The Department of Health and Human Services is 127,700 federal employes directing 250 programs that touch everyone. Its main charge: protecting Americans' health and helping provide millions of needy, disabled or elderly people with some income and medical care.
HHS has the largest budget of any federal agency. The $330 billion that it will spend this year consumes about a third of the entire federal budget and surpasses the $300 billion in Defense Department spending. The bulk -- $201 billion -- is paid out in Social Security checks. Medicare costs $75 billion; Medicaid for some of the poor, $25 billion; aid to families with dependent children (AFDC), $9 billion.
Directing these and scores of other programs has always been an administrative nightmare. When Secretary Abraham Ribicoff left the department, then called Health, Education and Welfare, in 1962, he said, "I feel sorry for the so-and-so who is going to take my place." One of his predecessors said, "They expect you to know everything, and it's just impossible."
The department's history goes back to 1798, when the first federal marine -- or seamen's -- hospital was opened. That was the forerunner of the Public Health Service. In 1887 the government opened a one-room research laboratory on Staten Island. That was the forerunner of the National Institutes of Health, today the nation's main supporter of biomedical research.
In 1953, during the Eisenhower administration, Congress tied together the Social Security Administration and many other agencies into a new Department of Health, Education and Welfare. Running so many complex programs tried the ablest administrators, and in 1980 a separate Department of Education was established.
By then welfare had become an unpopular word, if huge fact, throughout the country. So the remaining, still massive agency was renamed the Department of Health and Human Services.