Keeping Score: why policymakers need independent analyses
Policymakers are always looking for a way to tell a ‘story’, i.e. a way to communicate policy challenges to stakeholders in a way that helps them understand the problem, while helping them visualize a roadmap that could lead to a viable solution.
This usually requires analysis, and often a policymaker’s case can be strengthened and validated by independent assessments from nonpartisan groups.
Policy analyses require good data if they are to be worth the paper they are printed on, and often the data involve money, i.e. how much a policy problem is costing society, and how much it would cost to fix (or ignore) it. In other words - what are the potential budgetary impacts of a particular health policy intervention? The U.S. Congress, for example, often turns to the Congressional Budget Office (CBO) and the Medicare Payment Advisory Commission (MedPAC) for such independent, nonpartisan analyses and advice.
CBO is the independent nonpartisan agency that helps the U.S. Congress figure out how much a bill would cost if it were enacted into law, and what impact it would have on the federal deficit. Policymakers, stakeholders, and the press hang on to their every word, especially when the ‘score’ (the financial and budgetary analysis of what a bill would cost) is related to health care. This week for example, the CBO score for the hotly-debated proposal for repealing and replacing the Affordable Care Act is the nation’s most eagerly-anticipated health policy document.
MedPAC is an independent nonpartisan agency that provides policy analysis and advice regarding Medicare policy. MedPAC issues 2 reports a year, in March and June, required reading for the ‘committees of jurisdiction’ (the Congressional panels most responsible for Medicare funding and policy). These reports cover payments and reimbursements, baseline projections, workforce needs, and the cost of drugs in the Medicare system.
The policy benefits are immense, and the only downside is that various stakeholders or policymakers could choose to politicize the analysis to suit their own purposes. The benefits outweigh that risk. First, CBO and MedPAC are staffed by economists, clinicians, and other professionals, appointed for their subject matter expertise rather than partisan affiliation. Second, their work is data driven and they follow the numbers wherever they lead, and report accordingly. Third, their work is a matter of public record, and therefore subject to rigorous peer review, often in short order, in as close to real time as is possible under the circumstances.
There are many other independent, nonpartisan analysts that policymakers and stakeholders can turn to in order to understand the ‘sausage-making’ involved in health policy, but their value to the delivery of care, the elimination of health care disparities, and the pursuit of health equity, is worth highlighting, whether the data come from the local, state, or federal level.
