Shalala Reflects on Eight-Year Term in Hill Interview

In an interview last week with Washington, D.C.'s The Hill, Health and Human Services Secretary Donna Shalala discussed the department's accomplishments and challenges faced during her eight years in the position, citing improved health insurance coverage for children as one of the achievements of which she is "most proud." "Our American children are healthier and wealthier by any measure. There are more kids with health insurance, more kids using health insurance, less kids getting sick from diseases that we can immunize them against." Discussing patients' rights, Shalala said that such legislation is "very important" and "will bring some order to health care," but added that since managed care reform only helps those who have health insurance, it remains equally important to work towards helping the uninsured. Asked to estimate how far the United States is from "achieving a semblance of quality health care," Shalala said the country has "just started on the quality issues," such as reductions in medical errors, refocusing the payment system on outcomes instead of "heavy front-end regulations," and access to health care for low income citizens. Shalala said that she has learned that major programs need bipartisan support in Congress to succeed, since that "means they won't be unraveled, and it means there is consensus in this country about those programs." She added she considers HHS' ability to achieve such support during her tenure a "big accomplishment." When asked what she had not accomplished that she had hoped to, Shalala pointed to child care and the uninsured, saying, "There are lots of people in this country who get up and go to work every day, try to take care of their families, who have no health insurance. And they are still struggling to pay child care. Now it is not only paying for child care, it is finding quality child care." Shalala, who will become president of the University of Miami next year, said she is also considering writing a book comparing the first and second terms of Clinton's administration (Eisele/Jones, The Hill, 12/6).