December 2001

Grant Results

SUMMARY

From 1993 to 1998, the Health Care Economic Council (later changed to the Council on the Economic Impact of Health System Change) formed and met 12 times.

The council is a private, nonpartisan forum of nationally recognized economists, including two Nobel laureates, and industry leaders who:

  • Evaluate changes in the US health care system.
  • Identify and analyze key longer-term economic issues.
  • Generate new ideas for improving the financing and delivery of quality health services in the United States.

Key Results

  • The council met 12 times, providing opportunities for a discussion of issues among members and guests, who included health services researchers, members of Congress and their staffs, government officials, industry leaders and the media. Among the issues addressed by the council were:
    • Reform of the Medicare program.
    • Sources of funds to expand access to health insurance for the uninsured.
    • Hospital ownership conversions from nonprofit to for-profit status.
    • The impact of changes in the health care system on the development, adoption, and diffusion of new health care technologies.

Funding
The Robert Wood Johnson Foundation (RWJF) supported this project through two grants totaling $1,393,027 to the Brandeis University, Florence Heller Graduate School for Advanced Studies in Social Welfare, where the council is based.

 See Grant Detail & Contact Information
 Back to the Table of Contents


THE PROBLEM

In the early 1990s, health care policymakers, government officials, and others were engaged in a series of contentious discussions over ways to reform the current system of financing and delivering health care.

Recognizing the need for informed, nonpartisan discussions, RWJF staff and consultants began to talk about creating a high-level health economics institute analogous to some of the organizations that focus on foreign policy or international economic activities; its goal would be to analyze data and research and to develop models of the economic forces affecting the health care industry.

Given the vast resources already directed at health care research from multiple sources, however, they concluded it would not be feasible to create a single preeminent institution in the field. Ultimately, the decision was made to create a more modest body that could act as an "honest broker" of information and analysis and help the nation focus on responsible solutions in the midst of an increasingly polarized debate.

Through grants to Princeton University, RWJF also had begun sponsoring a series of health care economics conferences, which were known as the Princeton Conferences. The first was on the Clinton administration' health care reform plan (see Grant Results on ID# 023158) and the second on universal health coverage (ID# 023572).

 Back to the Table of Contents


THE PROJECT

The Council was established to provide a private nonpartisan forum of recognized experts who evaluate changes in the health care system, to provide leadership in identifying and analyzing key economic issues, and to generate new ideas for improving the financing and delivery of health services in the United States.

Its two primary activities have been: conducting independent, authoritative analyses of major health trends; and convening the nation's top experts to discuss relevant issues. The Council's members include some of the most influential economists in the country (among them, two Nobel laureates) representing academia, health care institutions, health care industry members, and foundations, as well as other industry leaders. (For membership rosters, see Appendix 1 and 2.)

Under the first grant (ID# 022975), the Council was to examine the economic consequences of reforming the health care system, focusing on the impact of major reform plans on:

  1. employers who pay for the health care of their workers;
  2. employment in the health sector;
  3. the nation's overall economic growth, particularly with regard to small business employment and technological innovation;
  4. government spending and the national debt.

However, by the time of the Council's first meeting in the Fall of 1994, passage of national health care reform legislation appeared unlikely, and significant market-based changes were altering the nature of health care institutions and the financing and delivery of care. Consequently, the Council shifted its focus from analyzing the consequences of specific health reform plans to examining the impact of longer-term economic trends, focusing particularly on the increasing consolidation of health systems and the erosion of employer-sponsored health insurance.

Initially, the Council met in private with a few invited guests to discuss issues, assign research projects to qualified experts, and release its findings and recommendations as a body. At each of the first two meetings, however, members decided not to try to reach consensus on every issue, but instead to report the range of opinions represented among the Council's politically diverse membership.

Beginning with its third meeting in November 1994, the Council opened its meetings to the public and moved the setting from Boston, Mass., to Washington D.C., which helped to attract members of Congress and their staffs, senior government officials, and the media, as well as health services professionals and industry leaders.

The second grant (ID# 023281) allowed the Council to continue its work of addressing the economic impact of changes in the health care sector, capitalizing on the organizational and analytic groundwork that had already been laid.

In addition to conducting its own meetings, the Council also took over responsibility for organizing and running the series of "Princeton Conferences" on health care economics issues, which RWJF had been sponsoring via grants to Princeton University (ID#s 023158 and 023572).

