An expert panel approach to assessing the rural implications of health care reform: the case of the Health Security Act.
The policy arena is hungry for objective information regarding the potential effects of comprehensive national and state health care reform. Such information reduces the dependence of policy-makers on information generated solely by advocacy groups and serves as a checkpoint for such information. Unfortunately, the academic community is often unable to mobilize its resources quickly enough to help meet this information need. This article describes one model for overcoming this difficulty. When the time frame is especially short, academic expertise can be brought together in the form of an expert panel. However, for such an approach to be effective, it must be carefully configured and orchestrated. Critical ingredients include much preparatory groundwork, a well-defined framework and methodology for conducting the policy analysis, and a professional facilitator. The Rural Policy Research Institute used such an approach to analyze President Clinton's Health Security Act shortly after the initial blueprint was released (but before the legislative language was released). The consensus of the expert panel was that the Health Security Act would, on balance, represent an improvement over today's rural reality. However, a number of troubling aspects were noted. First, the Act's emphasis on primary care and nonphysician providers is a double-edged sword. While these are precisely the types of providers needed in rural areas, the short-run effect may be to create increased competition for such providers from urban areas.(ABSTRACT TRUNCATED AT 250 WORDS)
A F
AF
Coburn
S M
SM
Cordes
R A
RA
Crittenden
J P
JP
Hart
K J
KJ
Mueller
W W
WW
Myers
T R
TR
Ricketts
D003191:Comprehensive Health Care / Q000458:organization & administration / Q000639:trends; D003245:Consensus Statements as Topic; D017144:Focus Groups; D017048:Health Care Costs / Q000331:legislation & jurisprudence / Q000639:trends; D018166:Health Care Reform / Q000191:economics / Q000331:legislation & jurisprudence* / Q000639:trends; D006302:Health Services Research / Q000379:methods*; D006280:Health Workforce / Q000639:trends; D006780:Hospitals, Rural / Q000191:economics / Q000331:legislation & jurisprudence / Q000639:trends; D009096:Multi-Institutional Systems / Q000458:organization & administration / Q000639:trends; D010821:Physicians, Family / Q000600:supply & distribution; D012423:Rural Health / Q000639:trends*; D014481:United States