The early stages of the Obama administration are beginning to resemble the Clinton years, which I observed from afar (I was a foreign correspondent in Tokyo at the time). Take Zoe Baird and substitute Tom Daschle, who dropped out of the running for Secretary of Health and Human Services today because of tax and conflict-of-interest problems. Take gays in the military and substitute putting in charge of the bank bailout a man (Tim Geithner) who knows all the bankers from his years at the New York Fed, seems overly solicitous to their needs, and has his own tax problems.

Once again, a new Democratic president appears to have a semi-automatic weapon semi-permanently aimed at his foot.

No doubt the New York Times editorial this morning, which came down on hard on Daschle's financial ties to health-related trade groups and firms (which GoozNews noted in its Sunday post), weighed heavily on the nominee's mind. In my view, this was not a tax issue, no matter how the press reports it. He had a structural conflict of interest that would have made it very difficult for him to do his job, at least in the first year, and he must have realized that any effort to pursue serious health care reform this year would run into allegations that his financial relationships influenced the administration's decisions.

Daschle and Geither are both fine public servants and would have (in Daschle's case) and will do (in Geithner's case) a decent job. But it's hard not to think that President Obama's infatuation with insiders and high-tone resumes is leading him to eschew what voters really were looking for last November -- a breath of fresh air in Washington.

He has a chance to rectify that situation in his search for a new Food and Drug Administration commissioner. Dr. Joshua Sharfstein, it is now rumored, is the frontrunner for the post. He's young; he's smart (from Harvard Med); he knows the agency from his years working for Rep. Henry Waxman on Capitol Hill and serving as director of the FDA transition team; and, most significantly, he left Washington two years ago to take on a big city health department in one of the nation's most troubled cities -- Baltimore. Unlike so many of the academics frequently mentioned as frontrunners for the post, he at least has a taste of major administrative experience.

Finally, unlike several other top candidates, he has never done any work for the pharmaceutical industry. One of the big debates in recent years as consumer advocates pushed to eliminate conflicts of interest on FDA advisory committees was whether the agency could find top-notch talent to fill those rosters if they eliminated everyone who worked for Big Pharma. The consumer groups argued that the agency would have to look a little harder, but the independent experts were out there.

Now that the salmonella-tainted peanut crisis has gotten the president's attention and made it more likely the new FDA pick will come sooner rather than later, Obama is lucky that he doesn't have to look far to find a top talent without ties to the industry. He's just 45 miles up the road in Baltimore.

(It's interesting how the Daschle situation is shining a "conflict-of-interest" spotlight on the FDA decision; read this interesting post by Dan Carlat, where he disqualifies all the prominently mentioned candidates except Sharfstein and Susan Wood of George Washington Univresity because of the others' ties to industry.)

Meanwhile, who will get the nod for HHS? My guess is one of the two Harvard health care economists who ran Obama's health care advisory board during the campaign: David Cutler or David Blumenthal. Both have their strengths and weaknesses: Cutler knows economics, but, in my view, has been overly solicitous to the idea that most new technologies are a good buy for the health care system. Blumenthal understands health care delivery systems better, and began his career conducting research and raising questions about conflicts of interest in medicine. But he's farther removed from the inside-the-Beltway savvy needed to push the health care reform agenda.

A dark horse? Ken Thorpe of Emory University. He has emerged as the leading advocate of bringing a prevention focus to health care reform and understands the need for better managing of chronic disease, which is concentrated among 20 percent of the population but accounts for 75 percent of all health care costs.

He's not like Donna Shalala, though, who also left academia to become HHS secretary. She ran the University of Wisconsin for a decade before spending a year in Washington at the Children's Defense fund; she remained as head of HHS during both Clinton terms -- the only cabinet official to do so.

Thorpe has been instrumental in pushing health care delivery system reform efforts around the country. He has strong, progressive views on the ways that income inequality, the built environment, food policy and public health interventions influence the overall health of the population. He would truly be a breath of fresh air in Washington. But he has virtually no administative experience, which matters when it comes to managing the sprawling HHS bureaucracy. Appointing Thorpe would be a risk, but given the way Obama has so far expended zero politlcal capital in that direction, it would be one worth taking after the Daschle fiasco.