The Council's involvement began with the May 1996 event on the future of financing and delivering care for the poor and uninsured (see Grants Results on ID# 029344), and continued with sponsorship of a conference on the future of Medicare (see Grant Results on ID#s 030394/031827), and a conference on the role of regulation in a market-oriented environment (see Grant Results on ID# 032672).

David C. Colby, Ph.D., a senior policy researcher and senior program officer at RWJF completed an assessment of the Council's work, based on interviews with Council members, policymakers, researchers, and media representatives, in the fall of 1998. That assessment concluded that the Council's performance, while good and improving over time, had not reached its full potential for the highest-level intellectual consideration of issues and for dissemination to outside groups.

 Back to the Table of Contents


RESULTS

Results of ID# 022975

  • The Council convened five meetings. Among the topics explored:
    • The impact on wages, economic growth, and government spending of employer mandates to provide health insurance to employees.
    • The effect of rate regulation and competition on state-level health care spending.
    • The changing structure of the health care industry and alternative approaches to cost containment.
    • The decline in employer-based health insurance.
    • Hospital mergers and antitrust policy in the United States.
    • The combined impact of changes in Medicaid, Medicare, and private health insurance on the uninsured.
  • The Council commissioned five research papers to highlight critical issues at each meeting and to stimulate further research and discussion. See the Bibliography for details. Topics were:
    • The health care delivery system.
    • Experiences in states that have had limited growth of hospital costs.
    • Labor market trends and their impact on employment-based health insurance.
    • Health insurance availability and the retirement decision.
    • Market concentration and antitrust policy in the health care industry.
  • The Council produced a recommended agenda for future research on market consolidation, antitrust, and public policy in the health care industry. Published and distributed nationally by RWJF, the research agenda spurred conferences, meetings, and research activities. It also formed the basis for a special Request for Proposals from the federal Agency for Healthcare Policy and Research (AHCPR).

Results of ID# 023281

  • The Council convened seven meetings. The following topics were explored:
    • The economic impact of the reduced growth in health care expenditures.
    • The conversion of hospitals from not-for-profit to for-profit status.
    • The impact of health system change on the development and diffusion of health care technology.
    • Potential sources of funds for the incremental expansion of health insurance.
    • The impact of health system change and the Balanced Budget Act of 1997 on hospital revenues, costs, and margins.
    • Health insurance for the near elderly.
    • The reemergence of health care inflation.
  • The Council commissioned nine working papers that guided meeting discussions. See the Bibliography for details. The papers covered these topics:
    • The nursing workforce and US hospitals.
    • The economic impact on New England of reduced growth in health care expenditures.
    • The conversion of hospitals from not-for-profit to for-profit status.
    • Current attitudes towards health care reform.
    • State regulation of health industry conversions from not-for-profit to for-profit status.
    • Advances in health care technology.
    • Sources of financing for incremental health care reforms.
    • Health insurance for the near elderly.
    • The near-term outlook for private health insurance spending.
  • The Council produced a recommended research agenda on how changes in the health system affect the development and use of new medical technologies.
  • A survey was fielded among Council members to discern their views on the role of regulation in a market-oriented health care system.

Communications

Council members and staff produced published eight articles in leading policy journals, including The New England Journal of Medicine and Health Affairs, in addition to a number of working papers and research agendas. Coverage of the Council's work has appeared in such national publications as Modern Healthcare and the Boston Globe. In addition, Council members and staff have made presentations at national meetings and in invited testimony before members of Congress. The Council's Web site describes the organization's activities, including meetings and publications. See the Bibliography for complete details.

 Back to the Table of Contents


LESSONS LEARNED

  1. The press coverage of a meeting may be determined in part by whether an issue is current at the time of the discussion. The Council's attempt to anticipate future policy concerns sometimes meant that areas of immediate interest were not discussed, which affected the extent to which its efforts received press coverage.
  2. The format of meetings is crucial to their success as convening activities. It was important to find an appropriate balance between informing the audience and allowing ample opportunity for discussion among Council members.
  3. Potential drawbacks exist to creating boards and forums comprised of high-visibility individuals. In particular, competing obligations may limit the time commitment members can make, preventing the fullest possible use of the available expertise.
  4. Projects designed to identify early trends and policy issues pose challenges because there is little inclination in Washington to tackle problems before they pose an immediate concern. Remaining topical is also made difficult by rapid changes in the health care scene.

