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Leading & Managing for Impact

Sylvia Mathews Burwell
The George Washington University
September 8, 2014
Washington, D.C.


Thank you, Dean Goldman. It’s great to be here with all of you at GW. This institution is a tremendous leader on so many health and human services issues: from research that is revolutionizing the treatment of cancers, to biomedical engineering, to your work training the next generation of doctors, nurses, social workers … and perhaps Cabinet Secretaries.

I’ve had the privilege of working with many GW Colonials – including many of the talented members of my staff at the Department of Health and Human Services. When you think of all the giants who’ve come through this university, it’s astounding: the great Robert C. Byrd, from my home state; Red Auerbach; Senate Majority Leader Harry Reid; Senator Mike Enzi; the founders of organizations as diverse as EMILY’s List, ESPN, and Operation Smile.

Now, all of these people had two very big things in common. The first, of course, is GW. The second is that each of them found their own road to impact.

I want to take this opportunity to share some thoughts with you as you look to find your own road to impact.

I’ve been at HHS for about three months now. It is the chance of a lifetime to lead and be a part of this Department at such a unique moment in our history (in fact, I should mention we have two and a half years to go, there are openings and we’re hiring).

I was honored to accept President Obama’s invitation to lead HHS, because there is so much potential to deliver impact that touches so many lives. I can’t imagine another place where you have quite the same opportunity to work at the intersection of policy, management, leadership, impact, and some very big challenges.

Since I joined his team a year and a half ago, I’ve found that President Obama emphasizes results, partnerships, accountability, and sound management.

This is the way I’ve always tried to work, and it is how we work at HHS. We believe in building bridges, relationships, and strong teams that have the talent and focus necessary to deliver results. We believe in managing well. We believe in transparency. And we believe in impact – impact on behalf of the American people we serve.

They are our “bosses.” Those hardworking Americans who rely on the work of our Department as they look to obtain the building blocks of healthy and productive lives.

Whether you’re talking about the Affordable Care Act, early childhood education, or the fight to stop Ebola, I believe the best paths to progress and impact are through this sort of leadership and management.

What’s central to all this is not politics. It’s progress: setting aside the back and forth, and instead choosing to move forward.

I’m a parent – and when I think about moms and dads sitting around their kitchen tables trying to make big decisions for their children, they don’t care whose idea something was. You don’t have time for that when you’re trying to figure out how to afford the next electric bill or next year’s tuition or how to make sure the kids are getting the homework gets done. You just want results, and you expect folks in Washington to look for the common ground necessary to deliver.

This is the approach we bring to the big challenges we face at HHS.


Each of us finds our own leadership and management philosophy in our own way. I learned fundamentally about the importance of relationships growing up in a place where my mom knew the one day I was tardy for school, because I was late for the 9 a.m. class she was teaching.

The values I learned growing up in a beautiful place called Hinton, West Virginia, are what anchor how I manage, how I work, and what I work on. You might think about what values and experiences got you here to GW and are going to take you beyond.

Hinton is the kind of place where relationships and trust matter. It’s the sort of community where neighbors tend to look for the best in each other, and everyone feels a personal stake in contributing to the common good.

As I’ve gone on in my career to manage budgets – including the federal budget – I’ve often thought about how, in our small community, every dime counted.

People worked so hard for the money they brought home. I watched the parents of many of my friends commute to difficult, oftentimes backbreaking work in the mines.

I saw my Pappou – which is Greek for grandfather – get up to open his restaurant at 6 a.m. He was a Greek immigrant, and he taught me to be grateful for the gifts this country gave to our family. His restaurant was called Denny’s – but not that Denny’s. (There was no “Grand Slam” on the menu). It was the English translation of his Greek name, Dionysius.

I learned about customer service and delivering results at Kirk’s - Home of the Hungry Smile. If you were the person who got stuck dipping the hard serve after Sunday church services, you’d just smile and keep on dipping until every last cone was dipped. And it was pretty simple to measure results. If you were asked to deliver two scoops of maple walnut and you gave someone one scoop of strawberry – then you didn’t deliver the customer the result of maple walnut.

Service was important to my mom and dad, and I think that’s why it’s so important to me. Mom was the President of the Church Women, she was a member of the Business & Professional Women, she was a member of the Service Club, she was a member of the State Board of Education. Dad always played the trait of Education in the citizenship pageant. We had a rule in our house: On Halloween, you had to Trick or Treat for UNICEF first before you could Trick or Treat for candy.

Leading & Managing Well

Fast forward a few years, and I still draw upon these values and experiences – whether it’s putting the customer first, valuing service, or looking to find the best in others even if we don’t agree on everything.

I’ve been fortunate in my career to be a part of organizations that are very good at strategy. I’ve also been a part of organizations that are very good at execution. I believe in leadership and management that are good at both strategy and execution – because this is the difference between great ideas that change lives and those that don’t.

My management philosophy is built on three principles: impact, prioritization, and relationships.

Now, I’ve said the word “impact” quite a lot already. It’s why I do what I do.

When we tackle a problem at HHS, I make sure that we set out a very clear definition of impact from the get go. What do we hope to accomplish and who do we hope to accomplish it for?

I think a lot about those moms and dads at the kitchen tables that I mentioned earlier and how the actions we take will impact them. They are our Boss. So are young women like Savannah Goodland who had to wait tables on a broken ankle that she wrapped herself, before she had health insurance. So are our neighbors who are beating addiction, so are children in Head Start. All these people are our Bosses at HHS.

