Information Trading How Information Influences the Health Policy Process (1997) / Chapter Skim
Currently Skimming:
Foreword and Introduction
Foreword and Introduction
Pages 1-10
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During the life of the program, virtually all the major health care issues that revolve around the triad of access, costs, anc3 quality have come to the forefront of the nation's attention anc3 have been discussed and debated from different policy and political perspectives depending on the year, the party in power, the health care environment, anc3 the social anc3 economic climate. It collie be said, 1
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Health Policy Fellows cleciclec3 that it might be useful to develop a number of case studies focused on major national or state health care initiatives anc3 to look more closely at how information is used anc3 conveyor anc3 to what degree it influences the outcome. The case studies selected anc3 presented in this volume the adoption of the successful Japanese just-in-time (~IT)
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The explosion in recent years in the amount anc3 sources of information around health care issues. The sheer volume of materials that crosses a legislator's or a staffer's desk cluring a typical work week is overwhelming.
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Instead, the importance of timing, leadership, anc3 identifying the right moment for bringing key stakehoIclers to the table really "to clear" are often the make-or-break factors. On Capitol Hill, the use of a dramatic anecdote or packaging of a message around a personal-interest story is a time-testec3 vehicle for garnering public attention more quickly anc3 memorably than the use of more comprehensive anc3 broadly represented information.
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Oliver Fein's paper, "Funding Graduate Medical Education in the Year of Health Care Reform: A Case Study of a Health Issue on Capitol Hill," traces the evolution of the 1994 GME debate in the U.S. Senate.
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According to the author, then majority leacler Senator George Mitchell toIc3 his staff that if health reform clic3 not pass in 1994, one consequence wouIc3 be that Congress wouIc3 be armed with how to make future cuts in Medicare anc3 Meclicaic3. Medicare GME func3ing continues to be on the cutting table in the 105th Congress anc3 may in the end fare less well than in that historical period when health care reform was aciciressec3.
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Benjamin Chu's paper "The Role of Graduate Medical Eclucation Consortia in the Postregulatory Era in New York State," provicles an interesting anc3 timely history of how New York State's Health Care Reform Act of 1996 was clevelopec3 anc3 passed. The clemise of national health care reform anc3 a new political anc3 policy environment proviclec3 a unique Winslow of opportunity for major change agents in New York State to challenge the usefulness of such bedrock issues as the state's highly regulated hospital ratesetting program anc3 traditional funding of GME in a more competitive, market-orientec3 health care marketplace.
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In "Information Tracling, Politics, anc3 Funcling for the National Institutes of Health in the 104th Congress," David Stevens offers a highly informative glimpse into the political process that drives biomedical research in an era of limited budgets. In the new environment even an icon of the American health care system like NTH will have to demonstrate value-aciclec3 performance.
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The biotechnology inclustry's information campaign is focused on the right of Americans to have access to genetic testing, preventing insurance discrimination on the basis of test findings, anc3 limiting the hand of federal regulation over the industry. The information of most interest to consumers focuses on how genetic information is being used to cl iscriminate against incl ivicluals with cl is abling concl itions anc3 health risk factors.
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Plans advocating a fairer anc3 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 anc3 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 anc3 voice for change: (~)
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