Ellwood, who served as an assistant to Shalala on welfare reform from 1993 to 1995, says Shalala's university management experience prepared her for her HHS appointment.

"She's used to thinking intellectually and looking at the big picture," he says.

"It taught me how to listen," Shalala says. "I'm comfortable talking to people."

Head Honcho of Health

In 1993, President Clinton appointed Shalala secretary of the Department of Health and Human Services--the division of the federal government that deals with programs like Medicare and Medicaid, federal welfare programs and children's programs like Head Start.

The department also administers such institutions as the National Institutes of Health (NIH) and the Food and Drug Administration (FDA).

During her tenure, the department has tackled a series of thorny issues, from welfare reform to organ allocation.

Shalala had previously served as the assistant secretary at the Department of Housing and Urban Development (HUD) under President Carter between 1977 and 1980.

At HUD, Shalala worked to improve the treatment of women through initiatives such as the creation of battered women's shelters.

Some thought that Shalala's appointment to HHS was a politically correct move to have a woman--and a friend of Hillary Rodham Clinton--heading the agency. Shalala, however, deflects such charges.

"They were wrong then, and they wouldn't say the same thing now," Shalala says.

Target Practice

Shalala had little time to worry about the scrutiny. Clinton asked her to tackle major administration initiatives like welfare and health care reform, both of which have achieved varied results.

"We didn't get universal health care," Shalala says. "Our proposal was too complicated, and the country wasn't ready for it."

Ellwood says that Shalala's successes far outweigh the failed initiatives under her watch, however.

"Quite a lot has happened since she has been there, from welfare reform to extending medical benefits to the poor to helping Social Security become an independent agency," Ellwood says.

Recently, Shalala has spearheaded an effort to make organ allocation for transplants based purely on need rather than proximity to available organs.