Our Boss is also the Taxpayer. People like those miners from Hinton work hard for their paycheck and they deserve a government that works and is strategic and efficient in spending their hard earned tax dollars.

That’s one of the reasons that prioritization is so important to me. Because setting priorities and staying focused are how you get to efficiency and impact. Determining what options are available, what policy levers are there, what will they do, and what you’re good at, and what your partners are good at – all these things make government work.

In order to determine which levers and initiatives are the most efficient and effective, we’re “data-driven” at HHS. I’m a big believer in metrics, benchmarks, and analytics. If you’re serious about delivering results and looking out for the Taxpayer, you need to know whether what you’re doing is actually working.

All these things have something in common: They need great people to make them happen.

That starts with building teams with the talent and focus necessary to deliver the sort of impact that the American people expect and deserve.

So from my very first days at the Department, I’ve been working to retain the great talent that was already in place, and to recruit more of the best and brightest to join us.

As far as our external relationships, I’m a big believer in the old cliché: Relationships are built on trust.

Transparency builds trust, and it is something we take very seriously. Even if the numbers aren’t quite where we want them to be, we’re going to tell you about it.

Take for example our recent announcements about the numbers of consumers in the Health Insurance Marketplace who have citizenship-based data-matching issues. It may not always make for the best and most attractive press release – but we believe that you build trust by sharing the news -- both good and bad.

We also believe in the power of good ideas – and we understand that nobody has a monopoly on them. That’s why active listening and being responsive are so important – hearing ideas, input and feedback and putting them into action wherever possible.

I’ve told my staff that we should work toward the goal of returning the letters we receive from Congress within 30 days – no matter who they’re from.

Now, many of the best ideas come from all different sectors of our society. I’ve been blessed with the opportunity to work across a number of different sectors – doing everything from scooping ice cream, as I mentioned, to leading Walmart’s efforts to feed meals to needy families … to running the Office of Management & Budget.

Along the way, I’ve learned to have respect for every sector of our society and to believe strongly that there really are more things that we have in common as Americans, than we have that are different.

That’s why, when we hear good ideas from the other side of the aisle, we want to listen.. So when Republican Congressman Fred Upton asked me to join him for a discussion on “21st Century Cures” later this week I said “Sign me up.”

One of my first meetings as Secretary was with the governors from both parties. I told them that if they’re finding our Department isn’t being responsive, I want to hear about it.

I also told them that I hope to work with them – regardless of party – to bring more states into the fold on Medicaid expansion. And recently, we were able to do just that with the state of Pennsylvania, that has a Republican governor. Hundreds of thousands of people can now get the health care coverage they need as a result.

The fact of the matter is, there are always places where we can work together.

There is nothing ideological about curing cancer. There isn’t a Democratic or Republican way to solve Ebola. There isn’t a liberal or conservative way to prevent suicide.

We have opportunities to work together across the aisle on issues ranging from medical research to Global Health Security to Early Childhood Education.

Shifting the Conversation to Affordability, Access & Quality

The American people are sending a very clear message that they want us to work together on health care, too.

When you start a job like mine, you end up taking a lot of time in the first few months to listen. I was once told that God gave us two ears and one mouth for a reason.

I can tell you that what I’ve been hearing over and over – whether it’s from friends that I talk to back in West Virginia, to business leaders, to elected leaders, and to my new colleagues at HHS – “enough already with the back-and-forth on the Affordable Care Act. We just want to move forward.”

What that mom and dad at their kitchen table really want to know is “what kind of coverage is available to me and my family?” “Can I afford it?” “Is it any good?”

What I hear from business leaders is that they are in the same place. They want to work together on solutions while making our care better, and investing dollars wisely

They want a better health care system. And so do we.

So what I’ve told my team at HHS, is that we’re not here to fight last year’s battles, we’re here to deliver on affordability, access, and quality.

Surely, these are goals we can all agree on no matter where we happen to live; whether it’s in West Virginia, Wyoming, or Washington state.

By these metrics, the Affordable Care Act is clearly working. Health care is more affordable for families, businesses, and for our economy as whole. Coverage and services are more widely available for more people. Doctors and hospitals are delivering better care to their patients.

As we have said all along, we can do more and we can do better.

The Affordable Care Act is not about making a point. It’s about making progress.

It’s about leadership and management: defining our goals, putting the right teams in place, setting the right priorities, and building relationships with anyone who “wants in” – consumers, issuers, providers, elected officials, faith leaders, civic organizations …

We want to work with people across our country and across all sectors on priorities we can all get behind:

Helping more Americans Get Covered and Stay Covered;

Making health care more affordable for working families;

Making sure that HealthCare.gov meets the standards the American people expect and demand;

Expanding Medicaid;

Working with doctors and hospitals to deliver quality and affordable health care;

Working with insurance companies to offer more choices, to more people, in more regions of our country.


So what you’ll be seeing from us in the days, weeks and months ahead is an open invitation for partnership … and a call for good ideas – no matter where they come from.

We’ll be looking to build and strengthen relationships with anyone and everyone who shares our passion for helping Americans obtain the building blocks of healthy, and productive lives.

And we’ll insist that the actions we take are managed well – with an eye on protecting the Taxpayer and delivering impact for the Boss.

Lets move beyond the back and forth, let’s move forward, together.

Content created by Speechwriting and Editorial Division 
Content last reviewed on January 6, 2015