HHS Reconsidered

  • Jay F. Hein
  • Jan 1, 2001
  • : National Policy, Welfare Reform

It is a time-honored tradition for the exiting presidential press secretary to leave a note for his successor, offering best wishes. Down the street from the White House, at the L’Enfant Plaza headquarters of the Department of Health and Human Services (HHS), it is unlikely that Donna Shalala will leave a note for her more conservative Health and Human Services successor-in-waiting, Tommy Thompson.

There are compelling reasons for the two to be pen pals. Both share the experience of moving from Madison, Wisconsin to take the reigns of HHS’ titanic $400 billion budget, 60,000-person agency. Dr. Shalala was chancellor of the University of Wisconsin-Madison during much of Thompson’s first two terms as Wisconsin governor. With offices at opposite ends of Madison’s pedestrian State Street, the two shared a passion for Badger State sports.

Indeed, the academically credentialed and diminutive Shalala is paradoxically best remembered in Madison for being the tour-de-force behind the University of Wisconsin football’s team ascent to glory. Determining that a good football program was key to a healthy school spirit and even healthier campus revenues, Shalala hired a new athletic director and head football coach who subsequently led the Badgers to two Rose Bowl victories in the 1990s, their first ever Pasadena successes.

Both Thompson and Shalala also lay claim as heirs to the state’s progressive political heritage, traced to Fighting Bob La Follette in the early 20th Century. La Follette embodied what the Progressives call the Wisconsin Idea of utilizing the academy’s resources to help solve societal concerns. Wisconsin reforms such as the nation’s first workers compensation system and early childhood education were among the results.

Dr. Shalala proved to be a worthy heir to the philosophical tradition of Progressivism, exhibited by her scientific inquiry into the dimensions of social ills and her reliance on government to solve them. She was an articulate voice in defining our nation’s problems and insisting on their resolution--but conspicuously absent when administration strategies ensued.

Notably, Shalala was on the sidelines during Clinton’s pursuit of his signature initiatives, both HHS concerns: the attempted redesign of health care and the reform of welfare. The former was led by Shalala’s ideological soul mate, Hillary Clinton, while lower-echelon administration members crafted Clinton’s ill-fated welfare reform plan. The president ultimately signed the Republican congress’ welfare-to-work bill over Shalala’s objections.

Thompson, for his part, assumed the mantle of Fighting Bob La Follette by his actions rather than his words. As President-elect Bush reminded us when announcing Thompson’s HHS nomination, the Wisconsin governor reformed welfare before welfare reform was cool. Through a myriad of reforms that began in the late 1980s, Thompson’s stringent work requirements were maddened liberals while his generous work-support provisions put compassion into his conservatism.

But HHS is more than welfare reform, and Thompson boasts a record of real results in such areas as health care coverage and long term care. Wisconsin’s BadgerCare health care initiative for the working poor, and its Pathways to Independence program connecting the disabled to jobs, are underreported models of success.

Shalala and Thompson not only reflect the dual heritage of La Follette—they also mirror the men who nominated them to the HHS challenge. Shalala’s boss is famous for his intellect but notorious for his lack of a trustworthy agenda. Thompson, like Bush, shares has a penchant for selecting a carefully limited number of priorities and refusing to be distracted by lesser concerns.

Thompson reportedly made two requests of Bush during his cabinet interview: that he be allowed to select his own staff and that he be involved in key policy decisions outside the immediate purview of HHS. This is a clear signal that Thompson plans to continue to serve as an executive who drives change rather than an administrator who tends to the routine of a large bureaucracy.

Thompson’s steadfastness, amply demonstrated in his fourteen years as governor, will be a useful quality as he meets the dizzying array of challenges that await him inside the Beltway as the primary executor of Bush’s compassionate conservative agenda. Bush’s promises of Medicare reform and an improved prescription drug benefit are among the priorities that Thompson will be charged with delivering. And the not-so-little matter of Social Security reform will occupy much of Thompson’s attention.

As a governor who relished the 10th Amendment that guaranteeing state sovereignty, Tommy Thompson often derided Washington as Disneyland East. Now he must find a way to lead his new agency effectively while continuing the revolution he helped to launch, a movement to return the power to address social problems returned to the states.

Tommy Thompson may not find a sentimental note on his new L’Enfant Plaza desk, but he will inherit something far more important: a golden opportunity to transform HHS, demonstrate the lasting value of welfare reform, and transfer additional power from Washington back to the states. If he does these things, then Thompson also will contribute mightily to the common purpose and common sense that the American people demand of their leaders today—whether they come from the left side or right side of Madison, Wisconsin.

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