Donna Shalala, former health and human services secretary, right, visits with Scott Weir, director of therapeutics, discovery and development at the Kansas University Medical Center, at the Kansas Life Sciences Innovation Center at the Med Center. At center is Executive Vice Chancellor Barbara Atkinson. Shalala received the 2009 Dole Leadership Prize on Monday night.

Donna Shalala, former U.S. Secretary of Health and Human Services in the Clinton administration, said Monday night that the country needs to offer affordable health insurance coverage to everybody.

The nation also needs a system that focuses on wellness care instead of sick care, she said. She strongly encouraged — more than once — the idea that people need to be more accountable for their own health.

“If everybody in this country didn’t smoke, ate right and exercised, we would have plenty of money to cover health care in this country,” she said. The comment was followed by a loud round of applause from the estimated 800 in the crowd at the Lied Center on Kansas University’s West Campus.

Shalala, president of the University of Miami, was at the Lied Center to accept the 2009 Dole Leadership Prize, the first woman to do so. Previous winners include former New York Mayor Rudolph Giuliani, former U.S. Sens. Howard Baker and George McGovern, and former U.S. President George H.W. Bush.

During an hourlong interview with Bill Lacy, director of the Dole Institute of Politics, Shalala talked about topics that ranged from her early influences to her love of working in the Peace Corps, challenges of gender discrimination and her record-long tenure as HHS secretary. She also displayed a sense of humor.

She described working with former President Bill Clinton as fun.

“You never knew what was going to happen,” she said with laughter. She said he was intelligent, energetic and wanted measurable outcomes. She joked that a “Twinkie tax” would not have passed during his administration.

She was more sentimental when she talked about working with former Sen. Bob Dole on a task force to evaluate how wounded service members transitioned from active duty to civilian life. She said it was an issue that Dole cared deeply about and he treated everyone with great dignity.

“I frankly was in awe,” she said of Dole’s compassion toward others.

But Lacy’s interview and questions from the audience mostly focused on health care reform.

Shalala said there’s no doubt that the health care system is a complex problem that is in need of improvements from reining in health care fraud to getting everyone insured to focusing on high quality and not quantity.

“We need to get started,” she said. “We need agreement from the American people that we want everybody to have health insurance. We need agreement that we want to deliver that health care in way that is efficient and fair and that’s cost conscious and that provides the best kinds of outcomes.

“I actually think we can get there.”

She said among the key components are eliminating pre-existing conditions and offering coverage to everyone — something she thinks most people are in agreement on.

“One way or another, we’ve just got to get everybody covered. We are paying for them now,” she said, adding that the cost of the uninsured are now figured into everyone else’s hospital bills.

When asked about the lack of health coverage for low-income children, Shalala admitted that the government’s Medicaid program and State Children’s Health Insurance Program are both underfunded. She said the reimbursement rates for doctors and nurses are not up to par, and therefore finding enough primary care physicians or nurses to take care of these children has been a challenge.

If a single-payer plan were introduced, Shalala said she was confident that private insurance companies would be able to compete.

When asked what the American public can do, she reiterated the basics: stop smoking, kick your children outdoors and start exercising. But she also said to be informed and ask questions.

For example, Shalala said she had an ankle injury and the doctor was going to order a magnetic resonance imaging exam. She asked whether a less expensive X-ray would work and the doctor said it would.

“The difference in prices is substantial between the two,” she said. “We need to take more responsibilities for ourselves and our own health.”