The Kaiser and Mr. Begich

Sen. Mark Begich has often cited the Kaiser Family Foundation as his preferred resource on the subject of health care reform. On more than one occasion, and multiple times during the September town hall session, the young senator suggested a visit to KFF to those individuals who might question his judgment, or for anyone who might want to become better informed. Nearly every time the young senator mentioned the foundation he also pointed out that a link to it is available at his web site.

Surprisingly, despite the rhetoric touting KFF as a vital source of information, the web link to it is not as strategically positioned on the Begich web site as it is strategically positioned in his personal presentations.

The young senator's oft-mentioned KFF provides needed credibility to his position. Concurrently he also uses the foundation's esteem to marginalize suggestions that he might limit reforms to specific problems and develop targeted interventions designed to remedy them. Thus, KFF is not a just a resource for the young senator, it is a tool on which he leans to demonstrate that he is "committed to ensuring quality, affordable health care for all Alaskans" and that he "...will not allow opponents of reform and the special interests who back them to delay the health reform we all deserve." (Quotes are from the health care page of Sen. Begich's website.)

KFF supports a total overhaul of the system, and so do the young senator and his party.

Proof of this accusation is in a Oct. 23, 2009 publication in "Pulling It Together" from KFF President Drew Altman titled "The ‘Third School' For Controlling Health Care Costs". In that article Altman writes, "The President also gave Systems Reformers a huge boost by embracing these themes until switching the emphasis more recently to ‘health insurance reform' when it became clear that Systems Reformers resonated better with insiders and policy wonks than with the public." (Bolded are author's emphasis)

Altman's article described Systems Reform in a reference to an article published January 26, 2009 in The New Yorker, "Getting There from Here" by Atul Gawande. In a feat never before seen in our field, Atul Gawande's wonderful New Yorker piece traveled through the White House and across Capitol Hill in about two days, not so much because the research he was describing was new (Wennberg had reported similar findings many times for thirty years) or because his analysis was so brilliantly written (which it was). The timing was right for a new strategy to bend the curve through delivery, information and payment changes that did not divide policymakers and stakeholders along the familiar ideological lines. The article also rippled through the medical profession with similar speed. For many practitioners this was health reform they could relate to; getting under the hood of medical practice and health care institutions and changing practice as well as pursuing quality improvement and cost containment in tandem. News media attention to the New Yorker piece and policymaker interest in it brought attention to Systems Reformers' ideas to new levels.

The Altman letter leaves little doubt as to why President Obama switched emphasis from Systems Reform to Health Insurance Reform. It also explains that there is even less doubt regarding the Kaiser Foundation President and Chief Executive Officer's position on health insurance reform, and presumably the foundation itself.