Donna Shalala, Secretary of Health and Human Services, visited The Baltimore Sun editorial board yesterday. In the course of the conversation, she was asked to evaluate the progress of the Clinton administration and its approach to governing. Following are excerpts from Ms. Shalala's reply.
I was in Washington before; I left 12 years ago. I had come as a young assistant secretary, working for another president [Jimmy Carter], but I was in a policy-making position and I saw the government up close.
I think so many things have changed. Washington has changed. Number One is that there really are other branches of government that operate quite independently. Whoever put in people's heads that there was a president, and he determined the agenda, and he went to Congress, and Congress ran with his agenda? I don't think it's simply because Congress had [to work with] a Republican president that they became their own branch of government with their own leaders and -- certainly in the committees -- their own very strong views about what government ought to do. Congress is really a separate body and sees itself as equal to the presidency in many ways.
It's not so much that there's tension in that relationship. It's a very different Congress than it was a generation ago. It has a very sophisticated staff and on the issues that the president wants to move ahead on, it's quite literate. There are members of Congress that are among the nation's leading experts on health care. They know a lot. They've spent 12 years learning health care. They know a lot about health care and how it will play in their neighborhood.
And so it is a stronger Congress with a very strong staff with very strong views on a range of issues, and in every appropriations committee you can see them taking the president's ideas and throwing some out and adding some. It is much more of an equal relationship than it was years ago.
The other thing that has happened is that Congress is no longer dependent on a national party. The members very much get elected on their own. They are very independent, particularly in the Senate.
Another thing is that you get no slack from the press. If there ever was a honeymoon -- and maybe that was a myth -- there
aren't any left in American politics.
Q. Isn't that a reflection of the public's lack of willingness to give anyone time to do something slowly? The demand for an immediate fix is so insatiable that it's being reflected in the press.
A. Yes, maybe it's reflected in the press. The experts suggest to us that [there is a single] lever, or a silver bullet or a single way to do [something] to be fair to the public. Look at advertising by the interest groups, or listen to expert testimony on the Hill.
All this policy-wonk stuff suggests that if you go in and think it through, there's an answer there. When you really raise questions about the welfare system, it requires that we develop a system in which we can constantly make changes, as opposed to one bill with one solution. I would argue that a health-care system at its best will take us years to fine-tune. What there is is a process and a way of thinking about it and a willingness to do evaluations and test it.
The biggest problem with our institutions is our lack of flexibility in terms of our ability to move money around. Congress is so into micro-managing, because they don't trust the government. I don't think that it's an irrational decision by them. I don't think they're just mucking around in the government. I think they've seen in their own experience and can point to too many bad things that have happened when they have given government more flexibility.
Q. So is government in this day and age doomed to disappoint? This stronger Congress that you describe is loathed by the public.
A. We probably will never live up to the expectations we have created. We have suggested in the process of campaigns, in our own testimony, in our speeches, in our own pronouncements that we know more answers than we do because we are trying to be straightforward and clear and because we see it as a part of our roles as leaders to give people hope. We tend to over-promise a little bit. If we were more cautious we would be described as wishy-washy, not knowing where we wanted to go and not having vision.
So the ups and downs are explainable in a more fundamental way than individual decisions or individual personalities. It is far more complicated to try to lead and govern in our society, but I still think it can be done. If you invite me back in four years, I think I'll be able to point to some genuine progress, because I believe that the president has appointed in my department some of the most gifted people that really do have humility, that are willing to work with the system and the employees to see if we can get it better.