University of Miami President Donna Shalala told 100 South Florida healthcare leaders that the key to making major changes was getting a consensus. Shalala, the former leader of Health and Human Services in the Clinton administration, noted the country had never "taken a giant leap" in any large social change without first getting agreement that there was a problem and then getting agreement on what the solution should be. The seven panelists who followed her during a discussion at UM's Wellness Center agreed that the system needed huge reforms, but there was no consensus about what should be done.