WASHINGTON — Each generation of Donna Shalala's family has served in the U.S. military. Two uncles were killed during World War II and a cousin now serves in Iraq as private first class in the U.S. Army Reserve.
So it hit home when wounded soldiers and their families told her about exhausted wives and mothers forced to relocate or give up jobs to serve as round-the-clock caregivers to the injured. Or when soldiers talked of the maze of bureaucracy that made securing a single medical appointment a major victory.
"It was devastating," Shalala said of the hospital visits she made as co-chair of a presidential commission charged with improving the nation's health care for wounded soldiers. "They and their parents were stunned at the enormity of the challenges. These parents had sent young, healthy men and women off to war and they came back broken.
"No matter whether you were for or against the war or think it should continue or not, you are absolutely supportive of these young men and women who serve," Shalala said. "Our first responsibility was to see that we are serving them."
Shalala, serving in her first high-profile public policy role since stepping down as U.S. Secretary of Health and Human Services in 2000, saw familiarity in the faces of the soldiers — some of whom are the same age as the college students on the University of Miami campus where she is president.
"Anyone of them could have been in the same situation," she said of her students.
Though military members and their families described top-notch medical and emergency care, they told commissioners about being frustrated by layers of bureaucracy when they sought care after leaving the hospital.
"These were people I figured would be cynical and depressed," Shalala said. "They weren't, but boy were they frustrated. That was part of the problem. They didn't want to sit around, waiting for appointments. They want to participate in life."
Appointed by President Bush in the wake of embarrassing reports about the treatment of the wounded at Walter Reed Army Medical Center in Washington, Shalala joined as co-chair with former Sen. Bob Dole, R-Kansas.
Dole had personal experience with military health care as a badly wounded veteran returning from World War II and the two agreed they wanted to recommend fixes to the system, not assign blame. They presented their findings to Bush on Wednesday.
"The president knew I'm not a bomb thrower," said Shalala, who served as health and human services secretary in the Clinton administration. "He knew I was a professional."
Dole, too, said politics never interfered.
"We're from different parties, but there were no politics in this," Dole said. "It was always `What can we do that's reasonable, doable and effective?'"
Indeed, Dole said he agreed to team up with Shalala as soon as Secretary of Defense Bill Gates — an old friend of hers — brought up her name.
"I was at the White House when they asked me about the commission and we sort of kicked names around," Dole said. "Donna's name came up and that was the end of the conversation.
"I knew it wasn't going to be partisan, but solution driven," Dole said. "We knew there were problems, otherwise there wouldn't be a commission, but we weren't there to review complaints, we were there to solve the problem."
Shalala balanced the demands of the commission — visits to various veteran health care facilities around the country and seven public hearings — along with her duties at the university. She also taught a class on the politics of health care to 150 students.
"She's type triple A," Dole said, laughing. "I'm a type A, but she's triple A. She's either got the cell phone going, or the Blackberry or she's in a conversation. She doesn't waste any time. She's all business, `Let's get this done and get this done right.'"
The commission recommended "fundamental" changes to the veterans' health care system, including better diagnosis and treatment of post traumatic stress disorder and brain injuries. It also recommended a complete restructuring of the disability and compensation systems for wounded soldiers and increased support for the families caring for the wounded.
Shalala said she knows first-hand the commission's work is being watched carefully. Kathryn Donovan, one of Shalala's former fellows at the White House — now a Navy commander stationed abroad — sent Shalala an e-mail hours after the commission delivered its recommendations to Bush, telling her that colleagues were glued to the television, watching Dole and Shalala being interviewed about the recommendations and pledging to hold lawmakers accountable for carrying them out.
When the interviewer noted that the commission "goes out of existence" with the issuance of the report, Shalala quickly interjected: "Sen. Dole and I don't."
"It's moments like this that motivate these leaders to keep going, even though we've been away from home for 15 months, it's 120 degrees outside, and the frequent afternoon sand storms are miserable," Donovan wrote to Shalala from Iraq. "Thank you so much for your selfless dedication to not only our battalion, but to those that have served and the wounded warriors. Thanks for staying motivated and leading from the front."
Shalala said she and Dole have every intention of continuing to push the administration and Congress for changes, including amending the Family Medical Leave Act to allow for up to six months leave for a family member of a wounded service member.
Most of the recommendations can be implemented by the administration, though some would require legislative approval. To that end, Dole and Shalala made the rounds on Capitol Hill the day after the report's release, meeting with House and Senate leaders to gain their support.
"We're going to keep on it," she said. "The commission expires, we don't."
(c) 2007, The Miami Herald.
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