MICHEL MARTIN, HOST:
Health and Human Services Secretary Robert F. Kennedy Jr. plans to dramatically transform the Department of Health and Human Services. He is aiming to lay off some 10,000 workers, eliminate departments and close regional offices. Another 10,000 employees have already left their jobs, so if this plan goes forward, it would represent a cut of about a quarter of the agency's staff. To understand what these changes could mean, we've called Donna Shalala. She headed HHS under President Bill Clinton from 1993 to 2001, and she is with us now. Good morning, Madam Secretary, thanks for joining us.
DONNA SHALALA: You're welcome.
MARTIN: I want to begin with a video that Secretary Kennedy shared on Elon Musk's social media platform, X, about his plans. Here it is.
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ROBERT F KENNEDY JR: We're going to eliminate an entire alphabet soup of departments and agencies while preserving their core functions by merging them into a new organization called the Administration for a Healthy America, or AHA.
MARTIN: I understand that you were approached with a proposal to reorganize the department when you headed the agency. Now, it was not the same as this plan. But in a recent op-ed, you wrote about why you rejected it. Could you just briefly tell us why?
SHALALA: Well, because it slows down your ability to get improvements in the department. I'm not into structural reform, and it just takes up so much time. It unsettles the people that you need to work. And they've combined this structure, which doesn't make a lot of sense with firing people. You can't fire the lead people for infectious diseases while you've got a measles outbreak. You can't fire 1,000 people at the FDA when you want to protect new vaccines, medical devices. It just makes no sense what they're doing. And they don't understand the department and its programs well enough to do these kinds of changes. So cutting a quarter of the workforce, it makes no sense, and it's probably dangerous for the future.
MARTIN: Well, let me dig into that in a minute. But one of the things you said in your op-ed is that you advised this colleague who presented this plan - unless it was data- and outcome-driven, that it was a waste of time. Do you think that this reorganization plan as presented by the current secretary is data- and outcome-driven?
SHALALA: There's no evidence that it is.
MARTIN: And when you say this would be dangerous, can you say more about that? Why?
SHALALA: Well, because the willy-nilly firing people and trying to do reorganization and slowing down the decision-making in the department, its ability to manage something like the measles outbreak and other outbreaks that are to come. Slowing down the progress that FDA will make on the approval of drugs, slowing down and eliminating what drives our economy, and that is the scientific research. And our deep investments in the NIH is going backwards, not forwards.
MARTIN: The secretary argues that the agency's core functions will still be performed, that this just eliminates bureaucratic overlay. Could that be true?
SHALALA: No.
MARTIN: And you say that because?
SHALALA: There's not a chance. What he calls bureaucratic overlay is actually the leadership of different programs.
MARTIN: So the top vaccine official of the Food and Drug Administration, Peter Marks, has resigned. He cited Secretary Kennedy's, quote, "misinformation and lies" as the reason for his departure. Now, people resign for policy differences before in other administrations. Is there something about this that you find noteworthy?
SHALALA: Yes, it's fundamental. And he's basically saying the opposite of what people in Congress on the Republican side are saying. He's basically saying Robert Kennedy Jr., the secretary, is not committed to vaccines, particularly vaccines for children.
MARTIN: And how is that different from - I'm thinking during the Clinton administration. I'm thinking about Peter Edelman, who resigned over the administration's direction on welfare policy. Is there something different than that? People resign when they disagree with the direction of the administration? Is there something fundamentally different about this?
SHALALA: Absolutely, because when Peter resigned, this was not about people dying. It was about a difference in how you would administer the welfare program for this country. It turned out to be pretty successful during that time. But in this case, it's about science. It's about whether you believe in childhood vaccines or you don't believe in childhood vaccines and whether children are going to get ill because you're sending mixed messages to parents all over the country. The anti-vax movement has resulted in children that should not be getting sick getting sick.
MARTIN: You know, I'm going to ask you to put on your member of Congress hat now because you've had a long and varied career. I mentioned that you were a secretary of an agency. You were an assistant secretary at HUD. You also have been a university president. And, you know, you've taught in public health. So you've had a long and varied career, but you were also a member of Congress. One of the arguments that people are making here is that the Democrats have not done a good job of explaining why these cuts matter to the American people. Do you think that that might be true?
SHALALA: I don't think it's completely true because I see it at the local level. Once you get out of Washington, you see members of Congress explaining to their communities what the impact of these cuts are. And by the way, if you live in New Mexico or in Texas and you see the measles outbreak - if you're getting Social Security and you find out that you can't go to your local office because they're closing it - you see the impacts. So over the next few months, Americans are going to see the impacts of what I believe are irresponsible cuts in government programs and in our ability to deliver successfully to help people stay healthy and to improve their welfare.
MARTIN: So what should your fellow people who are concerned as you are should be doing right now, particularly people in leadership, what should they be doing?
SHALALA: They should be talking to their members of Congress and their senators. They should be talking to them about how they feel these cuts are irresponsible, that they're dangerous to our health. And by the way, the business community needs to step up. If I was Big Pharma, if I represented the pharmaceutical companies, I'd be concerned with Peter Marks leaving.
MARTIN: OK.
SHALALA: And a thousand people being cut from the FDA.
MARTIN: OK.
SHALALA: What does that say about investors, who have fueled our economy with these deep investments in bioscience and in our pharmaceutical industry?
MARTIN: OK. OK. We have to leave it there. That is Donna Shalala, former secretary of the Department of Health and Human Services under President Bill Clinton. Madam Secretary, thank you for joining us. And I do want to say here that NPR has invited Robert F. Kennedy Jr. for an interview several times since his confirmation as HHS secretary. His office has declined our requests so far, but our invitation still stands.
(SOUNDBITE OF GAS-LAB AND GUILLAUME MUSCHALLE'S "GROWING SEASON") Transcript provided by NPR, Copyright NPR.
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