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Balancing Act ^ ? ? Ml M Surgeon General David Sateher, seated second from right, has faced challenges his first year. A year into job, Satcher still shaping role BY LAURA MECKLER THE ASSOCIATED PRESS . . WASHINGTON - A .year after taking a job that's been a magnet for controversy,. Surgeon Gerieral David Satcher has steered clear of politics and stayed away from the fray, quietly traveling the country as he picks His priorities. ? It's, kept him out of trouble - ' and the same cannot be said for His predecessor, Joycelyn Elders, ^ut some say Satcher will need to become bolder if he hopes to broaden his reach beyond Wash ington to directly impact the American people. Satcher says he's still figuring dut how to balance his ability to affect policy with the power of the bully pulpit. "You've got to make people qome together so it's not just you ipming out on your owftr he said. But he adds: "I hope to throw some bombs." In his first year, Satcher has focused on traditional health issues: encouraging regular exer cise, discouraging smoking. He's also brought sharp attention to the health gap between minorities and white Americans. >4' And he's challenged the black community to confront AIDS, felling black churches they must talk about sex when more than half of all new HIV infections are to blacks. ? He's toured the country, giv ing more than 50 speeches in 26 states - unable to accept most of the 200 invitations he gets each week. But in the $ne major contro versy so far, on needle exchange programs, Satcher declined to speak out, against a Clinton administration decision he thought was wrong. Instead, he's built on his repu tation as a consensus builder. Take the sticky issue of nqti fying thousands of Americans they were unknowingly infected with_ hepatitis C. Some officials thought it would be so djfficult to find those people there was no point trying: others believed it \?as vital"fa-public health. "David brought to that debate a sense of both the moral, ethical responsibility of government, <3nd an understanding of the practical issues," said John Eisen berg, a top Health and Human Services Department official. ; Administration officials say Satcher one of the top blacks in government has thenar of Pres ident Clinton, who calls ?o*h him fair advice on race as well as Health. . ! "He doesn't talk before he thinks," said Chris Jennings. Clinton's top health policy advis er. "And in Washington, that's a jjretty welcome development." And supporters cannot say enough about the qualities Satch er brings to the post from his qpbringing ii\ segregated, rural and dirt poor Alabdma to his years in academia, medicine and community health. Still, even his biggest boosters say Satcher has yet to effectively use the powerful bully pulpit that comes with the crisp uniform of' the surgeon general. Circumstances have not allowed Satcher to find his voice, says Dr. Harold Varmus, director of the National Institutes of Health., "We haven't had the public health crisis that would allow him to step up to the plate," Varmus said. _. The office had been vacant for more than three years when Clin ton swore Satcher in a year ago last Saturday. The outspoken Elders had been forced to resign after suggesting it might be good to talk about masturbation in schools (an alternative to sex with a partner, she reasoned). Then Dr. Henry Foster's nomina tion was scuttled over controver sy that he'd performed abortions. Satcher survived his confir mation battle in the Senate, despite objections that he refused to support a ban on so-called "partial birth abortions." Conser vatives also condemned his sup port for needle exchange pro grams, which try to stem HIV's spread by giving drug users clean needles to teplace possibly infect ed ones. Then, barely two months after Satcher's confirmation, needle exchange emerged again: Clinton sided with political and drug advisers and opted not to give -? federal money to local programs. ? Satcher was forced to sit beside HHS Secretary Donna Shalala as she struggled to justify the decision in terms of health, rather than politics. Asked jf he was disappointed, Satcher ducked the question^ Later, in interviews, he admit . ted the obvious: He was, in fact, djsappointed. Asked why he didn?t speak out more forcefully, Satcher suggest ed it was not his place, noting that he also serves as HHS assis tant secretary of health. "If you're a member of the i team and that team makes a deci sion. and you have had an oppor tunity to have a lot of input to that ... you don't majce an issue out of it," he said. Others agree he was right to take a low profile so soon after his confirmation fight. "He's been rebuilding his prestige, which the confirmation process is always so successful in tearing down," said Richard Sori an. a senior HHS official before taking a research post at George town University. Shalala said Satcher is quite capable of standing up to harsh criticism. She points to his defense of controversial AIDS studies in Africa, which have now shown some success. Satcher's Senate critics cited the studies. which withheld treatment from some pregnant women with HIV to test the effects of a new approach. "He believed from the begin ning that it was an opportunity to save lives and he didn't back ddwn," Shalala said. Surgeon General C. Everett Koop, who came to use his bully pulpit brilliantly, also laid back after a bruising confirmation fight. It wasn't until three years into his term that Koop talked about condoms and AIDS, Satcber notes - a major step when President Reagan had never uttered the word "AIDS." "It is unnecessary for a sur geon general to come out swing ing," agreed Sen. Bill Frist, R Tenn., a leader on health issues. "I appreciate Dp Satcher's establishing a voice,4 Frist said. "And, in a steady, continuous way, he will grow that voice over time." Blue from page AI ham wilt-co-chair an education budget subcommittee and head the committee that nominates mem bers to the powerful University of North Carolina Board of Gover ilors. Rep. Larry Womble will chair the travel and tourism committee and serve as vice chair of the com mittees on cultural resources and community development. In 1991, his first term as speak er, Blue gave 11 of 65 committee chairmanships, 17 percent, to minorities; and 6 chairmanships, 9 percent, to women. In his second term. Blue gave 11 of 52 chairmanships, 21 per cent, to minorities and 12 chair manships, 23 percent, to women. Black had 17 black members and 24 women from which to choose his chairmen, Blue had 14 blacks and 20 women in 1991; and 18 blacks and 24 women in 1993. The committee appointments should relieve any concerns about fairness. Black said Friday. "1 said all along 1 was going to i r~:_ uc i an auu inclusive," Black said. "I tried to be sensitive to the issues of gender, race, geographical diversity and party in my appoint ments" All f?ioht a ??? Democrats who voted against him got chairmanships, although not on the House's most important committees. Rep. Howard Hunter, D Northampton, one of those who voted against Black, said he was not surprised by Black's attempts to diversify the House leadership. "Over the summer, during the so-called short session, Jim told me he was looking at having a white female, a white male and an African-American co-chair appro priations," Hunter said. "I think he is very conscious of what he needs to do." Black on Thursday appointed Reps. Ruth Easterling, D-Meck lenburg; David Redwine, D Brunswick; and Thomas Hard away, D-Halifax, to co-chair the Appropriation^ Committee, the most powerful panel in the House. Hardaway is the first black and' Easterling the first woman to co chair that committee in the House. "If I question anything, I ques-' tion the experience he has sur-| rounded himself with," Hunter' said. "I don't think there is much there, but I believe they are all' capable." VMombio The Chronicle's e-mail address is: .> ' ? A ^ *? " } wschron@netunlimited.net You And The Law Seminars Sponsored By . ujJJSAM& Wells Jenkins Lucas & Jenkins PLLC Seminars conducted by Mike Wells, Attorney and hbst of "You And The Lav on WS]S AM. Please call 725-2900 for reservations. There is no charge for attendance but seating is limited. These seminars will be held in the Salem Room at The Inn at Hanes Mall, formerly the Holiday Inn. 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Winston-Salem Chronicle (Winston-Salem, N.C.)
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Feb. 18, 1999, edition 1
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