In 2016, when I was putting together a podcast on debt, I put out a call for stories about medical billing disputes. That was when I first heard about Sutter Health, the largest health-care provider in Northern California. An employer lawsuit was alleging that Sutter used its dominant market power to drain the financial blood of its unfortunate patients.

In 2018, California Attorney General Xavier Becerra sued them, too. Among the allegations: that Sutter’s market power, enhanced by a string of acquisitions, drove up health-care costs to the point where people in Northern California paid more than double what those in Southern California were charged for inpatient hospital procedures. Sutter quickly caved and agreed last year to a $575 million settlement — as well as to a host of other conditions including limiting the amounts they can charge out-of-network patients in surprise medical bills.

Is it Medicare-for-all? No. But Becerra’s efforts most certainly improved the lives of California residents who need medical attention.

But since President-elect Joe Biden announced the appointment of Becerra to head Health and Human Services earlier this week, he has been the subject of two lines of Republican attacks. The first is that Becerra — who filed more than 100 lawsuits against the Trump administration, including playing a leading role in the case to preserve the Affordable Care Act that the Supreme Court heard earlier this fall — is too partisan for the job.

Americans, the reasoning goes, need to trust the medical system. Putting in a resistance star like Becerra will lead to further deterioration at a time when a not-insignificant portion of Americans — divided over our response (or lack thereof) to the coronavirus pandemic — already view medical advice through a political prism. He is a supporter of Medicare-for-all and the public option, and right-wingers claim he is a bit too zealous in his support of defending a woman’s right to choose.

The second attack is more insidious. It’s that Becerra, who is not a medical professional, is not qualified. It is, said Sen. Bill Cassidy (R-La.), like “somebody without an experience in defense being the Secretary of Defense.” Never mind the fact that Cassidy voted to approve such Trump Cabinet all-stars as education hobbyist Betsy DeVos. (“An agent of change,” he called DeVos, who never spent a day as a student or teacher in a public school.)

President-elect Joe Biden announced California Attorney General Xavier Becerra (D) as his nominee for Department of Health and Human Services secretary. (The Washington Post)

HHS is the department responsible for administering, among other things, the Affordable Care Act, Medicaid and Medicare. And here there is a lot of cleaning up to do. The Trump administration has attempted to impose work requirements on Medicaid recipients. Following its failure to get Congress to repeal the Affordable Care Act, Trump and his minions have attempted to hamstring it in numerous ways, including cutting short the sign-up period and permitting long-term use of limited coverage plans that don’t cover preexisting conditions and a number of other illnesses.

But the most important problem is that we still need to get costs under control. Deductibles are high, and so are co-pays. Many Americans can’t afford to use their insurance or will get stuck with four-figure bills if they do. The issue is both moral and political — as I’ve argued in the past, our uncontrollable health-care system causes voters to turn on politicians and political parties time and time again.

Becerra, who served in Congress for more than 20 years, keeps a close eye on all this. When I spoke to him earlier this year (after he filed that 100th Trump lawsuit), the first thing we talked about was medical expenses. “Health care is no longer a service, it’s a commodity,” he told me.

Our best chance at relief, at least in the short run, is putting someone in at HHS who is skilled at Washington politics, knows the legal ins and outs, understands what can and can’t be done, and isn’t afraid to use that power aggressively. Becerra is that person. No wonder the Republicans are resorting to stale and disingenuous attacks in hopes of stopping his nomination.

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