 Back to the Table of Contents


AFTER THE GRANT

Since the close of the second grant, the Council has met five times with continued support from RWJF (ID# 035039, a $1.7 million, 36-month grant that includes support of the Princeton conferences). Topics of these meetings have been:

  1. policy options and trade-offs in expanding health insurance and strengthening the safety net;
  2. tax credits for the uninsured;
  3. Medicare provisions of the Balanced Budget Act;
  4. the impact of technological change on the cost of health care;
  5. current forces of change facing hospitals.

Topics planned for 2001 include structural changes looming for the hospital industry and medical inflation. As part of the grant, the Council also hosted a three-day retreat for a group of nationally recognized experts in a variety of fields to consider the economic implications of providing health and income security programs to an aging population. A book based on papers presented at the retreat is currently in preparation.

 Back to the Table of Contents


GRANT DETAILS & CONTACT INFORMATION

Project

Research on the Economic Implications of Health Care Reform

Grantee

Brandeis University, Florence Heller Graduate School for Advanced Studies in Social Welfare (Waltham,  MA)

  • Amount: $ 498,822
    Dates: October 1993 to September 1996
    ID#:  022975

  • Amount: $ 894,205
    Dates: November 1995 to October 1998
    ID#:  023281

Contact

Stuart H. Altman, Ph.D.
(617) 736-3803
altman@brandeis.edu

Web Site

http://sihp.brandeis.edu/council

 Back to the Table of Contents


APPENDICES


Appendix 1

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Members of the Council on the Economic Impact of Health Care Reform, 1994

Stuart H. Altman, Ph.D. (Chairman)
Sol C. Chaikin Professor of National Health Policy
Brandeis University
Waltham, Mass.

Henry Aaron, Ph.D.
Director of Economic Studies
The Brookings Institution
Washington, D.C.

Joyce Clifford, R.N., M.S.N.
Vice President for Nursing and Nurse-in-Chief
Beth Israel Hospital
Boston, Mass.

Karen Davis, Ph.D.
Executive Vice President
The Commonwealth Fund
New York, N.Y.

Douglas A. Fraser
University Professor of Labor Studies
Wayne State University
Detroit, Mich.

Michael J. Graetz, L.L.B.
Justus S. Hotchkiss Professor of Law
Yale Law School
New Haven, Conn.

Lawrence R. Klein, Ph.D.
Benjamin Franklin Professor of Economics, Emeritus
University of Pennsylvania
Philadelphia, Pa.

James Mongan, M.D.
Executive Director
Truman Medical Center
Kansas City, Mo.

Patricia Nazemetz
Director of Corporate Benefits
Xerox Corporation
Stamford, Conn.

Robert Patricelli
Chairman and CEO
Value Health, Inc.
Avon, Conn.

Uwe E. Reinhardt, Ph.D.
James Madison Professor of Political Economy
Princeton University
Princeton, N.J.

Charles Sanders, M.D.
Chairman
Glaxo Inc.
Triangle Park, N.C.

Robert M. Solow, Ph.D.
Professor of Economics
Massachusetts Institute of Technology
Cambridge, Mass.

Anthony Watson
President
Health Insurance Plan
New York, N.Y.

Burton Weisbrod, Ph.D.
Director & John Evans Professor of Economics
Center for Urban Affairs and Policy Research
Northwestern University
Evanston, Ill.

Gail Wilensky, Ph.D.
Senior Fellow
Project Hope
Bethesda, Md.


Appendix 2

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Members of the Council on the Economic Impact of Health System Change, 2000

Stuart H. Altman, Ph.D. (Chairman)
Sol C. Chaikin Professor of National Health Policy
Brandeis University
Waltham, Mass.

Henry J. Aaron, Ph.D.
Director, Economics Studies Program
The Brookings Institution
Washington, D.C.

David Blumenthal, M.D.
Chief, Health Policy Research and Development Unit
Massachusetts General Hospital
Boston, Mass.

Stuart M. Butler, Ph.D.
Vice President, Domestic and Economic Policy Studies
The Heritage Foundation
Washington, D.C.

Karen Davis, Ph.D.
President
The Commonwealth Fund
New York, N.Y.

Paul B. Ginsburg, Ph.D.
President
The Center for Studying Health System Change
Washington, D.C.

