Department of Justice. All of these positions have been filled. The Obama Administration will have an additional seven "Cabinet-level" posts*, which include:
- Vice President (Joe Biden)
- White House Chief of Staff (Rahm Emanuel)
- Environmental Protection Agency Administrator (Lisa Jackson)
- Director of the Office of Management and Budget (Peter Orszag)
- U.S. Trade Representative (Ron Kirk)
- Ambassador to the United Nations (Susan Rice)
- Drug Czar (Not Yet Named)
I've
written earlier about the widely circulated rumors that retiring Rep. Jim Ramstad (R-Minn.) might be named Drug Czar. Of course, no Cabinet-level appointment is without controversy. Since I last wrote, there has been some pushback from
others because of Rep. Ramstad's votes against issues like needle exchange programs and medical marijuana and his support for the
Teen Challenge program. Some insiders, including Rep. Patrick Kennedy (D-R.I.), have been pushing from the start for Ramstad to become the next SAMHSA Administrator rather than Drug Czar.
SAMHSA will be the agency with primary responsibility for implementing the parity law that Ramstad and Kennedy wrote and championed. In addition to his work on parity, Ramstad also, along with Kennedy, co-founded the House Addiction, Treatment, and Recovery Caucus. Both speak publicly about their substance use disorders and recovery.
For what it's worth, Obama promised a bipartisan Cabinet, and he has tapped two Republicans so far, Secretary of Defense Robert Gates and Secretary of Transportation Ray LaHood. Ramstad is a Republican as well--he has also said that he wants to return home to Minnesota after many years commuting to Washington. Early on Ramstad's chief of staff said that it was "
gratifying" to hear Ramstad's name mentioned, but there have been no public comments recently about any of the speculation.
(As I've mentioned before, Rep. Ramstad was NAADAC's 2008 Presidential Award Winner, the highest honor NAADAC gives to a non-clinician.)
Historically, drug czar appointees have not had a deep familiarity with the American treatment system before taking office. Many public health advocates see this appointment as an opportunity to shift ONDCP's focus towards demand reduction.
What qualifications do you think are important for the new Drug Czar? Let us know in the comments, but
tell the Transition Team too by
It's also worth noting that Obama is also taking the
controversial "czar" concept further than his predecessors--Secretary of Health and Human Services Tom Daschle has already been named "Health Czar" to oversee health care reform initiatives, and there will also be a
Tech Czar, and
Intellectual Property Czar. The federal bureaucracy's necessarily artificial structure (few political issues can be isolated within a single department) frequently causes serious problems and a lack of coordination. But it will almost always take more than creating a new position ("czar" or otherwise) to overcome it.
*For those of you keeping score at home, note that that's one more Cabinet-level post than President Bush had--he demoted Ambassador to the UN, which has traditionally been considered Cabinet-level.
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1. Broad knowledge, training, & experience in the poly-addiction field
2. Access to the best practitioners and science of addictive disease
3. Powerful ability to educate the whole country (a la Dr Koop vis a vis nicotine)
4. Ability to withstand negative industry and political pressures