When he takes over as expected as the next secretary of health and human services, Dr. Louis Sullivan will find himself confronted by much more than the incendiary subject of abortion. Several other fundamental social issues also will vie for attention from Dr. Sullivan, the president of the Morehouse School of Medicine, whom President-elect George Bush nominated Thursday for the cabinet post. They include:
Finding a way to slow the soaring cost of health care, while at the same time improving the access to care of the poor and the quality of care to all Americans.
Further, Sullivan will have the opportunity to influence the search that Congress will institute this year to figure out how to lift from individuals the heavy burden of paying for the cost of most nursing-home care. As a national average, the cost of this care, often referred to as ``long-term care,'' runs slightly more than $20,000 a year for each patient. Despite improvements in law enacted this year, government generally pays these costs only when most people who receive such care have spent so much of their assets that they are nearly impoverished.
Monitoring the administration and financial viability of the social security system. And - if appropriate - finding ways to reassure young Americans that this key retirement source will contain the money to make payments to them when they are ready to retire.
Providing strong leadership to states and communities as they seek to put into effect the welfare reform law enacted this fall. The new legislation is widely seen, even by many of its backers, as the start of a long process in which America seeks to turn its welfare system from a subsidy program into a plan primarily to getting able-bodied welfare recipients into the work force.
Finally, the intensely controversial abortion issue lies in wait, like a one-issue mine field. Anti-abortion groups forcefully pressure society, government, and the courts to reverse direction and make almost all abortions illegal. The issue appears headed again for the US Supreme Court.
Beyond these and other important policy questions, the Sullivan appointment broadens representation in the Bush Cabinet, as did the naming earlier this week of retiring Rep. Jack Kemp as secretary of housing and urban development. Sullivan is the first black named by Bush to his Cabinet; Representative Kemp was the first economic conservative selected for the Cabinet.
Dr. Sullivan's nomination was one of five that president-elect Bush made Thursday. The others were:
Samuel Skinner, an attorney and Illinois transit official, as secretary of transportation.
Rep. Manuel Lujan (R) of New Mexico, secretary of interior.
Edwin Derwinski, former State Department official and member of the House of Representatives, secretary of the new Veterans Affairs Department.
William Reilly, a conservationist who has been head of the World Wildlife Fund, to be administrator of the Environmental Protection Agency, a key environmental position but not officially of Cabinet rank.
Thursday's nominations leave only two of the 14 Cabinet slots unfilled, the secretaries of energy and labor.
Sullivan's nomination as HHS secretary was delayed most of this week because some abortion opponents feared he was not an abortion foe, based on his comments in newspaper interviews last weekend. He had indicated that he personally supported a woman's right to an abortion.
Dr. Sullivan's nomination came after he apparently reassured several anti-abortion members of Congress that his abortion views were compatible with those of George Bush: that he supports abortion only in cases of rape or incest, and to save the life of the mother. The issue is not considered closed, however, as some anti-abortion organizations remain skeptical.
With the exception of abortion perhaps the most difficult problem with which Sullivan will have to contend is the soaring medical costs across America.