Judith R. Lave, Ph.D.
Professor of Health Economics
University of Pittsburgh

Harold S. Luft, Ph.D.
Professor of Health Economics
University of California at San Francisco

Joseph P. Newhouse, Ph.D.
Professor of Health Policy & Management
Harvard University
Boston, Mass.

Mark V. Pauly, Ph.D.
Professor of Health Care Systems
University of Pennsylvania
Philadelphia, Pa.

Uwe E. Reinhardt, Ph.D.
James Madison Professor of Political Economy
Princeton University
Princeton, N.J.

Robert D. Reischauer, Ph.D.
Senior Fellow
The Brookings Institution
Washington, D.C.

Robert M. Solow, Ph.D.
Professor of Economics
Massachusetts Institute of Technology
Cambridge, Mass.

Burton Weisbrod, Ph.D.
John Evans Professor of Economics
Northwestern University
Evanston, Ill.

Gail R. Wilensky, Ph.D.
Senior Fellow
Project Hope
Bethesda, Md.

 Back to the Table of Contents


BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Books and Reports

Cannon NL. The Health Care Delivery System. Waltham, Mass.: Council on the Economic Impact of Health Care Reform, 1994. Working paper presented to the Council, April 1994.

Cohen HA. Experiences in States which have had Limited Hospital Cost Growth. Waltham, Mass.: Council on the Economic Impact of Health Care Reform, 1994. Working paper presented to the Council, April 1994.

Shactman D and Altman S. Market Consolidation, Antitrust, and Public Policy in the Health Care Industry: Agenda for Future Research. Princeton, N.J.: The Robert Wood Johnson Foundation, 1995.

Fronstin P, Snider S, and Salisbury D. Labor Market Trends and Their Impact on Employment-Based Health Insurance. Waltham, Mass.: Council on the Economic Impact of Health Care Reform, 1995. Working paper presented to the Council, May 1995.

Thorpe K, Shactman D, Altman S, and Shields A. The Combined Impact on Hospitals of Reduced Spending for Medicare, Medicaid and Employer-Sponsored Insurance. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1995.

Thorpe K, Shields A, Gold H, Shactman D, and Altman S. Anticipating the Number of Uninsured Americans and the Demand for Uncompensated Care. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1995.

Aiken L, Sochalski J, and Anderson G. Nursing Workforce and US Hospitals: Current Status and Future Implications. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1996.

Howell J and Frankel L. The Regional Economic Impact of Reduced Growth in Health Care Expenditures: The Case of New England. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1996.

Shactman D and Altman S. The Conversion of Hospitals From Not-For-Profit to For-Profit Status. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1996.

Shactman D and Taylor H. The Public Versus the Experts: Current Attitudes Towards Health Care Reform. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1996.

Shactman D and Fishman A. State Regulation of Health Industry Conversions From Not-For-Profit to For-Profit Status. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1996.

Bishop CE and Thomas CP. Advances in Health Care Technology in an Era of Health System Change. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1997.

Thorpe K E. Sources of Financing for Incremental Health Care Reforms. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1997.

Shactman D, Altman SH, and Thomas CP. "Health Insurance for the Near Elderly. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1998.

Thorpe KE. Back to the Future or Forward to the Past? The Near-Term Outlook for the Private Health Insurance Spending. Waltham, Mass.: Council on the Economic Impact of Health System Change, 1998.

Articles

Altman SH and Shactman D. "Should We Worry About Hospitals' High Administrative Costs?" New England Journal of Medicine, 336(11): 798–799, 1997.

Bishop CE. "Health Cost Containment: What It Will Mean for Workers and Local Economies." Public Health Reports, 113(3): 204–213, 1998. Abstract available online.

Claxton G, Feder J, Shactman D, and Altman SH. "Public Policy Issues In Nonprofit Conversions: An Overview." Health Affairs, 16(2): 9–28, 1997. Abstract available online.

Shactman D. "States Must Guard Charitable Assets." Modern Healthcare, 26(47): 33, 1996.

Shactman D and Altman SH. "Examining the Decline in Employment Based Health Insurance." Compensation Benefits Management, 1996.

Shactman D and Altman SH. "Hospital Conversions and Uncompensated Care." Health Affairs, 16(3): 270–272, 1997.

Shactman D and Altman S. "A Study of the Decline in Employment Based Health Insurance." Commerce Clearing House Health Law and Policy Reporter, 5173–5208, 1995.

