Barack Obama intends healthcare reform to be the signature innovation of his time in office. If he succeeds, it will do for his place in history what the creation of Social Security did for FDR. Which is why the worst single blow to Mr Obama’s administration was the failure to secure the appointment of Tom Daschle to head the department of health and as chief White House adviser on healthcare reform.

This week the president gave the first of those jobs to Kathleen Sebelius, governor of Kansas and loyal Obama supporter. She is an impressive politician and a good replacement, but she will have her work cut out. Mr Daschle, despite the forgetfulness over taxes that sank his appointment, was uniquely qualified to lead the health reform effort because he combined many years of experience in the Senate with a detailed understanding of the issue. Ms Sebelius lacks his particular strengths but is no novice. A popular governor and a moderate Democrat with a record of forming bipartisan alliances, she is also well grounded in state-level healthcare politics. She has tangled more than once with health insurance companies over health policy in Kansas.