HHS Secretary Thompson Uses ‘Hands-On’ Approach

HHS Secretary Tommy Thompson's "hands-on" approach to running the $423 billion agency is drawing praise but also has some observers wondering whether he will overextend himself trying to tackle the department's broad range of programs, the Los Angeles Times reports. Saying he "want[s] to know this department better than any other secretary," Thompson already has pledged by year's end to issue "hundreds" of proposed regulations that have "languish[ed]" for years. Recently, he personally delivered a proposed HCFA rule to the "obscure building" that houses the Federal Register, a move that "shocked" HHS' 63,000 employees, Thompson said. "I think that was the first time any secretary had ever been to that building," he added. Thompson has also said that he, and not the White House, will decide who to appoint to run the NIH and FDA, where "science and politics have often collided," the Times reports. Over the next few years, HHS will face a number of issues, including adding a Medicare prescription drug benefit while keeping the program solvent and reauthorizing the 1996 welfare reform act. Thompson's style has garnered support from Sen. Russell Feingold (D-Wis.), who hails from the state where the secretary served as governor for 14 years. Feingold said, "I think he's doing the right thing, delving into the monster to better understand it. I think he can make it work."

Others, however, are skeptical that Thompson's management style can work in an agency with the "breadth and scope" of HHS. "There is a limit to how much you can micromanage in an operation the size of HHS," Stephen Hess of the Brookings Institution said, adding, "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." Noting that Thompson is a "neophyte" on some issues, including senior health care, a federal official who spoke on the condition of anonymity said, "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." And a "high-ranking HHS official" in the administration of the first President George Bush said that Thompson "will learn [that] in order to make the secretarial decisions, he's got to delegate a lot of the decision-making to his deputies." So far Thompson has shown no signs of easing up. "I believe in making government work. I came here to make a difference," he said (Cimons, Los Angeles Times, 5/29).