Shactman D and Altman S. "Market Consolidation, Antitrust, and Public Policy in the Health Care Industry." Commerce Clearing House Health Law and Policy Reporter, 7106–7122, 1995.

Survey Instruments

"The Role of Regulation in a Market-Oriented Health Care System." The Council on the Economic Impact of Health System Change, fielded March 5–7, 1998.

Sponsored Conferences

"Impact of an Employer Mandate, The Changing Structure of the Healthcare Industry and Alternative Approaches to Cost Containment," April 24–25, 1994, Boston, Mass. Private meeting attended by Council members and invited guests.

Keynote Presentations

  • Nancy L. Cannon, "The Health Care Delivery System."
  • Harold A. Cohen, "Experiences in States which have had Limited Hospital Cost Growth."
  • Jonathan Gruber, "Projections on the Impact of the Employer Mandate on Jobs, Wages and Job Mobility."

Second meeting of the Council, July 11, 1994, Boston, Mass. Private meeting attended by Council members and invited guests.

Keynote Presentations

  • Jonathan Gruber, "Labor Implications of Employer Mandate."
  • Joel Cantor, "Examining Private Employer-Based Health Insurance in Ten States."

"Hospital Mergers and Antitrust Policy in the US," November 27, 1994, Washington, D.C. Attended by health care experts, Congressional staff and the media.

Keynote Presentations

  • David Shactman, "Market Concentration, Antitrust, and Public Policy in the Health Care Industry: Agenda for Future Research."
  • Glen Melnick, "The Case of California."
  • Alphonso O'Neil-White, "GHAA's Perspective on Antitrust Policy."
  • John Horty, "Community Hospitals."

"The Decline of Employer-Based Health Insurance," May 1, 1995, Washington, D.C.

Keynote Presentations

  • David Shactman, "Overview: The Decline in Employer-Based Health Insurance."
  • David Salisbury, "An Analysis of the Decline of Employment-Based Health Insurance between 1988 and 1993."
  • Tom Glynn, "Loss of Employer-Based Insurance Among the 'Anxious Class.'"

"Assessing the Total Impact: How Combined Changes in Medicaid, Medicare, and Private Health Insurance Will Affect the Number of Uninsured and the Health Delivery System," November 8, 1995, Washington, D.C. Attended by 54 individuals from 15 organizations. Organizations represented include the Health Care Finance Administration (HCFA), Heritage Foundation, American Medical Association, Service Employees International Union, Prospective Payment Assessment Commission (ProPAC), and Chrysler Corporation. Four presentations were made.

Keynote Presentations

  • Kenneth Thorpe, consultant to the Council, "The Impact of Changes in Medicaid and Declines in Employment Sponsored Insurance on the Number of Uninsured and the Amount of Uncompensated Care."
  • Stuart Guterman, "The Impact of Changes in Medicare on the Hospital Sector."
  • Stuart Butler, "The Impact of Entitlement Reform and Market-Based Changes on the Health Care System."
  • James Tallon, "The Health Care Future: Will the Emerging Public and Private Systems of Care Serve the Health Needs of the Country?"

"The Economic Impact of Reduced Growth in Health Care Expenditures," July 23, 1996, Washington, D.C. Attended by 89 individuals from 50 organizations. Examples of organizations represented include the American Nurses Association, Congressional Budget Office, Institute of Medicine, and National Academy of Sciences. Four presentations were made.

Keynote Presentations

  • Christine Bishop, "An Overview of the General Economic Impact of Reduced Growth in the Health Care Sector."
  • James Howell, "The Regional Impact of Reduced Growth: The Case of New England."
  • Henry Simmons, "An Employers Perspective of Reduced Growth in the Health Care Sector."
  • Linda Aiken, University of Pennsylvania, "The Impact on Nurses of Organizational Change and Reduced Health Sector Growth."

"Conversion of Hospitals from Not-for-Profit to For-Profit Status," October 4, 1996, Washington, D.C. Attended by 78 individuals from approximately 60 organizations. Examples of organizations represented include the US Senate (staff), American Association of Health Plans (AAHP), Lewin Group, Ford Motor Company, and the Federal Trade Commission. Five presentations were made.

