2008 Synergy Workshop

Institute of MedicineWashington, DC

Advocating Change in Health Policy

You can’t tell the players without a scorecard

Success inside the Beltway

• Understanding the Drivers• Who’s Who in the Iron

Triangle of Health Policy• Strategy Success

The Environment

• Economy• Mounting Federal Deficit• Politics

– Democratic Control of Congress– Republican President’s Popularity – Election Cycle

Who Makes Federal Policy?

• Administration

• Congress

• Stakeholders

The Administration

• Executive Office of the President

• Office of Domestic Policy

• Office of Management and Budget

Administration

• Health and Human Services

• Veterans Affairs

• Defense

ADMINISTRATION• Health and Human

Services–Center for Medicare and

Medicaid Services

–National Institutes of Health

HHS– Food and Drug Administration– Health Resources and

Services Administration– Substance Abuse and Mental

Health Services Administration– Centers for Disease Control– Indian Health Service

The Congress

• Senate Majority Leader

• Speaker of the House

Senate Committees

• Finance

• Health, Education, Labor and Pension

• Appropriations

House

• Ways and Means

• Energy and Commerce

• Appropriations

Stakeholders

Voluntary Health Associations

• March of Dimes

• American Heart Association

• National Cancer Society

• American Diabetes Association

• Disabled American Veterans

• National Alliance Mentally Ill

Trade Associations• American Hospital Association• Association of American Medical

Colleges• Federation of American Health

Systems• Pharmaceutical Research and

Manufacturers Association• Business Coalitions

UNIONS

• AFL-CIO

• UAW

• SEIU

Professional Societies

• American Medical Association

• National Medical Association

• American Nurses Association

• American College of Physicians

Academia/Think Tanks

• Every University

• Heritage

• Cato

• Urban Institute

• Opportunity Agenda

• Brookings Institute

Secrets to Success

Academics vs Politicians

Understanding and Strategy

Thought Processes• Scientific

– Problem Statement– Literature Search– Methods– Data Analysis– Results– Limitations– Summary and

Conclusions

• Political– The issue– Current Law– Positions

• The member• The party• Relevant Stakeholders

Budget Impact and Distribution

Staff recommendation

Values• Academic

– Publish or Perish– A Mile Deep– Peer Review– Teaching – Research/Grants– Community Service– Endowed Chair– Tenure

• The Hill– The Power of the Press– A Mile Wide– Public opinion– Meet and Greet– Fundraising– Jurisdiction (A/B)– Committee Chair– Reelection

PREFLIGHT CHECKLIST

• LEGAL

• TECHNICAL

• POLITICAL

• JURISDICTIONAL

• PERSONAL

Rules of the Road

• Rule #1 --- be honest

• Rule #2 --- seize the initiative

• Rule #3 --- never get between a

big dog and a fire hydrant