Live from Aspen: Three HHS secretaries on what the job is really like

The host

Julie Rovner KFF Health News @jrovner

Julie Rovner is chief Washington correspondent and host of KFF Health News' weekly health policy news podcast, "What the Health?" A noted expert on health policy issues, Julie is the author of the critically praised reference book "Health Care Politics and Policy A to Z," now in its third edition.

In this special episode of KFF Health News' "What the Health?" host and chief Washington correspondent Julie Rovner leads a rare conversation with the current and two former secretaries of Health and Human Services. Taped before a live audience at Aspen Ideas: Health, part of the Aspen Ideas Festival, in Aspen, Colorado, Secretary Xavier Becerra and two of his predecessors, Kathleen Sebelius and Alex Azar, talk candidly about what it takes to run a department with more than 80,000 employees and a budget larger than those of many countries.

Among the takeaways from this week's episode:

• The Department of Health and Human Services is much more than a domestic agency. It also plays a key role in national security, the three HHS secretaries explained, describing the importance of the "soft diplomacy" of building and supporting health systems abroad.
• Each HHS secretary — Sebelius, who served under former President Barack Obama; Azar, who served under former President Donald Trump; and Becerra, the current secretary, under President Joe Biden — offered frank, sobering, and even funny stories about interacting with the White House. "Anything you thought you were going to do during the day often got blown up by the White House," Sebelius said. Asked what he was unprepared for when he started the job, Azar quipped: "The Trump administration."
• Identifying their proudest accomplishment as the nation's top health official, Azar and Becerra both cited their work responding to the covid-19 pandemic, specifically Operation Warp Speed, the interagency effort to develop and disseminate vaccines, and H-CORE, which Becerra described as a quiet successor to Warp Speed. They also each touted their respective administrations' efforts to regulate tobacco.
• Having weathered recent debates over the separation of public policy and politics at the top health agency, the panel discussed how they've approached balancing the two in decision-making. For Becerra, the answer was unequivocal: "We use the facts and the science. We don't do politics."

Credits

Francis Ying Audio producer Emmarie Huetteman Editor