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Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care (2012)

Chapter: Appendix: Biographical Sketches of Panel Members and Staff

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Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
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Appendix

Biographical Sketches of Panel Members and Staff

Michael J. O’Grady (Chair) is president, West Health Policy Center. Prior to this position, he was a senior fellow in the Health Policy and Evaluation Department with NORC at the University of Chicago. He is a health policy expert with 24 years of experience working in Congress and the U.S. Department of Health and Human Services (HHS). From 2003 to 2005, he was the assistant secretary for planning and evaluation at HHS, where he directed both policy development and policy research across the full array of issues confronting the department. Previously he served as the senior health economist on the majority staff of the Joint Economic Committee of the U.S. Congress, focusing on Medicare reform, the uninsured, and other national health care issues. He has also served as a senior research director at Project Hope’s Center for Health Affairs. For several years, he was a senior health adviser to the chairman of the Senate Finance Committee. He also was a senior analyst for the Bipartisan Commission on the Future of Medicare, the Medicare Payment Advisory Commission, and the Physician Payment Review Commission. He spent several years with the Congressional Research Service of the Library of Congress and the Office for Civil Rights in both the U.S. Department of Health, Education, and Welfare and the U.S. Department of Education. He has a B.A. in political science from Alfred University and a Ph.D. in political science from the University of Rochester.

David M. Betson is an associate professor of economics and public policy and former director of the Hesburgh Program in Public Service at the University of Notre Dame. His previous positions have been at the Institute

Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×

for Research on Poverty at the University of Wisconsin–Madison and the U.S. Department of Health, Education, and Welfare. His research has dealt with the impact of tax and transfer programs on the U.S. economy and the distribution of income. A particular research interest is child support policy; he has written academic papers and consulted with numerous state governments on the development of their child support guidelines and served as a member of the Washington State Commission on the Review of Child Support Guidelines. In 2004, he was named a national associate of the National Research Council for outstanding contributions to its work, including service on the panel that produced the 1995 report, Measuring Poverty: A New Approach, and the planning group that organized the workshop described in the 2005 report, Experimental Poverty Measures: Summary of a Workshop. He has a Ph.D. in economics from the University of Wisconsin–Madison.

John L. Czajka is a senior fellow at Mathematica Policy Research in Washington, DC. He joined Mathematica in 1978 after a year as lecturer in sociology at the University of California, Berkeley. His work has focused on statistical and policy applications of program administrative data and the evaluation of estimates obtained from survey data. He has directed many studies of health insurance coverage, including analyses of the dynamics of coverage over time and the impact of the Children’s Health Insurance Program on trends in children’s coverage. Much of his research has been conducted for federal agencies, including the Statistics of Income Division of the Internal Revenue Service; the Office of the Assistant Secretary for Planning and Evaluation and the Centers for Medicare & Medicaid Services in the U.S. Department of Health and Human Services; and the Social Security Administration. He is a fellow of the American Statistical Association and a past president of the Washington Statistical Society. He has served on many National Research Council panels, including the panel that produced the 2009 report, Reengineering the Survey of Income and Program Participation, and the panel that produced the 2001 report, Evaluating Welfare Reform in an Era of Transition. He has a B.A. in government from Harvard University and a Ph.D. in sociology from the University of Michigan.

Edwin C. Hustead was senior vice president in charge of the Hay Group actuarial practice Arlington, Virginia, and all Hay Group governmental actuarial and benefits consulting. From 1980 until his retirement in 2007, he was responsible for analyzing and reporting on the financial condition of many governmental employee retirement plans. Prior to working at the Hay Group, he was the chief actuary at the U.S. Office of Personnel Management with responsibility for assuring the actuarial soundness of the largest employee benefit system in the United States. He directed many large-scale

Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×

federal projects, including a series of projects to assist the Congressional Research Service in the analysis of national health care reform proposals and a major series of projects to design and implement the Federal Employees Retirement System. He has also directed a number of comparisons of benefits plans, in the United States and worldwide, for large employers. He was co-chair of the 2004 Technical Review Panel on the Medicare Trustees Report. He is currently chair of the Medicare Steering Committee of the American Academy of Actuaries, a fellow of the Society of Actuaries, and a member of the Academy of Actuaries. He participated in the Society of Actuaries committees that produced the UP94, GAR94, and RP2000 mortality tables and chaired the Academy of Actuaries Task Force on Medical Savings Account. He received a B.A. in mathematics from Franklin and Marshall College in 1963.

