By Tim Vitale '92, photography by Jeremy Jensen

TO SAY THE ANSWERS to New York state's complex health concerns lay right outside the doors of Dr. Richard Daines' upstate country home certainly is to make light of the broad–scope and major problems facing the state's commissioner of health.

On the other hand, walk for a few minutes with Dr. Daines '74 across the rolling hills of his property as he discusses public health, and then in another breath… swing–beam barns; as he talks about reshaping primary and preventive health care and then… the shape and size of bluebird houses and the holes that access them; about the seemingly overwhelming problem of health care reform and then… how to dig a well… or why the piled–rock walls lacing the property are exactly where they are, or how that strangely designed old saw found on the property worked in its day, worked in the context of its times, in the context of the people who needed it.

With unstated pointedness, Daines notes evidence of practical solutions scattered at every angle around the farm, and he knows that it is practicality that will see the historian–turned–doctor through the monumental task of driving New York's health care agenda.

“Medicine itself is a very practical profession, and the key to solving our health concerns also will come by finding practical solutions,” Daines says. Solving health–care problems is not rocket science, if it is a science at all. In fact, in a way it might be as much his historian's training as it is his medical degree and knowledge that will help him have an impact in the coming months. He learned early in his history–degree days about the fine art and science of how people faced with living life evolve quickly toward that which is most efficient. They do what works, in other words. And Daines, the pragmatist, will do what works to change health care in New York.

As an undergraduate history student at USU, Daines worked directly under agricultural economist Leonard Arrington, one of the nation's preeminent scholars on how an agricultural community adapts as it colonizes uncharted territory. “These people were masters of efficiency, of figuring out the best way to do things. That's what I learned — that purist attitudes about things are nice, but you have to get something done when the day is over.”

Daines points to the foundation on his barn, noting how the builders used the local rocks and, in particular, one huge boulder still in its natural place — buried deeply, but an absolutely immovable foundation for the middle of the entire massive structure. So, use what is solidly in place, shore up the rest with new ideas.

When he begins talking about an original well on the property, somehow it seems a metaphor of sorts for his current position as a nominal Republican in a Democratic state and, especially, in a Democratic administration. He was named state commissioner of health by then–governor Eliot Spitzer, a liberal Democrat. And now, as he tells the etymology of the common phrase “cold as a well digger's (butt) in January,” somehow it seems that he knows something about being at the bottom of deep wells, in cold, deep water — let's say high–thigh deep in water. In Daines' case, however, he seems perfectly comfortable in the position. He can weather the cold, because he knows that health care issues don't break down neatly along partisan political lines. Definitely politics is key to accomplishing his goals, and there are no successful partisan policy purists — they don't get a budget through the Legislature.

Daines inherited his natural curiosity about everything historical from his father, Newel, a life–long doctor himself and the former mayor of Logan who would hands–down win any hammer–and–nails award for protecting historical resources in Cache Valley. The father Daines got things done, and that determination filtered into the next–generation's genes.

Daines had always planned to return to Cache Valley after medical school at Cornell, but when he finished his medical residency, his wife, Linda '75, still had a year to go at Columbia where she was finishing an MBA. So Daines took a job running the intensive care unit at St. Barnabas Hospital in the South Bronx, in those days a rough–and–tumble neighborhood in the middle of AIDS and crack epidemics. But medicine is medicine, Daines says, surrounded by crack alleys or not.

“We were still practicing the same medicine, and hospitals are hospitals. Once you get to know the people, hey, they're just families trying to make a living.”

And so his practical side enters the conversation again. The problems before him are massive as he oversees all of the public health agencies in the state, and as he and his team wrestle with the important “high–noise–level” topics (health care reform) he keeps an eye always on the core. Primary preventive care. Basic prevention initiatives. Reimbursement challenges. Obesity challenges. Budget challenges. Challenges, challenges. But Daines, pragmatic always, also is an optimist always about his job.

“It's interesting, exciting, I learn new things every day. The people I work with are stars and, yes, there are challenging intellectual arguments and political ‘training,’ which is forever ongoing,” he says with a smile. He has taken some heat in some circles for his stance on “abstinence education,” which he rejected for a simple, clear reason — it doesn't work. He is taking some shots for a proposal to tax sugared drinks, a proposal he strongly backs because…what else…because “we're right. It would work. It would reduce obesity.”

Which gets us back to his country home and to the practicality of the red barn on the property. “Beautiful,” I say, awed at the brilliant, red–washed structure. His answer? The historian: “Do you know why barns are red?… Ferric oxide — or, rust — is the primary component of red paint. And rust was cheap, so that appealed to the thrifty farmers of New York and New England.” Rust: a practical solution for practical people. And Daines–the–historian and Daines–the–state's–highest–ranking–doctor gets that message through and through.

—Tim Vitale '92