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Secretary of Health Donna Shalala "Pushes the System" for Better Health Care

Donna Shalala knew she'd made it when The New Yorker ran a cartoon showing a little boy and little girl talking. The boy held a doctor's bag. The girl pointed to the boy and said, "Okay, you be the doctor, I'll be the Secretary of Health and Human Services."

Shalala, Secretary of Health and Human Services and one of the most powerful women in America today, spoke in Chico as a Founders Week Presidential Lecturer. Although she was sponsored by the lecture series, Shalala told the standing-room-only audience, "I'm really here because the best student I ever had in a political science course, Diana Dwyre, has been encouraging me to come down to Chico ever since she moved here." Dwyre is an associate professor in political science.

Shalala's past includes stints as a Peace Corps volunteer, a director of the New York Stock Exchange, a college professor and chancellor, and a mountain climber.

Responding to recognized problems in the health care system, the Clinton administration proposed a universal health care system, which was rejected by Congress. Shalala said, "We didn't give up. In fact, one of the characteristics of first-class leaders, from my point of view, is that they don't give up, especially on the goal. So we embarked on an effort to try to fill in the gaps and to find the appropriate role for the federal government in health care."

Health insurance is one way to fill those gaps. Workers can now take their health insurance with them when they change jobs. Children's health insurance has expanded so that low income workers can get health insurance for their children. Children's programs have provided coverage for two million children. People with disabilities can now keep their Medicaid or Medicare when they enter the work force, allowing them to take jobs that may not have health insurance coverage.

Proposed changes for the next year include allowing people over the age of 55 to buy into Medicare, and expanding the children's coverage to include their families. Shalala noted that proposals to add pharmaceutical benefits to Medicare will pass this year or next year because today "no one would even think of designing a health care plan for seniors or the disabled without a pharmaceutical plan."

Insurance is fine if you can find health care. The current focus on increasing funding for free community health centers is one way to assure health care. Shalala defined the administra-tion's commitment for health care: "Make sure the most vulnerable people in our society have good quality [health care] and make sure it's seamless. Make sure that people aren't ashamed to walk in, that it's culturally sensitive, and put our resources strategically into those places."

In response to a question raised by an audience member and by the pickets she invited into the auditorium, "Why can't we just have a simple single-payer universal system?" Shalala answered, "That's in large part because we have consensus about what we're unhappy with, but we have no political consensus about what the solution is." She defined her job as "pushing every part of the system to see how far we can go."

She encouraged the audience to do the same. When asked about AIDS medications, Shalala explained that the federal government has funded the research, but has not actually produced medications. She said that this was a particular problem with vaccines of all types. In response to the problem, a new vaccine center will soon open which will have a small production facility. "We are clearly moving beyond our role in basic research and clinical research because of deep concerns about pricing," said Shalala. She encouraged the audience to maintain public pressure on the government, "You should not be satisfied with what I just said to you."

When asked about medical marijuana, Shalala said, "It's time the federal government was more open to funding that research, and, in fact, the National Institutes of Health for the first time is funding the research and providing marijuana for the researchers." As secretary, she is responsible for a marijuana research farm in Trent Lott's district.

Marijuana research is only one of many alternative approaches to health care that is currently being funded. "I think the federal government has to stop shuffling its feet about things like marijuana and other kinds of alternative medicine... We should not close our eyes to anything that not only will help our fellow citizens but will help people around the world." -- BA