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Reagan taps former governor as Health, Human Services chief

Otis R. Bowen, President Reagan's choice to replace Margaret Heckler as secretary of health and human services (HHS), has his work cut out for him. If the former physician and two-term governor of Indiana is confirmed by the Senate, as expected, he will inherit an agency that has repeatedly been on the losing end of philosophical challenges by the Reagan administration. Under Mrs. Heckler's stewardship the agency fought with the White House and the Office of Management and Budget (OMB) on issues ranging from eligibility criteria for social security recipients to funding for family-planning programs.

Dozens of important positions in the department remain unfilled -- partly the result of repeated skirmishes with the OMB. That leaves many programs without the leadership necessary to fight for them. And HHS can expect as tough a fight as any agency: At $330 billion, it has the largest budget of any department in the federal government, and is a ripe candidate for deficit-shrinking trims.

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Dr. Bowen's selection is apparently being quietly welcomed at HHS, where Heckler is expected to remain secretary until January. One official says the feeling at the agency was ``that it was the right choice, as opposed to a political choice.''

Many conservatives, however, had focused on the early favorite for HHS secretary, former California Secretary of Health and Welfare David B. Swoap. Now, they say, they will have to sit down and talk with Bowen before making any decision on him. They say the litmus test for their support will be how tightly Bowen controls the HHS budget, as well as how he handles the ever-nagging questions surrounding social security.

Bowen practiced general medicine for 26 years and began his political career as Marshall County, Ind., coroner. He then spent 26 years in the Indiana legislature, ultimately rising to speaker of the House. In 1973, he began an eight-year tenure as governor. Currently, he is a clinical professor of family practice at the Indiana University School of Medicine in Indianapolis.

Observers in Indiana describe Bowen as a moderate Republican. In addition, Robert V. Kirch, a political science at Indiana University, says Bowen was ``possibly the most popular governor that Indiana has had in recent decades.'' One acquaintance describes Bowen as ``down to earth, homespun, and candid.''

Bowen is no stranger to Washington. He chaired President Reagan's Advisory Council on Social Security, which in March 1984 proposed major changes in medicare to keep the federal health-insurance program for the elderly and disabled from expected bankruptcy. He has served on other advisory commissions under the Ford and Reagan administrations as well. One recommended a major increase in federal alcohol and tobacco taxes to help bolster the medicare hospital trust fund.

Bowen has a reputation for decisiveness, and a recent incident may indicate his approach toward at least one branch of HHS: the Food and Drug Administration (FDA). According to published accounts, Bowen told the 1981 American Medical Association convention that he gave his dying wife a drug designed to relieve pain, in addition to a marijuana derivative. Neither drug had been approved by the FDA at the time, although the marijuana derivative has since been approved. He then criticized the FDA for delays

in approving pain-relieving drugs.

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But FDA is not the main problem. Analysts say the new chief's first job will be to get the White House to stop blocking HHS appointments. Next will come the task of repairing the department's badly frayed relations with Congress.

Capitol Hill staff members say several important reports on medicare payments to physicians and hospitals were supposed to be submitted to them months ago. Indeed, innumerable studies and regulations ordered by Congress have been delayed for one reason or another. So lawmakers have been considering substantial changes in health and welfare programs with little HHS assistance.

Bowen may have an easier time at rebuilding burned bridges with the executive branch than Mrs. Heckler had. For one thing, the top people interested in health policy at OMB are gone now, and budget director James C. Miller III is said to be not so concerned with health policy was his predecessor, David A. Stockman.

Bowen's selection ends a five-week search that began when Mrs. Heckler agreed to give up her Cabinet post to become ambassador to Ireland. -- 30 --

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