The departure of HHS Secretary Donna Shalala when the Clinton administration leaves office in January is expected to usher in an era of more hands-on involvement in federal healthcare policy by the holder of the Cabinet-level post.
Many of the likely candidates to be HHS chief in either a Republican or Democratic administration are viewed as more activist on healthcare policy than Shalala has been.
The former chancellor of the University of Wisconsin relied heavily on subordinates to carry out President Clinton's agenda on healthcare reform, Medicare preservation and coverage expansions.
Shalala, 59, last week announced she will become president of the University of Miami after President Clinton leaves office Jan. 20. She will assume the post June 1.
The longest-serving secretary in the department's history, Shalala is the first of Clinton's Cabinet to announce post-administration plans. She has been Clinton's only HHS secretary.
Healthcare lobbyists view Shalala as a good executive who assembled a solid team of managers, and left the detail work of the department's 11 agencies to them.
"She really gave (agency heads) the authority to run those agencies and make the policy calls," said Richard Pollack, executive vice president of the American Hospital Association.
During her tenure, HCFA has been headed by two administrators: Bruce Vladeck and Nancy-Ann Min DeParle. DeParle left Oct. 1, and the agency is now being directed by acting Administrator Michael Hash.
DeParle now is seen by some as a possible HHS secretary should Vice President Al Gore prevail in the presidential election. Meanwhile, Gail Wilensky, a HCFA administrator in the administration of former President George Bush and now chairwoman of the Medicare Payment Advisory Commission, is considered a likely HHS secretary should Texas Gov. George W. Bush win.
In either case, the HHS secretary will spend more time developing and implementing healthcare policy than Shalala did, predicted Frederick Graefe, a healthcare lobbyist with the law firm Baker & Hostetler.
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