Sylvia Mathews Burwell is taking over the leadership of the Department of Health and Human Services (HHS) from Kathleen Sebelius, and the two women had very different career trajectories to the cabinet-level position.
Kathleen Sebelius started her career with the government of the State of Kansas. As the below chart of her employment timeline shows, Sebelius slowly worked her way up through the ranks of the state government and was eventually elected governor. She also had some experience in the the healthcare industry as the state insurance commissioner. HHS Secretary was the first position that she held at the federal government level.
Sylvia Mathews Burwell’s career path has been the opposite of Sebelius’s.
Burwell spent 11 years working in different roles for the federal government, most recently as the director of the Office of Management and Budget. But she’s not a career bureaucrat.
As the below chart shows, Burwell has spent almost an equal amount of time working in the private sector for both the Bill & Melinda Gates Foundation and the Wal-Mart Foundation. In these roles, she worked on some global and domestic health-related projects, but she has little direct experience working in the healthcare industry aside from serving on the board of the University of Washington Medical Center (which is not included in the chart below).
The New York Times notes that President Obama’s decision to nominate Burwell “places a relative outsider at the helm of one of the government’s largest bureaucracies.”
But that might have been part of her appeal. Burwell “works hard to be seen as a practical manager rather than an ideologue,” observes Elise Viebeck of The Hill.
In her nomination hearing before the Senate Finance Committee, Burwell sought to bridge gaps with Republicans and admit the flaws of the rollout of the Affordable Care Act. Sebelius, meanwhile, was criticised for her lack of transparency, particularly with her refusal to testify before Congress on failed aspects of the rollout.
And since reigning in healthcare spending continues to be be a priority in Washington, Burwell’s economic policy background and private sector experience appealed to legislators on both sides of the aisle.
In the end, Viebeck notes, Burwell’s confirmation process was “unusually smooth.”
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