‘Hands-On Kind of Guy’ Tackles Details at HHS

Tommy G. Thompson, the new secretary of Health and Human Services, views Washington as his final frontier: He wants to go where no Cabinet secretary has ever gone before.

He intends to climb into a bulky biohazard “spacesuit” and work with government scientists in Atlanta who handle the world’s most lethal microorganisms.

No more intimidated by bureaucrats than by bugs, he plans to work a week in every agency of his department--starting with Medicare headquarters in Baltimore, where he already sat in on a week’s briefings and got involved in all of the policy decisions.

Frustrated with the bureaucracy’s sluggish pace, he personally carried a proposed regulation to the obscure building where the Federal Register, the repository of all federal regulations, is published.

“I’m a hands-on kind of guy,” he said in a recent interview. “I want to let them know I really care. I want to know this department better than any other secretary.”

Thompson’s style served him well in Wisconsin, where he was the nation’s longest-serving governor (14 years) when he came to Washington.

But can it succeed in a department with the breadth and scope of Health and Human Services, whose $423-billion budget is more than 20 times the state of Wisconsin’s?

Sen. Russell D. Feingold (D-Wis.), a frequent political opponent who has known Thompson for 20 years, thinks Thompson’s human touch is no less appropriate in Washington than in Wisconsin.

“He’s from a small town in Wisconsin, like I am,” Feingold said. “He was brought up in an environment where you’re friendly to people. That’s who he is. I think he’s doing the right thing, delving into the guts of the monster to better understand it. I think he can make it work.”

But longtime Washington hands, with knowing smiles and nods, say: not a chance.

“There is a limit to how much you can micromanage in an operation the size of HHS,” said Stephen Hess, a senior fellow at the centrist Brookings Institution think tank in Washington. “You may lose sight of what’s important. The scale of the job can almost be physically debilitating. He may find one day he has a hard time getting out of bed.”

Thompson’s immediate predecessor, Donna Shalala, trusted her deputies to handle the details and weighed in only to resolve conflicts and make the final decisions.

“I’m not like Donna Shalala,” a former Clinton administration official quoted Thompson as saying in a recent meeting. “I like to be involved in the individual decision-making.”

In the next few years, Thompson’s department will grapple with a host of major issues. The 1996 welfare reform bill expires next year and must be reauthorized. The Medicare program must be saved from the prospect of insolvency even as Democrats clamor to add a prescription drug benefit.

Thompson has a head start on welfare reform. As Wisconsin’s governor, he forced recipients from welfare to jobs before it became the law of the land.

On other issues, such as health care management for seniors, he is a neophyte. If he insists on making all the decisions, he will inevitably make some bad ones, said a federal official familiar with health care financing issues.

“Someone who arrives without [the necessary] background will grind the process to a halt, or make bad decisions that cost billions, if they try to do it all themselves,” said this official, who, like others interviewed for this story, did not want to be identified for fear of antagonizing the new secretary.

A former high-ranking HHS official, who worked in the administration of President Bush’s father, said that all new HHS secretaries are stunned by the magnitude and range of the department’s programs--food, drugs, children and families, biomedical science. All need time to determine which issues merit their attention.

“He will learn . . . in order to make the secretarial decisions, he’s got to delegate a lot of the decision-making to his deputies,” this former official said.

However, Thompson does not want to waste any time before revving up the system. He promises, for example, that he will clear by year’s end hundreds of proposed regulations that have been languishing for 15 years or more.

“I believe in making government work,” he said. “I came here to make a difference.”

His efforts have already caught the attention of the army of 63,000 bureaucrats who work in his department. Speaking of his role as messenger to the Federal Register, Thompson said: “They were shocked. I think that was the first time any secretary had ever been to that building.”

Thompson wants to keep close track of those 63,000 bureaucrats. For example, he wants to know when federal biomedical researchers are off delivering scientific talks--and he wants to learn exactly what they’re talking about.

After appearing at a recent news conference to announce the licensing of a new breakthrough cancer drug, he took the scientists back to his office and, over chocolate chip cookies and iced tea, talked with them about the state of cancer research.

“Science is very important in making decisions,” Thompson said. Accordingly, he has called for federal regulation of tobacco, which Bush opposes, and he hinted in his interview that he has advised Bush to allow federal funding of stem cell research--a position that has put him crosswise with abortion foes, who had once considered him one of their own.

Although his roots are deeply conservative, Thompson also is regarded as more moderate than Bush on many social programs. His positions in Wisconsin were a complex amalgam, particularly in the area of health care, where he made a great effort to reach out to the working poor and those leaving welfare.

He insists that he has the president’s ear and that he--not the White House--will decide who gets the top jobs at such major parts of his department as the National Institutes of Health and the Food and Drug Administration. At these two agencies in particular, science and politics have often collided.

Bush abruptly accepted the resignation of Dr. Jane E. Henney, President Clinton’s FDA commissioner, hours before his inauguration, and ordered her to clear out her office in 24 hours. Many believe that Henney, popular both on Capitol Hill and with industry, was ousted because the FDA approved the controversial abortion pill RU-486 on her watch.

So, Henney was stunned when Thompson invited her to his office recently to interview her for the very same job. The meeting may have been Thompson’s way of soothing angry senators who demanded during his confirmation hearings that he consider reappointing her.

Thompson insists that she is a serious contender--and that he doesn’t see anything unusual about the meeting. “I’m impressed with her. I like her. I consider her a candidate.”

Although some observers already are betting that his tenure will be short, others wonder whether his quirky charm and outspokenness could actually help Bush in the long run.

“Sometimes . . . when a secretary expresses different views, he can help the president appeal to a wide range of constituents,” said the former HHS official who worked for Bush’s father. “If Thompson selectively expresses shades of difference, it may end up being politically useful to Bush, although, for Thompson, it’s a difficult line to walk.”