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One Up, One Out: More Bush Lineup Changes

Highway chief Mary Peters is nominated as Transportation secretary. Medicare's Mark McClellan says he is leaving his post.

September 06, 2006|Ricardo Alonso-Zaldivar | Times Staff Writer

WASHINGTON — President Bush named a new Transportation secretary Tuesday, while one of his top healthcare experts announced he was resigning -- all part of ongoing personnel shifts as the administration prepares for its last two years.

Bush nominated former Federal Highway Administrator Mary E. Peters to the transportation post, replacing Norman Y. Mineta, the veteran San Jose congressman who had been the only Democrat in the Cabinet.

Meanwhile, after having largely succeeded in steering the complex new prescription benefit for seniors through its rocky rollout this year, Medicare Administrator Mark B. McClellan announced he was taking a respite from government and would be joining a public policy center.

Peters, 57, went to work at the Arizona Department of Transportation as a secretary in 1985 and worked her way up to become its director in 1998. Although her professional background is in highway planning and construction, her first major challenge will be to win congressional reauthorization of the government's commercial aviation policy next year.

Accepting her nomination at the White House on Tuesday, Peters said her top priority would be to reduce congestion in all types of transportation.

"Today, our vital transportation infrastructure is showing signs of aging," she said. "We are experiencing increasing congestion on our nation's highways, railways, airports and seaports, and we're robbing our nation of productivity and our citizens of quality time with their families."

As federal highway chief, a position she held from 2001 until 2005, Peters sought to promote the use of special toll lanes to ease congestion and worked to allow private entrepreneurs into road planning and construction -- a field traditionally dominated by state and local governments. She left the government to join HDR Inc., an engineering firm, as a vice president and policy advisor.

"She is very market-oriented and future-oriented," said Robert Poole, director of transportation studies for the libertarian Reason Institute think tank in Los Angeles. "She really understands the growing obsolescence of paying for highways out of gas taxes, and she understands the importance of tolling and market pricing for the highway system of the future."

How Peters' free-market principles will carry over into the heavily regulated sphere of aviation policy remains to be seen, but the airline industry urged the Senate to promptly confirm her. At issue in next year's aviation debate will be financing for the Federal Aviation Administration, and the allocation of costs among passengers, major airlines and smaller carriers.

McClellan, a physician who also holds a doctorate in economics, served on the White House Council of Economic Advisors and as commissioner of the Food and Drug Administration before moving over to Medicare in 2004.

At 43, he is expected to return to the public policy arena in future debates about restructuring the health system to deliver better quality care while curbing the growth in costs.

An energetic manager, he worked to nudge the Centers for Medicare and Medicaid Services from a traditional bill-paying and fee-setting focus toward a more active role in changing the healthcare system. He emphasized preventive care for people at risk of chronic health problems and sought to improve disclosure by hospitals and doctors of quality-of-care information. He supported experiments to begin paying hospitals and doctors for quality care, not just for the volume of services provided.

In an interview, McClellan said his family needed a break from his years of high-pressure public service. He and his wife have twin daughters who just started third grade.

"It's a time-consuming job," he said of leading the agency. "It involves many long hours, not only here working with the staff, but it also involves a lot of travel around the country."

John Rother, director of policy and strategy at AARP, the seniors lobby, said he thought that McClellan's tenure would have a lasting effect.

"I think he laid enough of a foundation that whoever steps in is going to be expected to continue the same kind of emphasis," Rother said. McClellan "is a star, and certainly when you lose a star there is an effect, but I think [Medicare] has changed and will not fall back automatically to what it was before."

Bush called McClellan a "trusted advisor [who] leaves behind a strong record of accomplishment."

McClellan also administered Medicaid, the health insurance program for the poor. His successor has not been named; one candidate is Deputy Administrator Leslie V. Norwalk, a healthcare lawyer with an encyclopedic knowledge of policy.

McClellan's greatest challenge was putting into place the new Medicare prescription drug benefit, which delivers coverage to seniors through dozens of private insurers -- a first. The rollout of the program was plagued with problems for several million beneficiaries, particularly the poor. McClellan and his staff worked round the clock to fix the problems, most of them rooted in the program's design, and most seniors now report they are satisfied.

However, the timing of McClellan's departure raised eyebrows among some Democrats in Congress. It comes just as growing numbers of seniors are expected to hit a gap in coverage, known as the "doughnut hole," that Congress built into the middle of the drug benefit to save money. That particular problem, it seems, will land in his successor's lap.


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