1. Based on your experience and familiarity with the Pew program, what did the fellowship really accomplish? What were the most important contributions?
My program's principle accomplishment was that it pulled a number of experienced people, so-called midcareer people, into an environment where they were enabled and helped to become valuable contributors to health care policy, both public and private. They were enabled to do this in a way that grounded policy making in experience and knowledge based on research, which I would say is a very high-quality way to approach policy. That does not mean that policy is not carried out in a political context, which it always is. Yet my experience is that there is a huge advantage in terms of the policy that ends up being made or implemented, grounding it in principle and knowledge, and the political context doesn't just drive it. My program took people who weren't just graduate students and gave them an opportunity to contribute in that way, for example, my participation with the U.S. Congress and also private or quasipublic things like the Kaiser Family Foundation, the University of Virginia, and the Radiological Society of America. A secondary contribution was that it enabled many of us to learn the basics, and in my case more than that because I already had a strong background in health services research, and to do that research in a policy-relevant manner. A lot of health services research that is done is of very little value in developing policy, guiding policy, or guiding action in general. The analog of policy in the private sector is not legislation, regulation, and so forth but how you run an organization and so forth. I think those are the most important contributions of my program. For the program, in general, I think roughly the same things apply. My impression is that the other programs had a lot more junior-level, inexperienced people, and what they turned out were people who were less likely to be able to, at least in the short turn, contribute to policy and more likely to end up in lower-level positions or academic positions. Since they are younger and less experienced you would need to look at longer trajectories. If you look 10 years out you might find that by then they have moved into more senior positions.
2. What was the most innovative or unique aspect of your particular program design and implementation?