Crusader takes on US health reform

IF CHANGE is the watchword of Clintonism, then it should be sought in the distaff side of the incoming Democratic administration and nowhere more so than in the diminutive, hugely energetic and fiercely committed person of Donna Shalala.

In venerable figures such as Lloyd Bentsen and Warren Christopher, the 42nd President has opted for caution, pragmatism and institutional wisdom. Those are not the hallmarks of Ms Shalala, named last month to be secretary of health and social services. She is a proven administrator, but also a liberal crusading reformer on behalf of women, blacks and other minorities, who throughout her career has attracted plaudits and controversy in almost equal measure.

Today, her confirmation hearings will begin in the Senate - and, if Republican mutterings are borne out, sparks could fly as they probe the record of the woman dubbed 'the high priestess of political correctness' for her campaigns to ban offensive speech and promote racial diversity at the University of Wisconsin at Madison, where she has been chancellor since 1988. But Ms Shalala is likely to give as good as she gets.

For the best part of two decades, she has been a firebrand in public life. An expert on New York, she was a prime mover in putting together the rescue package that saved the city from financial collapse, before moving to Washington for a senior position at the Housing Department with the Carter administration.

It was a salutary if initially chastening experience. 'I thought of myself as aggressive until I went to Washington, but I didn't know what aggressive was,' she said later. In her first year, infighting of the federal bureaucracy overwhelmed her: 'Sometimes I'd cry myself to sleep at night. I got chewed up.'

Such unpreparedness would not be repeated. In the next phase of her career in the higher reaches of US education - as President of Hunter College in New York then at Madison, in charge of the flagship campus of one of the country's 'Big Ten' universities - she has carried the battle to her foes.

In Wisconsin, she has campaigned tirelessly for multiculturalism, and sponsored regulations against 'hate speech' which were subsequently ruled constitutional by a federal judge. No less vigorously, she has tried to increase the number of minority students on campus, and opposed a ban on homosexuals in the military reserve programme.

Such efforts focused attention on her private life. Ms Shalala, 51, is unmarried and in the last few weeks has been obliged to deny claims by homosexual groups that she is a lesbian.

More relevant are queries about her qualifications for the job, one of the most taxing in government. Not only will she administer a dollars 549bn ( pounds 356bn) budget: she will be a pivotal figure if Bill Clinton is to make good his promise of root-and-branch reform of the country's entire bloated healthcare system, which now accounts for 14 per cent of gross national product.

Ms Shalala has few doubts. Earlier she had been tipped as a possible Education Secretary. 'A place like Health is a natural for me,' she told reporters after her nomination, pointing to her ability to handle a large university bureaucracy, and her unquenchable activism. No less important, she is a veteran member of the Clinton network, particularly close to Hillary Clinton. Above all though, she has learnt about Washington the hard way. If anyone is to knock sense into America's doctors, medical lobbies and health insurers, it is Donna Shalala.

(Photograph omitted)