Likely Successor Needs to Look Beyond Wisconsin, Shalala Says

Outgoing Secretary of Health and Human Services Donna Shalala said Monday that the biggest hurdle for her likely successor, Gov. Tommy G. Thompson of Wisconsin, will be to stop thinking like a governor--advice that might apply as well to the president-elect, former Texas Gov. George W. Bush.

Thompson’s “biggest challenge will be to stop thinking about Wisconsin when sitting at my desk--his desk now,” she quickly corrected.

In an interview Monday, as she prepares to leave government, Shalala reflected on the administration’s accomplishments and disappointments during the last eight years.

“I’ve had a great time,” said Shalala, who has accepted a position as president of the University of Miami in Florida. “I’m not burned out. There were some hard times . . . but, boy, what a run.”

Shalala--who worked for Thompson as chancellor of the University of Wisconsin-Madison before joining President Clinton’s Cabinet--talked about the adjustments she expects him to face when he succeeds her after 14 years as his state’s popular governor.

The department oversees more than 300 programs, including the nation’s largest health insurance programs. Governors, by job definition, are sympathetic to state-based approaches--preferring, for example, the idea of getting federal dollars in block grants that give them wide latitude.

Shalala said Clinton made his 1993 transition in gradual but “dramatic” fashion--”he moved from being a governor to being a president . . . and you could see him change.”

One of the first and biggest fights that Thompson will confront, she predicted, is whether federal support for Medicaid, the health insurance program that is jointly funded by the federal government and the states, should be provided with block grants.

Thompson was one of the governors who led an effort in 1995 to convert Medicaid--which covers poor pregnant women and children as well as the disabled--into a block grant. The effort was stopped by Clinton, who feared that deep cuts and lack of standards would leave uncovered many whom the federal government had long protected.

“In the end, they will have to sort out whether they are trying to write laws for the best states or to write laws to make sure people are treated fairly no matter where they live in the United States, which is the particular role of the federal government,” Shalala said.

However, when it comes to government regulations, Shalala predicted that the incoming administration will leave in place many of the department’s initiatives, saying that they have enjoyed bipartisan support. “The department has consistently landed where the consensus is,” she said.

Shalala said it is unlikely that the incoming administration would change policies that allow federal funding of research using embryonic stem cells and fetal tissue--both part of the heated debate over abortion.

Furthermore, Shalala was confident that approval of the abortion-inducing medication RU-486 would be difficult to reverse, barring a change in the scientific evidence supporting it.

Thompson opposes abortion, but he has expressed support for stem cell work. He understands biomedical research needs, Shalala said, pointing out that University of Wisconsin researchers were one of the first two teams to grow stem cell lines. “He’s not, in my experience, an ideologue,” she added.

Asked what the department, under her, would be most remembered for, she replied: “My staff would say kids, because we focused so much on kids. I would say science,” referring to the research accomplishments at the National Institutes of Health.

Shalala said that she would miss her fellow Cabinet members--outgoing Secretary of State Madeleine Albright is hosting a farewell dinner next week for the women of the Cabinet--and that she believes the longevity of many contributed to the administration’s effectiveness.

She refused to discuss the one Cabinet meeting where she reportedly took Clinton to task for his behavior in the Monica S. Lewinsky affair.

“Cabinet meetings were usually fun, but not that one . . . ,” she said.