An Open Powerpoint Deck to Policy Makers

Questions, hope, anxieties from a health economist in the US Midwestern tundra

Stephen T Parente, Ph.D., M.P.H., M.P.P.University of Minnesota

Presentation at the AIS, Health Policy Makers Conference, July 10, 2008

Sponsored by the opportunity cost of college education for the three children of Stephen T. and Carrie D. Parente of Wayzata, MN.

Questions - Uno Why do we think COMPREHENSIVE health

reform is possible in 2009 when it was impossible under the Wilson, Roosevelt, Truman, Johnson, Nixon, Carter and Clinton Administrations? Did a ‘stakeholder’ take a holiday, go out of

business? Before we invest in an independent assessment

on the geopolitical fall-out of various military incursions of the decade, can someone explain in the same sort of CNN Reports style we all like why health reform always went so bad so long ago……

Questions - Duo Help me understand how my and many

other Universities square the following simultaneous activities? Health policy courses about covering the

uninsured Medical school course to increase ultra

specialization Business school courses to make more from less

public health insurance programs through med technology and pharma.

Or: UtilityAmerica = f[H, M, B, X(other things)]subject to $36 trillion of unobligated Medicare funds

Questions - Tres Can we stop seeing ‘dead people’ in

our public policy? McCarran-Ferguson (1945) Employer-based health insurance tax

exemption (1943 – origin moment) Or – are we willing to have 1940s

medical care (e.g., ‘best practice for schizophrenia’ – pre-frontal partial lobotomy) in exchange for preserving these policies without question or debate that results in a floor vote?

Hope

You all actually came to this.

Even folks in this for the fourth iteration, have not lost patience that something should be on the table.

Both parties presidential campaigns have real CHANGE on the agenda.

Anxieties

Health economists find that technology is both good for society and huge cost driver.

Stakeholders will not come clean over their past in an effort to say what is different this time.

Actuaries find the best way to keep costs within general inflation is through catastrophic insurance.

Advocating catastrophic insurance for all might be the surest way to a two year House of Representatives visit.

Econometric ApproachDidn’t you get your coffee yet

Do you know that economists spend the equivalent of 5 years of waking time concerned with the econometric issue of endogeneity.

Quiz! Is a first order condition the marginal effect of change in a reduced form equation or a House rule for subcommittee procedure?

Caveats

I worked for a Democratic Senator. I run a medical industry MBA program. I actually know something about public

health. I’m advising the McCain 2008 campaign. I lost most functioning follicles working for

an insurer.As part of treatment to restrain follicle

growth, I consult for health insurers. I’d rather take you all sailing right now.

Discussion

To quote Chancellor Gorkin in Star Trek VI – The Undiscovered Country (Shakespeare Too) – “Don’t Let it End this Way, Captain”.

And Spock: “There is a historic opportunity for peace”

And Kirk: “Don’t believe them, Don’t trust them… Let (the Klingons as a race) die!”

We have all seen this story before.Please, please, please – let’s all try to make ‘The

Undiscovered Country’ – The Future - a real option this time for health reform. It’s our opportunity to fail again.

Thank You!

For more information on our research, please visit:

www.ehealthplan.org

Stephen T. Parente, Ph.D., M.P.H., M.S.Associate Professor, Department of FinanceDirector, Medical Industry Leadership InstituteCarlson School of ManagementUniversity of Minnesota321 19th Ave. South, Room 3-122Minneapolis, MN 55455612-624-1391 (v)sparente@csom.umn.eduhttp://www.tc.um.edu/~paren010