The Roosevelt Institution
Policy Proposals
http://rooseveltinstitution.org/policy/health/rooseveltrx/publication/policy
Policy Section Overview
The policy papers for the Roosevelt Rx Publication will follow the general format used in the Roosevelt Institution’s 25 Ideas series. The 25 ideas series is designed with the policy maker in mind: from the two-page, condensed formatting, to the inclusion of concise sets of key facts and talking points. Ideas can focus on the local, state, and federal levels of government and for the Roosevelt Rx publication, they will specifically focus on cost, disparities, and access.
Please send policy submissions to rxpolicy@rooseveltinstitution.org by June 15, 2008.
To see the first 25 Ideas series,
click here and to see more advice click
here.
Good ideas
* Don’t be bound by practicality. We want some stuff to be implementable and get implemented out of this, but we also want some stuff where people are like, “huh, that’s so crazy it just might work.”
* It’s OK if it’s not your idea. We can write up ideas that come from our friends, from other folks on campus, or even stuff that’s already going on around us that could be ported to another state. If you did get your idea from somewhere else, be sure to cite your sources and think about how you can make a good idea even better.
Bad ideas
* Something that’s not an idea. This is not the place for arguments or analyses or reframing or anything like that.
* Something that could not be done. These are things you can do or that some specific person can do.
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First page (300 words)
Title: Be direct and get to the point so the reader can get to the proposal. (4-7 words)
The idea: A one sentence elevator pitch of what you propose to do, how it helps solve the challenge, and what makes it great. (~20-30 words)
Key facts: Give the readers the simple statistics that make them think. How big is the problem? How much does it cost? What evidence is there that your idea will work? (~50-75 words)
Talking points: Talking points are for the politician who picks up your paper and what to tell their constituents. Why is it better than all the other alternatives on the table? (~50-75 words)
Front page: The text on the front page presents the idea, the key facts, and the talking points in a coherent narrative form. Choose your limited number of words wisely. (~150-200 words)
Second page (350 words)
History/ Analysis: Where did this idea come from? What like it has been tried? Is If it has been implemented before, what are the results? This section also justifies the facts and figures on the front page. What would it cost, why would it cost that much? How many people would be affected and which people? You won’t be able to describe all your research here, but keep a copy of your references and resources for when a legislator starts asking for more information.
Audience/ Next Steps: Who benefits from this? Who should care about the idea? Also, if someone is interested in running with this idea, what do they need to do? Is this something someone could implement now? If we can act on it now, where do we start and what is the five-step process for getting it done?
Sources: Tell us how you know what you know (But don’t cite Wikipedia!)
Cost Policy Section
Theme statement
Between 1960 and 2005, health expenditures within the US rose from 5% to 16% of GDP. Although it is often overshadowed by the issue of access, cost control is a major problem within the health sector—even if insurance coverage could be provided to everyone, the trend of rising costs is clearly unsustainable. This section will include ambitious policies designed to reverse this trend.
Some suggested areas for policy ideas
- The insurance industry: Insured individuals are separated from the direct costs of medical services. Can premiums, deductibles, and co-payments be adjusted to better control costs? Are policies like community rating and experience rating helpful in controlling costs? Should insurance be linked to employers?
- Providers: Doctors are unique in that they often both recommend services to their customers and provide these services. Is fee-for-service the best way to pay providers? Should consumers be given information on provider performance? Are monopolies protected too much or not enough in the health sector?
- The role of the federal government: From licensure requirements to advertising restrictions, the federal government imposes many restrictions on competition. Is there too much or not enough government intervention? What effect does the FDA’s drug approval process have on costs? Would a single payer system help us better control costs?
- Entitlement programs: The amount of money Medicare and Medicaid are projected to pay out vastly exceeds the amount they will be bringing in. How can we ensure that we can pay for care that has been promised?
- Other areas: Why do we see regional variation in costs without accompanying variation in outcomes? Is it inevitable that technological advancements will drive up costs? What effect would mandates have on costs? Can preventitive care measures help to control costs?
Health Disparities Section
Theme statement
This section will include policy ideas that characterize disparities in access, education, and health outcomes—whether between insurance schemes, socioeconomic status, race, ethnicity, gender, age, or geographic region—and outlines creative and bold recommendations for the reduction of these disparities and for improvements in the monitoring of such inter-population inequities. Policy ideas that recognize and address the broader social and economic determinants of health—such as housing, education, community, and political institutions—are especially encouraged.
Some suggested areas for policy ideas
- Characterizing and tracking health care inequalities: Before we can hope to address any sort of disparities in health, we must first identify and monitor such inequalities. How can we improve the current system of data collection and outcome monitoring?
- Disparities in education: Disparities in health are not just limited to inequalities in health outcomes. How can we foster a more diverse medical profession of nurses, doctors, and physicians’ assistants?
- Existing programs such as Medicare, Medicaid, Social Security, S-CHIP: How can we make existing and popular programs such as these more equity-oriented?
Access Policy Section
Regardless of whether one sees access to health care as a right or as a privilege, the lack of access to health care in the United States is a major concern in domestic health policy. In general, access to health care can be defined as the availability and accessibility of health care services. Specifically, availability refers to the supply of health care facilities and providers, while accessibility refers to the ability of an individual to utilize those facilities and providers whenever a health care need arises.
Policy questions that target the availability component of access to health care include (but are by no means limited to) whether or not there are enough clinicians in the workforce and whether or not to expand safety-net facilities (like community health centers) into underserved locations.
Policy questions that target the accessibility component of access to health care are abundant, and include how to expand insurance coverage to the 47 million Americans who are currently uninsured and how to reduce or eliminate non-financial barriers to care through the provision of enabling services. Such services might include transportation, translation, and health literacy outreach efforts. Please note that while the high cost of health care might represent a significant barrier to access, papers on that topic should be submitted to the health care costs section.
These are but a few examples of policy issues surrounding access to health care. We encourage you to draft submissions that propose unique but feasible options for increasing Americans’ access to health care by focusing on the availability component, the accessibility component, or both.