Making Good Government Happen: A Conversation with Tom Komaniecki, Regional Inspector General for the U.S. Department of Health and Human Services

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is an independent division of HHS charged with protecting the integrity of HHS programs and the health and welfare of HHS program beneficiaries. The OIG is a nonpartisan “watchdog” that conducts audits, investigates fraud, and evaluates programs for efficiency and effectiveness. Within HHS OIG, the Office of Evaluation and Inspections (OEI) conducts national evaluations of HHS programs and issues recommendations to improve efficiency and prevent fraud, waste, and abuse.

Tom Komaniecki is an evaluator with OEI in HHS OIG. He has directed and participated in studies examining multiple programs within HHS including medical devices, Head Start, rural health, and Medicare and Medicaid issues. He joined OEI as an intern in 1987. Tom holds a Master’s degree in Public Administration from the University of Illinois at Chicago.

Let’s get started by discussing your career path. What led you to a career in the public sector?

I had a calling. I wanted to serve in some way, and I felt like government was a good place to be. Very early in my life I wanted to join the Navy, then the Foreign Service. My dad is from Poland, and my mom is first generation Polish. At the time [when I was in school] the Communist regime was in power, and I was interested in that. It drove me toward public sector, public service work.

You received your MPA from the University of Illinois at Chicago (UIC) and began working at HHS OIG as a graduate student. How did you choose a degree in public administration and a career in program evaluation?

In undergrad I was a political science major and a history and economics minor. My real goal was to join the Foreign Service, but I struggled with passing the language portion of the exam. A professor said to me, “Have you thought about going into public administration?” At the time, UIC was starting up a Master’s program in public administration. I looked into it and it seemed to fit, especially because I had always wanted to do public service. As for the OIG, I never sought this job out; the job found me.

How would you describe the mission of HHS OIG?

We’re an independent body that is meant to ensure efficiency and effectiveness and prevent fraud, waste, and abuse. There are lots of IGs, but this one is special because the department it oversees is so broad. HHS touches every person’s life in the U.S.—whether it’s through the FDA, with drug approvals, or through CMS, via Medicare and Medicaid—[HHS OIG] has such a broad mission. The role it plays is in making sure good government happens. I have friends who say, “I pay your salary.” I say, “So do I, I pay my own salary!” I want their taxes and my taxes to be used in the most economical and efficient manner possible. I want programs to serve the public the way they’re supposed to. Sometimes things aren’t designed well; our task is to make improvements. We try to stay out of the political—whether this is a “good” or “bad” policy—and instead make sure that if there is a policy, it works as well as possible.

We are also different from a lot of IGs because of our external [outlook]. We oversee Medicare and Medicaid, making sure those programs aren’t defrauded by providers such as hospitals and physicians. In that way, we’re focused [not just on CMS but] on the whole healthcare arena. The decisions that CMS and [HHS OIG] make affect not only Medicare and Medicaid, but the provision of healthcare in general.

In your opinion, what is the impact of your work?

It’s a long-term investment. The people who run these programs are dedicated individuals. But sometimes our role is to ask them, “Why?” When they go, “Because that’s how we’ve always done it,” the question becomes, “Is that a good reason?” A program that was developed 20 years ago—does that stand the test of time or should you think about other ways of doing it? We don’t want to be “gotchas.” We’re not in the game to get people for not following the rules. We think of it as, the past is the past. Let’s make sure we can change things for the better going forward.

Can you tell us about your favorite evaluation you’ve conducted at HHS OIG?

After 9/11, there was an effort to identify other potential security threats. With a very short turnaround, we were asked to look at food security. That term gets used in many ways now; this was, “Is our food supply chain secure from external threats?” A lot of food gets imported into the U.S., and there was concern that we could be attacked via contamination of the food supply. We conducted a study where we went to distributors and importers along the coasts and the borders to get a sense of what steps they were taking to ensure the security of their supply chains. We talked to customs, asked them what they did as supplies were coming over. We also talked to the FDA to see how they prioritized their inspection routines. Which foods should we worry about and which should we not? For example, the acidity in stewed tomatoes may make that product less susceptible to attack, but another product could be more vulnerable. It was fascinating.

What is the biggest misconception people have about working for the Federal government?

That people are here just for the paycheck and benefits—that they’re lazy. The vast majority are here because they want to serve, to do what’s right, to make the world better. They care. If they didn’t, they could make a lot more money doing something else. 

Anything else you’d like to add?

I’ll make a pitch for the IG’s office. This job gives you the opportunity to expand your mind daily. On any given day, you’re exploring a new topic, learning what does and doesn’t work and how it affects people. I once described this job as being able to take apart a puzzle, understand how it all fits together, and put it back together in a much simpler way. It’s challenging, and the rewards are there when the recommendations from our work are incorporated into legislation. It’s cool that something we do has that impact. If you want a better understanding of how government works, and make government work better, this is the place to be.

Featured photo: cc/(Piotrekswat, photo ID: 953929042, from iStock by Getty Images)