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’ – prefrontal 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 Approach
 Didn’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 Finance
Director, Medical Industry Leadership Institute
Carlson School of Management
University of Minnesota
321 19th Ave. South, Room 3-122
Minneapolis, MN 55455
612-624-1391 (v)
[email protected]
http://www.tc.um.edu/~paren010