Sheila Burke ... said this is an important moment [in health reform] .... We agree that government now has to intervene. -- Sen. Daniel Patrick Moynihan on "Meet the Press," Sept. 19, 1993
Senator Dole told me, "If you and Sheila can agree, I'll vote for the plan." Hillary Rodham Clinton at a working White House dinner on Health Reform, Feb. 22, 1994
So who is this Sheila Burke? "Nothing less than the most powerful woman in American government," offers a top Senate Democratic aide. But what about Hillary Rodham Clinton, lately in the bunker but still leading the charge to reform health care? Simply put, Burke is health reform's Other Woman. As Minority Leader Bob Dole's chief of staff and Senate Finance Committee Chairman Daniel Patrick Moynihan's favorite resident health care expert, Burke is the one most likely to write the final reform compromise. Whitewater aside, the first lady may remain the lead negotiator, but it will be in a legislative process run by Burke. She is, says Senate Finance Committee Democrat John Breaux, "the key to any final deal."
Any careful C-SPAN viewer has probably seen Burke, Zelig-like, sitting directly behind Moynihan and Dole during health hearings or in a seat on the Senate floor. Burke, 43, has worked for Dole for almost 17 years -- eight as his chief of staff, the rest as a top health aide. Yet the debate over health reform is clearly her legislative moment: The issue has always been the driving passion of the onetime surgical nurse. In fact, that is precisely what gives some key Senate Democrats hope that, in the end, Dole will work with them to cut a deal. The White House remains confused about Dole's intentions, which is either (a) the way he wants it or (b) the way it really is. So, instead, Clintonites try to figure out what Burke is thinking -- and take some comfort in her open devotion to reform. Universal coverage, she says, "has clearly got to be the goal that we set for ourselves. I just don't know how realistic or how quickly we can achieve it."
No alter ego. A key political rule of thumb: The more complex the issue, the more important the staff. On health care, Republicans are split, and this past weekend's Senate Finance Committee retreat offered no instant bipartisan solutions. So Dole has told Burke to begin drafting a bill. "It's not going to be the Sheila Burke plan," he says. "She knows what I think, and she also is realistic enough to know what might be the framework of an agreement." Not surprisingly, Burke takes a more incremental approach than the White House: She considers universal coverage a goal, yet opts for a "far less prescriptive benefits package" and for smaller and voluntary "alliances" to help workers in small businesses cut insurance costs. A host of insurance reforms, like portable coverage and no restrictions on pre-existing conditions, is a gimme; a requirement that employers pay insurance costs is not. "All the mandates," says Dole, "are in intensive care."
But Sheila Burke is not Bob Dole's alter ego (for which some of his Senate colleagues are no doubt grateful). She came to his staff as a Democrat with a "bias on the liberal side." Her Republican evolution has been gradual; conservative senators charge it hasn't gone far enough. (Dole admits she is "on their suspects list.") Unlike Dole, Burke's perspective on health care came from work in urban California hospitals. She knew little of the problems of rural health care delivery in Dole's Kansas -- so little, in fact, that Dole often had Burke call his mother's optometrist to sound him out on health issues. Still, there was a link: Dole's life changed after he spent 39 months in hospitals after a World War II injury. The experience, Burke says, "was of having people raise money for his care [with] cigar boxes at the drugstore. He is grateful, but he doesn't think people should have to do that."
Neither does Burke -- a point not lost on key players in the health debate. Like Dole, she is no soft touch. "The lady eats nails for lunch," says one Clinton insider, who also marvels at her ability to take care of Bob Dole and three small children at the same time. Her husband is an insurance company executive, but Democrats do not charge conflict of interest. The reason: Burke is considered a serious policy student. Even amid the Whitewater-inspired partisan eruptions, members on both sides of the aisle seek her counsel. Moynihan, in fact, often acts as if Burke is his health care adviser. That's not insignificant, since he runs the committee soon to write health reform; there is also a good chance that Dole and Moynihan want to write a bill together, just as they did in 1983 to fix Social Security.
Dole, of course, is no talking puppet. When he decided to adopt the "no health care crisis" line and use it in his response to the president's State of the Union message, Burke was opposed. She told her boss that "people really do think if it's a personal problem, it's a crisis for them. I was fearful that he would be misunderstood, and he was." Dole soon backed off the strong tack. "I've never fooled myself that I'm the person who ultimately decides," says Burke. "He does." But first, he likes to know what she thinks.
