2008 Synergy Workshop Institute of Medicine Washington, 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