Washington ? It is beyond me to understand or explain why newly dismissed Treasury Secretary Paul O’Neill was not a comforting figure to the financial world. But if replacing him with railroad executive John Snow will calm the nerves of those wailing babies on Wall Street, I will rejoice along with all the other 401(k) plan holders who have watched their retirement savings dwindle.

Still, O’Neill will be missed in Washington for two quite different reasons. This capital never has a surplus of truth-tellers, and they are in particularly short supply at the moment. O’Neill was notably one of them – which might be one reason why he was the first to be fired from the Bush Cabinet.

Sen. Chuck Grassley, the Iowa Republican (who himself would be on any short list of straight shooters), said it well. As the once and future chairman of the powerful Senate Finance Committee, Grassley did a lot of business with O’Neill. When he got word of the president’s action, he put out a statement that said: “I enjoyed Paul O’Neill’s candor about everything. More of his unreserved honesty is needed inside the Beltway. O’Neill serves as an example of unselfish service for the good of the American people that more of corporate America should follow.”

I can second those views. The Treasury is not my normal beat, but every time I had a chance to hear or interview O’Neill, I came away impressed that here was a man with a down-to-earth grasp of realities, who scorned dogma of any variety – left or right – and who was ready to wrestle with the ambiguities and uncertainties of policy-making and to change course when his original notion failed to get results.

Early in the administration, when the air was filled with confident – nay, smug – talk about vast budget surpluses stretching at least a decade into the future, O’Neill used what I have described as a barnyard epithet to dismiss those rosy forecasts. My colleague at that breakfast interview, columnist Robert Novak, was dismayed at O’Neill’s heresy. But when those projected surpluses melted into deficits this year, O’Neill’s judgment was vindicated.

Now, anonymous White House officials are saying they want the new man to “sell” the old economic policy better than O’Neill did. I would hope Mr. Snow would also be willing to address budgetary realities as bluntly as O’Neill did and challenge the political types to make their numbers add up.

The second reason to regret O’Neill’s forced departure is that he knows as much about what needs fixing in the American health care system as anyone around. It would have been very useful to have him engaged in the health care debate that Congress and the Bush administration now seem ready to begin.

As CEO of Alcoa, O’Neill organized a collaboration of doctors, hospitals, insurers and employers to improve the quality and efficiency of health care services in southwestern Pennsylvania. On his own last year, he dragooned Health and Human Services Secretary Tommy Thompson and two of the major players on Capitol Hill, Republican Sen. Bill Frist and Democratic Sen. Ted Kennedy, into spending a day in Pittsburgh to learn about this experiment.

As a tag-along that day, I grasped just enough to understand that internal changes in hospital and medical practices – organizational reforms and specific measures to reduce errors and improve patient outcomes – have to be at the heart of any serious effort to rescue our dysfunctional health care system.

Perhaps in his involuntary retirement, O’Neill can go back to that project and bring his personal understanding into a broader national debate about health care.

People are beginning to figure out that unless we address health care as a whole, incremental “reforms” – whether a children’s health insurance program, or a nurses’ training bill, or a patients’ bill of rights, or a prescription drug benefit for the elderly – will not halt the rapid slide into systemic failure.

Sens. Ron Wyden, an Oregon Democrat, and Orrin Hatch, a Utah Republican, plan to push a bipartisan bill to create a 26-member citizens’ commission on “health care that works for all Americans.” It would have public hearings and draft a report on a universal, high-quality and affordable health care system, with a built-in assurance that Congress would consider and act on its recommendations.

O’Neill would be a natural to lead such a commission. And I guarantee you one thing: He would force everyone to face facts about our faltering health care system.