Policy Roundtable Abstracts - AcademyHealth

Performance Health System is charged with promoting a
high-performing health system that provides all
Americans with affordable access to high-quality, safe
care while maximizing efficiency in its delivery and
administration. The Program on Payment and System
Reform supports the analysis and development of
payment policy options that include incentives to
improve the effectiveness and efficiency of health care
delivery while curbing growth in health spending.
Previously, he directed the Centers for Medicare and
Medicaid Services Office of Research, Development,
and Information.
The panelists will include: Marsha Gold, Ph.D., a
senior fellow at Mathematica Policy Research in
Washington, DC. She is a nationally known expert on
health care delivery and financing, especially in
managed care and public programs such as Medicare
and Medicaid. Her expertise covers trends in the
organization and financing of medical care and its
implications for access to care.
Lawrence Casalino, M.D., Ph.D., Chief of the
Division of Outcomes and Effectiveness Research and
The Livingston Farrand Associate Professor of Public
Health in the Department of Public Health at Weill
Cornell Medical College. His research focuses on the
organization of physician and hospital practice.
Randall Brown, Ph.D., an expert in health care
policy issues related to care for the chronically ill, longterm
care, managed care, and quality of care. He is
nationally known for his evaluations of care coordination
and disease management programs for Medicare
beneficiaries, as well as studies of long-term care issues
and Medicare managed care.
Paul Wallace, M.D., medical director for Health
and Productivity Management Programs at Permanente
Federation and senior advisor for the Care Management
Institute (CMI) and Avivia Health, the Kaiser Permanente
disease management company established in 2005.
Since 1997, his full-time focus has been administrative
and development endeavors in the application of
evidence-based medicine within disease management,
measurement of clinical performance, technology
assessment, and use of the electronic medical record.
The Ongoing Politics of Health Reform
Organizer/Moderator: Walter Zelman
Monday, June 13 * 8:00 a.m.–9:30 a.m.
Panelists: Walter Zelman, PhD, California State
University, Los Angeles; Mollyanne Brodie, PhD,
Kaiser Family Foundation; Len Nichols, PhD, George
Mason University; Alan Weil, JD; National Academy for
State Health Policy
Roundtable Summary: I propose to offer a policy panel
focused on the ongoing politics of health reform. The
panel will explore the political elements of the ongoing
debate over health reform and the efforts of some to
repeal or alter it and others to defend it and move it
forward. While reform has passed it is clear that the
political struggle around it goes on, with a variety of
efforts underway to undermine or repeal it. While few
expect reform to be repealed in the near term, efforts at
the state and national levels still threaten its
implementation and conceivably, the election of 2012
could be, in large part, a referendum on reform.
Specifically, the panel will look at such factors as
public opinion, support and opposition of activities of
various interest groups, positions of key political and
partisan organizations, and messaging and other
strategies being deployed by reform supporters and
opponents. It will also review those health reform
constructs that are engendering the most controversy
and how the different stakeholder and political
organizations are addressing those issues both in terms
of content and message.
The panel will focus on both federal and state
government activities. At the federal level the panel will
review political activity in both Congressional and
regulatory arenas. The purpose here is not to explore
the substantive proposals at issue. It is assumed that
those will be thoroughly addressed by other ARM
sessions. The purpose here is to look at the political side
of the reform equation: interest group efforts, public
mobilization, electoral considerations, media and
messaging strategies, etc. Specific policy areas may be
addressed, but primarily to the extent that they are being
highlighted by reform opponents or supporters as part of
the larger reform debate, and to the extent that those
policy areas may still be open to a larger negotiation on
reform policy. Looking ahead, the panel will discuss the
role the ongoing health reform debate may assume in
2012 elections.
Regarding health reform politics in the states,
the panel will focus primarily on the efforts of the states
to establish the health reform infrastructure necessary to
implement reform. Most specifically the panel will review
Exchange-focused discussions and activities in the
different states. It will review how political leadership in
the various states –especially governors and
legislators—are approaching the exchange issue. E.g.
are Republican governors taking the view that while they
oppose reform and may fight it in court proceedings they
are still going to support creating the exchange
infrastructure should their efforts to roll back reform fail
Or, are at least some taking the view that the process of
creating (or failing to create exchanges) is part and
parcel of the larger effort to undermine reform To this
end, an effort will be made (data permitting) to compare
the progress being made on the creation of exchanges
in different political environments. As will be the case
with a review of national government activities, the panel
will look at the state level involvement of stakeholder
groups, political leadership, and messaging strategies.
Four individuals have agreed to participate in the
panel discussion. (One more may be added) All have
been deeply involved in the reform process in one way
or another. All are unquestioned experts in the both the
policy and politics of health reform. All have written
extensively on the subject, as researchers and policy
analysts. All are continuing that involvement and that
research.