Can Benjamin nomination change the debate?

That's because Benjamin's life and work illustrate the value, difficulty and necessity of primary care in the American health system. (Picture from the Federation of State Medical Boards.)

Benjamin, a 2008 MacArthur "genius grant" recipient, is not really a genius. She is just a persistent family doctor who has built, rebuilt and re-re-built her Bayou La Batre (pronounced Baylabatray by locals), Alabama clinic, providing consistent service that has kept many people healthy at modest cost.

She enters a debate where the primary of universal primary care is being forgotten in the arguments over who will sacrifice to replicate what she has done, on a national basis.

Her whole life is a rebuke to reform critics. Her care is not expensive. Her salary is not high. Yet her life, she says, is full, and was full, long before the spotlight fell on her.

By being what a doctor is supposed to be, she can face down those who seek profits at the expense of quality care. By being a clinic manager, she faces down those who say care must be expensive. As a black woman in Alabama who rose to head the Federation of State Medical Boards, she is a rebuke to all who say such a rise is impossible.

More important, she's not shy. She is going to be an active part of the debate, starting with her confirmation hearings. She has a gravitas Sanjay Gupta, the CNN journalist who turned down the nomination early this year, lacks.

Just let anyone, Republican or Democrat, tell Regina Benjamin that high quality and low cost are contradictions, or that primary care is not fulfilling, or that serving the poor is not possible.

The debate has just hit another level.