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ASU expert aids national health care reform effort

July 28, 2009

A top Arizona State University health management expert is among those providing feedback to the White House on health care reform. Marjorie Baldwin, director of the School of Health Management and Policy at the W. P. Carey School of Business, has been participating with other health care experts in conference calls held by the official White House Health Reform Task Force.

“I was honored to be selected,” says Baldwin, a renowned health economist who has authored more than 30 health care articles. “Obviously, I care very much about the outcomes of health care reform, and I’m concerned that legislators consider the potential unintended consequences of any reforms they propose.”

Arizona Rep. Kyrsten Sinema is in charge of communicating feedback from Baldwin and other selected Arizona health care representatives to the White House and the state’s Congressional representatives in Washington, D.C. The Arizona meetings and conference calls have been taking place since July 15 and will run through Thursday. As Baldwin follows the debate happening at the same time in Washington, she has growing concerns.

“I don’t understand why it’s important to get it done by early August,” says Baldwin. “It’s more important to develop a plan that is likely to accomplish our goals than to act before an arbitrary deadline. I would recommend an incremental approach, addressing one big issue at a time – for example, the inequitable tax treatment of employer-provided health insurance versus the public plan -- and observing the outcomes before more changes are implemented. Health care reform has far-reaching implications for the entire economy, as we can see from the recent overhaul of Massachusetts’ health care system, which is costing far more than anticipated and is nearly bankrupt.”

Baldwin notes that different groups involved in the Arizona meetings and conference calls are interested in different agendas. For example, alternative health care providers, such as chiropractors and nurse practitioners, want to be sure their specialties are covered under the new reform plan. Doctors want caps on malpractice awards.

“People are very focused and concerned about their individual interactions with the health care system, rather than the big picture,” says Baldwin. “I think this says a lot to politicians about how personal the health care reform debate is.”

Baldwin says much of the reform talk centers on making sure all Americans have access to coverage without exclusions for preexisting health conditions, but she hopes insurers will be allowed to offer discounts to people who live healthy lifestyles and get preventive services.

“It just makes sense that if you pay less for homeowners insurance when you have a security alarm and pay less for car insurance when you have no accidents, then you should pay less for health insurance when you take care of yourself and follow guidelines for preventive care,” Baldwin explains.

She also wants to make sure any reform plan includes an integrated approach to mental and physical health, saying, “Psychiatric conditions have been treated in a separate system, with different reimbursement rates, for far too long, helping to perpetuate the stigma of mental illness.”

Baldwin has an especially keen interest in all of these issues as she prepares to head up the nation’s first public university Master of Public Health program focusing specifically on urban health. The new program will address the issues of homelessness, mental health and access to affordable health care that have been brought even more to the forefront because of the recession and the health care reform movement. The first classes will be held at ASU’s downtown Phoenix campus in fall 2010 through the nationally ranked W. P. Carey School of Business, in collaboration with the College of Nursing and Health Innovation.