A Conversation with Secretary Tommy Thompson: In February, Tommy G. Thompson Stepped Down as Governor of Wisconsin to Serve as Secretary of the U.S. Department of Health and Human Services (HHS)

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"I took this job because there is no other job in America where you have a greater opportunity to help people--to actually make a difference in people's lives and improve the quality of life they lead," Thompson told HHS employees after his swearing-in.

Secretary Thompson has dedicated his professional life to public service, most recently serving as governor of Wisconsin since 1987. He made state history when he was reelected to office for a third term in 1994 and a fourth term in 1998. During his 14 years as governor, Thompson focused on revitalizing Wisconsin's economy. He also gained national attention for his leadership in education and expanded access to health care for low-income residents.

Most notably, in 1996 Thompson enacted Wisconsin Works, the state's landmark welfare-to-work legislation, which served as a national model for welfare reform. The program required participants to work and, at the same time, provided services and support to participants to enable them to make the transition to work.

As secretary of HHS, Thompson leads the federal government's largest department. With a fiscal year 2001 budget of $429 billion, HHS has the largest budget among cabinet-level departments, representing 23 percent of federal outlays.

HHS provides a wide array of services to Americans, including medical and social science research, food and drug safety, Medicaid and Medicare, financial assistance for low-income families, prevention of child abuse and domestic violence, and comprehensive health services for Native Americans. POLICY & PRACTICE recently talked with Secretary Thompson about his views on the public human services.

P&P: As governor of Wisconsin, you frequently criticized HHS as an obstacle to the welfare and health care innovations that were occurring in your state. Now that you're head of HHS, what are your goals for the department?

Thompson: Health and Human Services touches every American in one way or another, so its goals must be many and varied. While we have concentrated recently on the results of the September 11 attacks and subsequent acts of bioterrorism, we must continue to pursue other priorities. They include plans to:

* provide access to affordable health insurance for the more than 43 million Americans who are uninsured;

* strengthen and modernize Medicare, and include a prescription drug benefit;

* reauthorize welfare reform legislation to bring even more people into the job market, while strengthening family structures;

* improve foster care and adoption programs to ensure every child has the opportunity to succeed;

* enhance the groundbreaking research being done at the National Institutes of Health;

* place a new emphasis on preventive care to improve people's lives and save billions in health care dollars; and

* create an aggressive program to encourage organ donation and transplants.

P&P: Some observers believe you'll be a powerful voice in the Bush Administration for further loosening the reins on states. They offer as evidence the way in which you've approved state Medicaid waivers at warp speed. Can you share your views on that assumption?

Thompson: President Bush and I both served as governors, and he is a strong advocate of letting states try new approaches toward providing services to their citizens. It is with the president's full support that Health and Human Services has approved state waivers and amendments for Medicaid and the State Children's Health Insurance Program (SCHIP). We recently cleared up a backlog of more than 400 such requests and, with the states, extended expanded eligibility to more than 1.4 million people and enhanced benefits for about 3.5 million people.

P&P: In July, HCFA (the Health Care Financing Administration) was revamped and is now known as the Centers for Medicare & Medicaid Services, with three new business centers to better serve people's health care needs. …