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Dora Hughes

Counselor to Health and Human Services Secretary Kathleen Sebelius

Why She Matters

Hughes worked as an aide in President Barack Obama's Senate office before becoming a key health policy adviser during Obama's 2008 presidential campaign. Hughes, a medical doctor, represented the campaign at health-industry conferences, speaking about the possible shape of health-care reform in the Obama administration.

After the 2008 election, Obama named Hughes to his transition team as one of only two doctors on his health-care policy working group. The group was led by then-Health and Human Services Secretary-desgnate Tom Daschle, and Hughes was "poised for a leading role" in Daschle's HHS, according to The Washington Post. Daschle withdrew his nomination in February 2009 over revelations he had failed to pay back taxes. Kansas Governor Kathleen Sebelius took the HHS job instead, and Hughes now serves as her counselor.

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Background

At a Glance

Career History: Health policy adviser to Barack Obama (2005 to 2008); Deputy director for Health, Sen. Edward M. Kennedy (D-Mass.) (2003 to 2005); Senior program adviser, The Commonwealth Fund
Alma Mater: Washington University School of Engineering, B.S., 1992, Vanderbilt University, M.D., 1996, Harvard School of Public Health, M.P.H., 2000

Web site

Path to Power

Hughes, who is board-certified in internal medicine, received an M.D. from Vanderbilt University in 1996. After medical school, she won a competitive residency in medicine at the Harvard-affiliated Brigham & Women's Hospital in Boston.

From 1999 to 2000 she stayed in Boston as a Commonwealth Fund/Harvard University fellow in minority health policy. During that year, she received her master's in public health at Harvard.

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The Issues

Hughes is an expert on disparities in health care relating to race, ethnicity and gender according to Congressional Quarterly. As an Obama adviser, she'll be looking to help the president lower the cost of health care and expand health insurance coverage.

Obama's campaign health care proposal would require employers to either cover their employees, or else contribute to a pool of money to fund a national health insurance plan. The amount of money contributed to this national pool would be a percentage of the company's payroll, but small businesses with low-income workers would be exempt. "This 'play or pay' approach, many details of which Obama's campaign has yet to flesh out, embraces the view that companies should remain the primary sponsor of private health coverage and bear the burden of covering workers' medical needs," Congressional Quarterly reported.

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Hughes told a pharmaceutical industry conference that the proposal would cover an estimated 18 million uninsured Americans in its first year, and, eventually, expand to cover 35 million people, Congressional Quarterly reported.

Generic Drugs

Hughes is a proponent of reducing health care costs by making generic drugs more widely available, the Associated Press reported.

When a pharmaceutical company develops a new drug, the Hatch-Waxman acts gives that company exclusive rights to produce and sell the drug - usually at a high price - for three to five years. After that, other companies can make generic versions of the drug and price them competitively. Hughes told the Generic Pharmaceutical Association that Obama wants to see as short a market exclusivity period as possible in order to get affordable biogenerics to market.

"We know that expanding the use of generics and eliminating barriers to that goal must be a centerpoint of any health reform effort," Hughes said.

Drug Reimportation

During the campaign, both Obama and GOP presidential nominee Sen. John McCain (R-Ariz.) said they were in favor of importing cheaper drugs from other countries, including Canada. But that changed when contaminated heparin imported from China killed 81 people in March 2008."Certainly, subsequent to the heparin incident, there has been a lot less enthusiasm," Hughes said to a September pharmaceutical industry conference.

A Grassroots Effort

Hughes made waves when she and fellow transition health working group member Lauren Aronson were featured in a video on Obama's transition Web site. The minute-long video posted on www.change.gov in November 2008 asked users: "What worries you most about the health-care system in our country?" The question elicited 3,700 responses, posted as comments on the site, on topics ranging from expanding health insurance coverage to restructuring the FDA.

In a second video, team leader Daschle assured users, "Already we've begun to follow through with some of the ideas."

The Network

Hughes' work at the Commonwealth Fund ties her to other like-minded health-care reformers. In October 2008, the Commonwealth Fund issued a report saying Obama's health-care proposal would successfully insure twice as many people as McCain's proposal.

Hughes is no stranger to Capitol Hill. She worked closely with Sen. Kennedy on the Senate Health, Education, Labor, and Pensions Committee. During the 2008 campaign, Hughes joined a stable of Obama health-care advisers including Jeanne Lambrew, Harvard's David Blumenthal and Jeffrey Liebman, Stuart Altman of Brandeis University and Austan Goolsbee of the University of Chicago, as well as campaign aides Heather Higginbottom, Jason Furman and Neera Tanden.

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Additional Resources

Reichard, John, "Mulling Obama's Early Health Care Moves," Congressional Quarterly, November 5, 2008
Rugaber, Christopher S., "Election to Benefit Some Industries, Harm Others," Associated Press, November 2, 2008
Bettelheim, Adriel, "Issues: Health care: An urgent need," Congressional Quarterly, October 6, 2008
www.commonwealthfund.org
Kamen, Al, "Yesterday's 'That Guy' is Today's 'The Man,'" The Washington Post, Thursday, November 27, 2008
"Press Release, "Senior Advisors to Presidential Candidates John McCain and Barack Obama Affirm Support for Increased Access to Generic Medicines and Creation of an FDA Approval Pathway for Biogenerics," Generic Pharmaceutical Association, September 18, 2008
"Join the Discussion: What worries you most about the health-care system in our country?" change.gov, November, 26, 2008
"Obama Aide: 'Less Enthusiasm' About Drug Reimportation After Heparin," FDA Week, September 19, 2008
"Meet the Person Most Likely to be New FDA Commissioner," Pharma Marketing Blog, December 1, 2008. http://pharmamkting.blogspot.com