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Unformatted text preview: The Landscape in 2009: A Conversation with Bruce C. Vladeck Michael Birnbaum United Hospital Fund Abstract Michael Birnbaum interviews Bruce C. Vladeck about the landscape for national health reform in 2009. Vladeck, who worked under President Clinton directing Medicare and Medicaid as administrator of the Health Care Financing Administration, discusses some of the challenges and opportunities facing the Obama administration. By comparing the current political and economic environments with those he faced while working in the Clinton administration, Vladeck argues that this time around America might be ready for pragmatic reforms leading toward universal coverage. He explores the future of employer-based coverage; problems and solutions for America’s aging workforce; poor customer service in Medicare; the “Medicaid Stigma”; the promise of immigration; and the trade-offs between access, quality, and cost in the American system. Finally, Vladeck offers a silver lining to the current economic catastrophe. As he sees it, common sense and results may be taking the place of ideology in policy making and policy analysis: “The intellectual hegemony of neoclassical economics has been blown out of the water.” The following interview took place on November 10, 2008 — several days after the election of President Obama — in Bruce Vladeck’s New York City office. Bruce C. Vladeck, PhD, is a nationally recognized expert on health policy, health care financing, and long-term care. He is currently an exec- utive director of Ernst and Young’s Health Sciences Advisory Services practice. Dr. Vladeck also serves as the president of the board of directors of the Medicare Rights Center, is a member of the New York City Board of Health, and sits on the editorial board of Health Affairs . Dr. Vladeck Journal of Health Politics, Policy and Law , Vol. 34, No. 3, June 2009 DOI 10.1215/03616878-2009-005 © 2009 by Duke University Press 402 Journal of Health Politics, Policy and Law has held prominent positions in the public sector, in academia, and in philanthropy. He served as an administrator of the Health Care Financing Administration (HCFA) under President Bill Clinton between 1993 and 1997, directing both the Medicare and the Medicaid programs. At the time, these two programs accounted for nearly one-fifth of the federal budget and more than one-fourth of all national health care spending. The Big Picture Michael Birnbaum : Sixteen years ago, a new Democratic president arrived in Washington and attempted to move a major health care reform and insurance expansion through a Democratic Congress. Does 2008 look different than 1992, or have you seen this movie before?...
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- Spring '10
- Management, Universal health care, Bruce C. Vladeck