ties in Medicare's average adjusted per capita costs (AAPCC). In the case of AAPCC, the major stakeholders have had a special interest in keeping the issue under wraps, given the significant and for the most part adverse financial consequences of any change. Plans advocating a fairer and more equitable payment formula had to "get the story out," do important coalition building and hone a compelling message in the context of current congressional debate related to Medicare reform and budget reductions. From her key role in developing the Fairness in Medicare Coalition, the author offers three important points for any new group wanting to become an effective player and voice for change: (1) welcome the opportunity to testify at a public hearing—being a witness gives a group new on the scene important visibility among the trade press and key members of Congress; (2) develop principles and guidelines for what the group wants to accomplish, but maintain some flexibility as various legislative proposals are drafted; and (3) develop a cadre of dedicated champions.

Anyone interested in public policy and affecting the policy process will find valuable lessons and pointers in this volume. The art of information and information trading in a political environment, while ever changing, continues to be a fascinating if not always edifying reality of the legislative process.



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