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Explore the inner workings of the US Department of Health and Human Services (HHS) through a 50-minute conversation featuring two former HHS Secretaries. Gain insights into their proudest achievements, toughest decisions, and advice for future leaders. Delve into the daily challenges of managing a $1.8 trillion budget while addressing critical issues such as Medicaid expansion, disease outbreaks, health at the border, Congressional pressure, food safety, medical research priorities, and children's wellbeing. This talk, part of Aspen Ideas: Health 2022, offers a unique perspective on the complexities of leading the second-largest US federal agency and shaping national health policy.