Emmett B. Keeler is a professor at the Pardee RAND Graduate School, an adjunct professor at the School of Public Health at the University of California, Los Angeles, and senior mathematician at RAND. In the pathbreaking RAND Health Insurance Experiment, he investigated the theoretical and empirical effects of alternative health insurance plans on episodes of treatment and on health outcomes. The resulting microsimulation model has been used to study spending and insurance choice. Recently, he led a large study to evaluate a new model for helping people with chronic diseases manage their health better. He served on the National Research Council panel that produced the 2010 report Accounting for Health and Health Care: Approaches to Measuring the Sources and Costs of Their Improvement. He has taught at Harvard University and the University of Chicago while on leave from RAND. He is the author or co-author of numerous refereed articles and four books. His research interests are in cost-effectiveness analysis, insurance design, health economics, and health services research. He is a member of the Institute of Medicine and in 2003 was named distinguished investigator by AcademyHealth for his contribution to the field of health services research. He has a B.A. in mathematics from Oberlin College in Ohio and a Ph.D. in mathematics from Harvard University.

Willard G. Manning is a professor in both the Harris School of Public Policy Studies and the Department of Health Studies, in the Division of the Biological Sciences, at the University of Chicago. His primary area of interest is the effects of health insurance on health care and health. He has studied the demand for various health services under both fee-for-service cost-sharing and prepaid insurance, as well as the impact on the appropriateness of care and health status. In recent work, he has examined the optimal insurance coverage for preventive care and treatment, considering

Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×

the trade-off between the costs from moral hazard and the gains from risk-pooling across medical services and over time in health insurance. He has also examined the health effects of insuring the formerly uninsured when the near-elderly become Medicare-eligible at age 65. He has examined statistical, measurement, and economic issues in modeling the use of health services and health care expenditures. His research interests further include the economics of poor health habits, such as smoking and heavy drinking. He is a member of the Institute of Medicine. He has a B.S. from the California Institute of Technology and an M.A. and a Ph.D. in economics from Stanford University.

Wilhelmine D. Miller is a senior fellow with NORC at the University of Chicago and a lecturer in health policy at George Washington University (GW). She served as associate director of the Robert Wood Johnson Foundation’s Commission to Build a Healthier America at the GW School of Public Health and Health Services, overseeing the preparation of the 2009 report Beyond Health Care: New Directions to a Healthier America. Previously, she was a senior program officer at the Institute of Medicine, directing various committees that assessed the health, economic, and community consequences of uninsurance and that made recommendations to federal agencies for incorporating cost-effectiveness information in analyses of regulations addressing human health and safety risks. Her research interests include the uses of cost-effectiveness analysis in health care, the ethical dimensions of resource allocation decisions to improve population health, and policies to reduce socioeconomic inequalities in health. Her degrees in health policy and management and political philosophy are from Harvard and Georgetown Universities, respectively.

Cathy Schoen is senior vice president for policy, research, and evaluation at the Commonwealth Fund in New York. She is a member of the fund’s executive management team and research director of its Commission on a High Performance Health System. Her work includes strategic oversight and management of surveys, research, and policy initiatives to track health system performance. From 1998 through 2005, she directed the Task Force on the Future of Health Insurance. Prior to joining the fund in 1995, she taught health economics at the University of Massachusetts (UMASS) School of Public Health and directed special projects at the UMASS Labor Relations and Research Center. Previously, she directed the Service Employees International Union’s research and policy department. In the late 1970s, she was on the staff of President Carter’s national health insurance task force, where she oversaw analysis and policy development. Prior to federal service, she was a research fellow at the Brookings Institution in Washington, DC. She has authored numerous publications on health policy

Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×

issues, insurance, and national and international health system performance and coauthored the book, Health and the War on Poverty. She holds an undergraduate degree in economics from Smith College and a graduate degree in economics from Boston College.

