. "Appendix G The Reorganization Option:Views from Former Secretaries of the U.S.Department of Health and Human Services." HHS in the 21st Century: Charting a New Course for a Healthier America. Washington, DC: The National Academies Press, 2009.
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HHS in the 21st Century: Charting a New Course for a Healthier America
discount the impact of perquisites in the political island called Washington, DC. This is certainly what Congress intended to convey in not disapproving the reorganization plan that created the Department of Health, Education, and Welfare in 1953. It is also what it intended 25 years later when it split the Department of Education from that entity.
Even if one can find ample history to support reorganization, it is important to note that creating or redesigning departments or agencies is not a panacea for all that ails a given function. Merely combining similar units will not produce coherent policy, for example, nor will it yield better performance, increase morale, or raise budgets. It most certainly will not make broken agencies whole. If an agency is not working in another department, there is no reason to believe that it will work well in the new department. Conversely, if an agency is working well in another department or as an independent agency, there is no reason to believe that it will continue to work as well in the new department. Bluntly put, “If it’s broke, don’t move it; if it ain’t broke, leave it alone.”
The elevation of an existing agency to cabinet status is no guarantee of success either, a point well illustrated by the elevation of the Veterans Administration to cabinet status in 1988. Congress and the President felt that the department would use its newly granted status to provide better, faster health care and benefit processing. Yet neither came to pass. From this author’s perspective in studying the reorganization, veterans won a seat at the cabinet table, but no guarantee of stronger leadership, more funding to replace antiquated systems, or a greater commitment to veterans care.
HOW THE SECRETARIES VIEW REORGANIZATION
Department secretaries bring an important perspective to the analysis of reorganization and its costs and benefits. Some secretaries enter office at the beginning of the implementation process, while others are in office when the reorganization takes effect. Some recommend reorganizations, whereas others oppose them. However, all of the secretaries interviewed for this paper understood that reorganization is a difficult task—simply put, it should only be undertaken with a clear rationale and reasonable expectations.