“Timing is everything,” Commonwealth Fund president Karen Davis reminded the audience at the Sept. 23 Leadership Forum hosted by the Office for Diversity and Community Partnership. The health economist was referring to Path to a High Performance Health System: Realizing the Potential of Health Reform, a report published by the Commonwealth Fund in February 2009. The report was released at the start of Barack Obama’s presidency, just as Congress was looking to shape the health reform bill. Davis said Congress welcomed the “concrete, detailed proposal … as a sort of starting point for their deliberations.”
It was clear that “timing,” as Davis meant it, is not to be confused with luck. Rather, her overarching themes were preparedness and rigor. Speaking on the six-month anniversary of the Patient Protection and Affordable Care Act’s signing, Davis emphasized the importance of having the necessary research in place in order to inspire change at the national level. In the case of the 2009 report, its viability and availability gave advocates needed ammunition in their fight to enact reform.
Davis detailed the report’s recommendations. Among those that made it into the final bill: insurer oversight and consumer protections, accountable care organizations, and Medicaid expansion. The reform is expected to cover an estimated 32 million of the nation’s uninsured.
The Commonwealth Fund, which promotes effective policy and practice in health care, also supports research aimed at improving health care access and quality. In recent years, this work has included an effort to increase the number of voices that speak for the underserved.
According to Davis, after the defeat of the Clinton health reform bill, she “[vowed] that next time, a diverse group of experts would be at the table helping to inform the debate.” One product of her resolve is the Commonwealth Fund/Harvard University Fellowship in Minority Health Policy (CFHUF), a program under the direction of HMS dean for Diversity and Community Partnership Joan Reede that offers intensive study in health policy, public health, and management. CFHUF and two associated fellowships—the Joseph L. Henry Oral Health Fellowship in Minority Health Policy and the California Endowment Scholars in Health Policy at Harvard University—have graduated 99 fellows since 1995.
Among the current crop is Ashaunta Tumblin, an HMS alumna. Tumblin has taken to heart Davis’s message about the need for timely, detailed research and intends to apply that lesson while advocating for future reform.
Tumblin is particularly concerned with health disparities and social determinants of health—areas she said were not broadly addressed in the new law, perhaps because the existing research did not make a convincing enough case. Tumblin explained, “It’s incumbent upon us to come up with the level of rigor that’s required so that we can begin to turn [research] more formally into policy.”
