Douglas Elmendorf, the 2015 Seidman lecturer, will become the next dean of Harvard’s John F. Kennedy School of Government, starting in January. Image: Steve Lipofsky
Douglas Elmendorf, the 2015 Seidman lecturer, will become the next dean of Harvard’s John F. Kennedy School of Government, starting in January. Image: Steve Lipofsky
Unless those who object to the Affordable Care Act are willing to put forth an alternative with comparable information about its effects on spending and access to care, then the huge amount of time that has been devoted to the ACA debate should be used for more constructive policymaking.
This was the theme at the 15th annual Seidman Lecture at Harvard Medical School on Nov. 2, delivered by the next dean of the Harvard John F. Kennedy School of Government, Douglas Elmendorf.
“We have a lot to do, and we should get going,” Elmendorf said.
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Elmendorf drew upon his vast experience to share his analysis of the Affordable Care Act and his recommendations for next steps for federal health care policy. In addition to heading the Congressional Budget Office from January 2009 until March of this year, Elmendorf spent much of his prior professional career at the Federal Reserve Board, the Council of Economic Advisers and the Treasury Department
Elmendorf is currently serving as a visiting fellow at the Brookings Institution. He was named to head the Harvard Kennedy School in June and will assume that role in January 2016.
The audience for the Seidman Lecture included leading scholars in health policy from HMS, the Harvard T.H. Chan School of Public Health, the Harvard Kennedy School and the Harvard Faculty of Arts and Sciences, as well as physicians and leaders from Harvard-affiliated and other Boston area hospitals.
“The incoming dean was able to weave together judgments related to value and critical analysis in his review of the ACA,” said Barbara McNeil, Ridley Watts Professor of Health Care Policy and head of the HMS Department of Health Care Policy, in an interview after the event. “HMS was pleased to be the first school at Harvard to introduce him to this distinguished community.”
Assessing the state of federal policy
“In my view, the system of rules and subsidies established by the ACA is the right system in its fundamental elements, although we could discuss the pros and cons of specific changes within that system,” Elmendorf said.
His view was based on two judgments. “The first is a value judgment—I think we should bear the cost of achieving nearly universal health insurance in this country,” he said, “and the second is an analytic judgment—there are no alternatives to the ACA framework that would achieve that goal at significantly lower cost.”
Elmendorf made recommendations for changes to federal health care policy that he said could potentially further reduce spending and improve the value of care, including incentives to limit the use of unduly expansive health insurance, payment reforms for Medicare, and efforts to make markets for health care and health insurance more competitive.
“This was a remarkably clear, comprehensive assessment of where the American health care system is—the challenges it faces and how it might address those challenges,” said Michael Chernew, Leonard D. Schaeffer Professor of Health Care Policy at HMS, in an interview after the event.
In 2000, on the occasion of his 50th reunion from Harvard Law School, Marshall J. Seidman provided endowment support to the Harvard Medical School Department of Health Care Policy to support research related to health care costs and quality and to host an annual meeting by a leading policy maker on issues related to costs and quality of health care with a particular emphasis on activities that are most likely to impact on federal and state approaches to these problems. The department has sponsored the lectures yearly since 2001.
