Grading the cabinet

By DAVID S. BERNSTEIN  |  January 29, 2009


JUDYANN BIGBY | Health and Human Services | B

• Well-liked and respected by health-care professionals

• Passionate and dedicated

• Needs to learn how to manage at this level

There are two competing takes on Bigby, who oversees the largest chunk of the Commonwealth's budget. Some view her as the one emerging standout in Patrick's administration. Others view her as a well-intentioned but inexperienced health advocate placed well above her capabilities.

Although Bigby enjoyed a great reputation as medical director of community-health programs at Brigham & Women's Hospital, many were taken aback when she was tapped to run this $13.5 billion department.

And while she has brought to the department a consideration for the poor and the suffering that many felt was lacking in previous administrations, she has sometimes seemed over her head managing the department's vast infrastructure and effectively pushing an agenda.

One example was Bigby's handling of a perceived revenue shortfall in health-care financing, when enrollments surged a year ago. Bigby's proposals angered the business and insurance communities, threatening the delicate coalition holding the reform effort together. Meanwhile, it is far from clear that the shortfall will even materialize.

"It's been a very steep learning curve," says one close State House observer, who says that Bigby continues to display "some inexperience and naïvetû, especially from the political perspective."

She has, however, brought in top-notch staff to run the show day-to-day — most notably John Auerbach, stolen from Mayor Tom Menino's administration to be commissioner of public health; Sarah Iselin, at health-care finance and policy; and Tom Dehner, at the office of Medicare.

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