March 31, 2009
Tuesday

Nancy-Ann DeParle thought she was done with a career in public service.

Busy raising a family, she had settled comfortably into a private-sector job after holding down influential government positions in Washington and Nashville, Tenn. She was still interested in the issues that had drawn her into public service years ago but was content, as she puts it, "to be cheerleading from the sidelines."

Then Barack Obama called.

The new president was about to embark on the monumental task of reforming the nation's health care system. He wanted someone by his side who not only understood the intricacies of the health delivery system, but someone who also had been involved in past reform efforts and could work with Congress to get legislation passed.

He wanted Nancy-Ann DeParle.

"I decided it was the right thing to do," DeParle said, reflecting on her return to public life as the president's new health reform czar.

It wasn't just Obama's commitment to lowering health care costs and guaranteeing insurance coverage for all Americans that persuaded her to take the job, DeParle said.

More so, it was the sense that things had changed significantly since former President Bill Clinton and former first lady Hillary Rodham Clinton attempted health reform unsuccessfully back in the early 1990s.

DeParle, a Clinton staffer at the time, had worked on that reform effort. This time, she said, something feels different. This time, she believes, health reform is not just a laudable goal, it's an achievable one as well.

"For one thing, the problem of rising health care costs has only gotten worse," the Tennessee native said. "American families are having a really hard time. Premiums have skyrocketed. Businesses are finding it increasingly difficult to maintain coverage because of health care costs. So, from that standpoint, things have gotten worse.

"But at the same time, I think more businesses and people realize that the problem is there and are committed to doing something about it."

If Obama wants to do something about the nation's health care system, he made a wise choice in asking DeParle to lead the reform effort, say those who have known and worked with her for years.

Former Tennessee Gov. Ned McWherter recognized DeParle's potential early on when he tapped her, at age 29, to head the state's Department of Human Services.

"She was the shining star of my early administration -- young, with leadership and education abilities," McWherter said. "I've never known a young woman like her. She has it all."

Years later, after DeParle had joined the Clinton administration in the White House budget office, McWherter remembers the president telling him how impressed he had been with a presentation that DeParle had given. "He said, 'It's the best presentation that has been made to me since I've been up here,'" McWherter recalled.

Former Senate Republican Leader Bill Frist, a heart and lung surgeon, said he used to take his staff to meetings with DeParle when she ran the Health Care Financing Administration, now the Centers for Medicare and Medicaid Services, under Clinton.

Frist was impressed by her willingness to listen all sides of an issue, to delegate and to make sure everybody had equal access to her -- all traits that will serve her well in her new job, he said.

Not only does DeParle bring to the job institutional knowledge from her work on the Clinton reform initiative, she also understands from experience how quickly things can veer off course unless people feel they are partners in the debate.

In the four weeks that she has been on the job, she has represented Obama at health reform forums in Vermont and Iowa -- part of the administration's plan to include ordinary Americans in the dialogue -- and has met with Congress members who will be key players in the discussion.

"We learned it's important for everyone to be at the table," she said, explaining how the battle scars from the failed Clinton effort are helping shape the current debate. "That's why (President Obama) has made clear that he wants this to be an open and transparent process, and that's what we're doing."

"The other thing I think we learned," she said, "is that people want us to fix the problem, and they want us to make sure we are focusing on lowering costs. And they do want to see us be on the path to covering all Americans."

Obama has said he wants health reform accomplished during his first year in office -- a goal that strikes some as overly ambitious, given the enormity of the task and how the dismal economy is commanding so much of the new administration's time.

DeParle, however, is convinced that one year is a realistic time frame.

"Now is the time to deal with the enormous problem because it has such an inextricable link to our economy," she said. "Unless we get our health care house in order, we can't get our financial house in order."

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