The chairman of the Kansas Health Policy board said Friday it would be “perfectly acceptable” to make the quasi-independent agency part of the governor’s cabinet.
“If I were elected governor and I came in and saw the way things are, I’d start asking questions because I’d probably want the agency to be my responsibility as a cabinet leadership post,” said Joe Tilghman, testifying before the joint Health Policy Oversight Committee.
Such a move, he said, would likely “get rid of” the health policy authority’s nine-member board.
Tilghman was responding to concerns that some legislators — how many is unclear — think the health policy authority has strayed from its initial mission.
He reminded the committee that while some of the agency’s policy proposals — an increase in the state’s cigarette tax and a statewide smoking ban — were not politically popular, they were in full compliance with state laws that direct the agency to advise lawmakers on how to improve the public’s health.
Putting the health policy authority in the governor’s cabinet, Tilghman said, would be a decision “based on, basically, power politics, because that’s where a majority of elected officials want it, for whatever reason. I want us to understand that.”
The decision, he said, should not “be based on the perception of poor performance.”
Rep. Bob Bethell, R-Alden, welcomed Tilghman’s comments, noting he thought the health policy authority’s efforts have been hampered by not having the “governor’s ear.”
Bethell said he would like to see the health policy authority reconfigured in a way that retained the board and its expertise while “being in dialogue” with the governor’s office.
“I really don’t care who the governor is,” Bethell said. “There needs to be contact with the governor, there needs to be a dialogue” because agency sits atop a $2.6 billion budget.
Bethell’s proposal is similar to a plan first proposed by former Gov. Kathleen Sebelius in 2004. Legislators, however, insisted the agency function independent of both the Legislature and the governor’s office.
“The idea was to have it be outside the cabinet so people would feel free to come forward with non-politically correct possibilities,” Rep. Brenda Landwehr, R-Wichita, told KHI News Service. “We wanted it to be outside the box.”
Landwehr said “if I had to vote on (Bethell’s proposal) today, I’d probably be against it. I’d have to know more.”
During the committee meeting, Landwehr, a conservative, said that she thought the health policy authority had too often aligned itself with “advocates” and, as a consequence, had forfeited its independence.
Other committee members’ reaction to having the health policy authority answer to the governor:
• “I was chuckling to myself,” said Sen. Laura Kelly, D-Topeka, “because the executive order that then-Gov. Sebelius presented in 2004 would have done exactly what was being discussed (today) and now, all of a sudden we’re on the cusp of there being a new governor and the idea re-emerges as wonderful.
“Now, I’m not going to suggest that it’s not,” Kelly said. “I think we need to review the current structure and see how well it’s really working and whether it could work better, but the timing is not lost on me.”
• “No, no, the very structure of the health policy authority was designed to bring stakeholders and smart people on health care together in a way that kept them as far from the political process as we could so they could come to us with new, cutting edge ideas,” said Rep. Jim Ward, D-Wichita.
“Putting them in the governor’s cabinet is all wonderful and good, but as we all know it’s political,” he said. “I’d rather see it stay in the hands of the smart people.”
The committee did not act on Bethell’s proposal, though it’s expected to be discussed following a review, later this year, of the agency’s performance.
Bethell assured Tilghman that he wasn’t being critical of the health policy authority’s performance.
“I’ll make this point,” Bethell said, “there’s a second agency that spends a lot more than the health policy authority and it doesn’t have the governor’s ear, either. And that’s education.”
-Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at dranney@khi.org or at 785-233-5443, ext. 128.