P.J. Eric Stallard is research professor in the Social Science Research Institute and associate director of the Center for Population Health and Aging in the Duke Population Research Institute at Duke University. His research expertise includes modeling and forecasting for medical demography and health and long-term care actuarial practice. He is principal investigator on a research grant from the Society of Actuaries and on two research subcontracts to Duke from Purdue and Columbia Universities, the primary grantees, funded by the National Institute on Aging. He is senior investigator on three other research grants from the National Institute on Aging covering the areas of health, disability, long-term care, and mortality. He is a fellow of the Conference of Consulting Actuaries, a member of the American Academy of Actuaries, and an associate of the Society of Actuaries. He chairs the American Academy of Actuaries’ Long-Term Care Committee. He recently completed service as a deputy editor at Demography with responsibilities for the demography of aging, actuarial science, and mathematical demography. Previously, he served on the Social Security Advisory Board’s 2007 Technical Panel on Assumptions and Methods. He has a B.S. in psychology from Duke University (1988).

Gooloo S. Wunderlich (Study Director) is a senior program officer for the Committee on National Statistics, where she has directed numerous studies on such topics as measuring food insecurity and hunger, reviewing the National Children’s Study research plan, new measures of disability, and improving health care cost projections for the Medicare population. She has over 50 years of experience at the program and policy levels in health and population policy analysis, research, and statistics in the U.S. Public Health Service, President’s National Advisory Commission on Rural Poverty, the U.S. Bureau of the Census, and at the National Academies. Her professional interests and experience have focused on the conduct and analysis of national health care surveys, analysis and public policy formulation relating to population research, family planning, aging, long-term care, disability, and a wide range of health policy issues. Prior to joining the National Academies in 1990, she was director of the Division of Data Policy in the Office of the Assistant Secretary for Health in the U.S. Department of Health and Human Services, serving for many years as the focus throughout the Public Health Service for data policy development, planning, analysis, coordination of health information systems, and statistical activities. She directed the review and approval of statistical, research, evaluation, administrative, and

Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×

regulatory data collection activities throughout the Public Health Service agencies. She is an elected member of the National Academy of Social Insurance. She received her B.A., M.A., and Ph.D. from the University of Bombay, India, and completed 2 years of postdoctoral studies in sociology and demography at the University of Minnesota and the University of Chicago.

Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 113
Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 114
Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 115
Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 116
Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 117
Suggested Citation:"Appendix: Biographical Sketches of Panel Members and Staff." Institute of Medicine and National Research Council. 2012. Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care. Washington, DC: The National Academies Press. doi: 10.17226/13525.
×
Page 118
Next: PART II: RESOURCES FOR THE STUDY: DEVELOPING A MEASURE OF MEDICAL CARE ECONOMIC RISK - WORKSHOP SUMMARY »
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The United States has seen major advances in medical care during the past decades, but access to care at an affordable cost is not universal. Many Americans lack health care insurance of any kind, and many others with insurance are nonetheless exposed to financial risk because of high premiums, deductibles, co-pays, limits on insurance payments, and uncovered services. One might expect that the U.S. poverty measure would capture these financial effects and trends in them over time. Yet the current official poverty measure developed in the early 1960s does not take into account significant increases and variations in medical care costs, insurance coverage, out-of-pocket spending, and the financial burden imposed on families and individuals. Although medical costs consume a growing share of family and national income and studies regularly document high rates of medical financial stress and debt, the current poverty measure does not capture the consequences for families' economic security or their income available for other basic needs.

In 1995, a panel of the National Research Council (NRC) recommended a new poverty measure, which compares families' disposable income to poverty thresholds based on current spending for food, clothing, shelter, utilities, and a little more. The panel's recommendations stimulated extensive collaborative research involving several government agencies on experimental poverty measures that led to a new research Supplemental Poverty Measure (SPM), which the U.S. Census Bureau first published in November 2011 and will update annually. Analyses of the effects of including and excluding certain factors from the new SPM showed that, were it not for the cost that families incurred for premiums and other medical expenses not covered by health insurance, 10 million fewer people would have been poor according to the SPM.

The implementation of the patient Protection and Affordable Care Act (ACA) provides a strong impetus to think rigorously about ways to measure medical care economic burden and risk, which is the basis for Medical Care Economic Risk. As new policies - whether part of the ACA or other policies - are implemented that seek to expand and improve health insurance coverage and to protect against the high costs of medical care relative to income, such measures will be important to assess the effects of policy changes in both the short and long term on the extent of financial burden and risk for the population, which are explained in this report.

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