In the closing weeks of his successful race to the White House, the campaign of President-Elect Barack Obama made a strategic decision to blanket the air waves and his stump speeches with health care messages closely tied into the fears of voters that they could lose their health insurance as the economy sunk deeper into recession. Exit polls showed that the decision paid off handsomely for Obama whose campaign spent an estimated $100 million in advertising on health care issues that attacked the proposal put forward by his Republican opponent.

In results reported by Public Opinion Strategies, a Republican firm, Bill McInturff said that voters were more likely to have heard Obama discuss health care than John McCain by a margin of 45% to 11%. Those voters who heard Obama discuss health care issues were more likely to vote for the candidate by more than a two-to-one margin (45% to 20%). Obama also secured more support among voters that made up his political base on the issue (70% to 1%) and among independents as well, although not as resoundingly (26% more likely to vote for him versus 19% less likely.)

Moving Quickly To Fill Key Positions. Having retaken the White House after a Democratic drought of eight years, Obama and his lieutenants are moving rapidly to fill Cabinet posts and key White House positions and identify those individuals he will appoint to head executive agencies. Other important tasks will include settling on legislative strategies to implement his countless campaign pledges and to decide which of the many regulations put in place by the Bush administration should be undone first.

Republicans quickly seized on Obama’s first decision—naming hard-charging Rahm Emanuel as his chief of staff—as an indication that the president-elect is not serious about reaching across the aisle. House Minority Leader John Boehner (R-Ohio) described the appointment as an “ironic choice for a president-elect who has promised to change Washington, make politics more civil and govern from the center.” In a November 7 op-ed column in the Washington Post Boehner added: “Obama campaigned by masking liberal policies with moderate rhetoric to make his agenda more palatable to voters. Soon he will seek to advance these policies through a Congress that was purchased by liberal special interests such as unions, trial lawyers and radical environmentalists, and he’ll have a fight on his hands when he does so.”

Emanuel, a Chicago congressman and close confidant of Obama’s, chaired the Democratic Congressional Campaign Committee in the 2006 election cycle. In a statement announcing the appointment, Obama said, “no one is better at getting things done than Rahm Emanuel.” But for Emanuel, the appointment had a bittersweet quality to it. While considering it an invitation he could not refuse, it upset his ambition to become the next speaker of the House of Representatives.

Avoiding The Clinton Administration’s Mistakes. In discussions that began before his election victory, it became apparent that Obama and his team took to heart lessons learned from the dismal failure of the Clinton administration to enact a comprehensive health reform proposal. For one, there will be no 500-person brain trust encamped behind closed doors to craft a reform plan. Obama—reflecting his experience as a community organizer—plans to oversee a far more open process that will enable not only monied interests to weigh in but also people widely representative of the middle class and the dispossessed.

The Obama administration will very likely not even send a legislative proposal to Capitol Hill but rather rely on Congress to craft a measure based on a set of principles that the new administration is honing for release in the coming weeks. The administration will not establish a precise time table as did Clinton, who pledged that within 100 days of taking office a comprehensive health care reform package will be delivered to Capitol Hill. Clinton missed his target by a matter of months and when all 1,000-plus pages arrived on Capitol Hill, it was greeted with disdain. Reflecting its campaign success, the Obama administration will continue to tie health care reform closely to its proposals to repair the tattered economy.

Cleaning House. Another first order of business for Obama is quickly removing the Republican appointees of executive agencies who have crossed swords with the Democratic Congress and replacing them with the choices of the new administration. No one would expect Health and Human Services Secretary Michael Leavitt to remain in that post, but other Republican appointees at the sub-cabinet level will be sent packing as well.

High on that list are Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention; Dr. Andrew von Eschenbach, commissioner of the Food and Drug Administration, and Elizabeth M. (Betsy) Duke, who has been administrator of the Health Resources and Services Administration since 2002.