Keynote Presentations

  • David Shactman, Council staff, "Conversions of Hospitals from Not-for-Profit to For-Profit Status."
  • David Shactman and Andrea Fishman, both Council staff, "State Regulation of Health Industry Conversions from Not-For-Profit to For-Profit Status."
  • Thomas Scully, American Federation of Health Systems, "The Community Role of Investor-owned and Nonprofit Organizations - A Perspective."
  • James Swartz, Deputy Attorney General of California, "Proposed Guidelines for State Regulators."

"The Impact of Health System Change on the Development and Diffusion of Health Care Technology," June 22–23, 1997, Washington, D.C. Attended by 53 individuals from approximately 38 organizations. Examples of organizations represented include the Institute of Medicine, The Alpha Center, and Eli Lilly and Co. Seven presentations were made.

Keynote Presentations

  • Christine Bishop, "Technology in an Era of Health System Change."
  • Blair Beebe, "Impact of Health System Change on Adoption and Diffusion of Medical Technologies."
  • Bryan Luce, "Impact of Health System Change on Adoption and Diffusion of Medical Technologies."
  • Burton Weisbrod, "Impact of Health System Change on Applied Research."
  • Richard Lamm, "Health Care Technology in a World of Limited Resources."
  • Charles Sanders, "Impact of Health System Change on Basic Medical Research."
  • David Korn, "Impact of Health System Change on Basic Medical Research."

"Potential Sources of Funds for Incremental Expansion of Health Insurance," October 9, 1997, Washington, D.C. Attended by 84 individuals from 60 organizations. Examples of organizations represented include the US Congress (staff), Medicare Payment Advisory Commission (MedPAC), National Academy of Social Insurance, United Hospital Fund of New York, and the US General Accounting Office. Three presentations were made.

Keynote Presentations

  • Kenneth Thorpe, "Sources of Financing for Incremental Health Care Reform."
  • Nancy Kane, "Exploring the Value of Hospital Tax-Exemption."
  • Raymond Sweeney, "The New York State Health Care Reform Act."

"The Impact of Health System Change and the Balanced Budget Act of 1997 on Hospital Revenues, Costs, and Margins," November 21, 1997, Washington, D.C. Closed Council Meeting attended by Council members and staff; invited individuals, the American Hospital Association, and ProPAC. Two presentations were made.

Keynote Presentations

  • Kenneth Thorpe, "Estimated Hospital Revenues, Expenditures and Margins."
  • Dominic Hodgkin, "Medium Hospital Cost Projections."

"Health Insurance for the Near Elderly," May 27, 1998, Washington, D.C. Attended by 61 individuals from 39 organizations. Examples of organizations represented include The White House, US Congress, US Senate, Health Insurance Association of America (HIAA), American Association of Retired Persons (AARP), AFL-CIO, and the Blue Cross/Blue Shield Association. Five presentations were made.

  • David Shactman, "Current Trends in the Supply, Demand, and Cost of Health 1nsurance for the Near Elderly and Early Retirees."
  • Deborah Chollet, "Problems of Access and Cost of Health Insurance in the Individual Market."
  • Christopher Jennings, "The Clinton Plan."
  • David Kendall, "The FEHBP Plan."
  • Chip Khan, "Industry Perspective."

"Is Health Care Inflation Re-emerging?" September 16, 1998, Washington, D.C. Attended by 73 individuals from 50 organizations. Examples of organizations represented include the Congressional Budget Office (CBO), The Urban Institute, Families USA Foundation, The Henry J. Kaiser Family Foundation, and the Institute of Medicine. Four presentations were made.

Keynote Presentations

  • Paul Ginsburg, "Current Trends in Health Premium Costs and Underlying Causes."
  • Kenneth Thorpe, "Future Trends in Health Premium Costs and Underlying Causes."
  • Mark Freeland, "The Next Ten Years of Health Spending: What Does the Future Hold?"
  • Mary Jane England, "The Outlook for Health Premium Inflation in the Short and Medium Term: The Payer Perspective."
  • Marianne Udow, "The Outlook for Health Premium Inflation in the Short and Medium Term: The Insurer Perspective."

Presentations and Testimony

David Shactman, "Policy Issues Resulting from Changes in Hospital Ownership Status," at the American Hospital Association, February 25, 1997, Chicago, Ill.

Stuart H. Altman, "State Policy Issues Involved In Hospital Conversions," at the Michigan Health Policy Forum, February 26, 1997, Lansing, Mich.

