Page 13 - Volume 70 Number 1
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be looking for new policy ideas; 2) circumstance –
in this case, the election of 2008, which put Democrats with an interest in health care reform in the leadership in the Congress; and 3) luck – finding a congressional staffer who saw the potential value of the concept as
a win-win proposition.
Nothing moves through the Congress without a legislative champion, i.e., someone to sponsor the bill or the part of a bill with your ideas in it. Congressional staffers are critical in every sense of the word and are the key to finding a champion. But you have to keep in mind that they are going to listen to your pitch not necessarily with your goals in mind, but rather with an eye toward how it might meet the needs of the legislator for whom they work. How will this proposal work politically?
Will it fit into the larger scheme of health care reform?
To sell your idea, you need language: words that convey the concept in terms that are easily understood and grasped. The wrong sound bite can be deadly: consider the fate of ‘death panels.’ And you need to prepare arguments to address criticisms that are sure to come from all sides. Fendrick was advised by an influential opinion leader: every program change has winners and losers: who are the losers? They will come at you.
Which is why, despite all the preparation and coaching, sometimes you need to come up with quick, convincing answers to unanticipated questions: Asked in a House hearing, isn’t what you propose rationing care? Fendrick, thinking quickly, responded: This is not rationing care; it is rationing harmful care, a sound bite that is now a staple in his sales pitch.
Please keep in mind as you read my much-abbreviated versions of Fendrick’s testimony in June that it was tailored for the House Committee on Ways and Means, Subcommit- tee on Health. The concept, however, could be applied more widely, and is worth your serious consideration.
For a fuller explanation of how to influence national health care policy, I refer you to the article by Fendrick, et al, which appeared in Health Services Research 47:1, Part II (February 2012).
Volume 70 • Number 1 Washtenaw County Medical Society BULLETIN 13

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