Stuart H. Altman, "Future Issues Affecting the US Healthcare System," at the College of Healthcare, March 1, 1997, Chicago, Ill.

Stuart H. Altman, "The Role of Research in Managed Care," at Building Bridges III: Translating Research into Action, cosponsored by the American Association of Health Plans (AAHP) and the Agency for Health Care Policy Research (AHCPR), April 3, 1997, New Orleans, La.

David Shactman, "The Role of the States in Hospital Ownership Conversions," at the National Conference of State Legislatures, May 19, 1997, Topeka, Kan.

David Shactman, "For-Profit Hospital Conversions and Their Impact on Health Care in Massachusetts," at the 24th Annual Conference, Deaconess Glover Hospital, May 28, 1997, Needham, Mass.

David Shactman, "Hospital Ownership Conversions and Health Industry Restructuring in Massachusetts," at the 7th Annual Massachusetts Labor Management Conference, June 2, 1997, Newton, Mass.

David Shactman, "When Not-For-Profit Hospitals Convert: Policy Issues and New Questions for Research," at the Association for Health Services Research, June 15–17, 1997, Chicago, Ill.

Stuart H. Altman, "The Use of Case Mix Techniques to Pay Hospitals by Managed Care Companies," at the Ninth National Case-Mix Conference, September 7, 1997, Brisbane, Australia.

Stuart H. Altman, "The Future of the American Hospital," at Healthcare Association of New York State meeting, October 17, 1997, Bolton Landing, N.Y.

Stuart H. Altman, "Comparing Governmental Funding Options for Children and the Elderly," at Institute of Medicine Annual Meeting, October 21, 1997, Washington, D.C.

Stuart H. Altman, "Managed Care: A Private Sector Response to Controlling Health Care Costs in the United States," at Managed Care Conference, November 7–8, 1997, Brussels, Belgium.

David Shactman, "Hospital Ownership Conversions and Their Implications for Legislative Policy," at the Maryland Hospital Association's Special Forum on Changes in Hospital Ownership, November 12, 1997, Baltimore, Md.

David Shactman, "Hospital Ownership Conversions: What Have We Gained or Lost?," at the Ninth Annual Public Rounds, Harvard School of Public Health, April 7, 1998, Boston, Mass.

David Shactman, "Declining Access to Private Health Insurance for the Near Elderly, to the Senate Committee on Labor, Health and Human Services, June 25, 1998, Washington, D.C.

David Shactman, "Medicare Reform Options for an Aging Population," at the John F. Kennedy School of Government, Harvard University, October 17, 1998, Cambridge, Mass.

World Wide Web Sites

sihp.brandeis.edu/council provides a description of the Council's activities, including meetings and publications.

Print Coverage

"Study: Uninsured Could Rise 50 Percent," in Medicine and Health Perspectives, November 13, 1995.

"Council Sees Dire Impact of Funding Cuts on Hospitals," in Modern Healthcare, December 18, 1995.

"Shrinking Private System Maroons the Uninsured," in Medicine and Health Perspectives, April 29, 1996.

"Poll: Health Care Big Campaign Issue," in Medicine and Health, July 29, 1996.

"Report: Tic Tax Exemption to Benefits," in Modern Healthcare, October 7, 1996.

"Study: Unregulated Conversions A Multibillion Dollar Rip-Off," in Medicine and Health Perspectives, October 1996.

"Seeking Sharper Focus On Hospital, I-IMO Ownership Issues," in Medicine and Health Perspectives, November 4, 1996.

"Conversion Experiences," in Medicine and Health Perspectives, November 4, 1996.

"Some in Corporate World Worried about Health Bill," in American Medical News, December 11, 1996.

"Health Care Talks Reach End Game," in Congress Daily, July 23, 1997.

"Medicare Reform: Even Solutions Off the Table," in Health Line, July 25, 1997.

"Miles To Go on Medicare," in The Boston Globe, August 26, 1997.

"Is Congress Leaving Seniors in the Dark About Choices?," in Medicine and Health Perspectives, November 17, 1997.

"Health Care Jobs Boom Likely to Slow," in The Boston Globe, May 5, 1998.

 Back to the Table of Contents


Report prepared by: Dexter Hutchins
Reviewed by: Richard Camer
Reviewed by: Karyn Feiden
Program Officer: Nancy Barrand
Also interviewed: David Colby

Most Requested