Health Policy and Management
Among his innovations at the School of Public Health, Dean Hiatt created a Department of Health Policy and Management (HP&M). Its existence responded to the reality that the health care system had become a complicated structure with many players and tensions—regulation from government at all levels, providers (physicians, hospitals, nursing homes, and other personnel), payors (insurers and government), and consumer interests. As the health costs in the United States rose as a percentage of gross national product, using health resources wisely became ever more important. For example, some hospitals were not well supplied with managerial staff who understood the business side of the institution, and they could be helped by training in hospital management. The government should, of course, assess the impact of its activities and regulations on the health care system because well-intended regulations often create unintended bad outcomes—what economists call externalities.
The department therefore included faculty with business training and special knowledge of health care, economists, evaluators, policy analysts, and faculty concerned with the analysis of health care practices and with health services research.
The administrative situation in the department in 1981 was in some ways reminiscent of the Department of Social Relations in 1953. Instead of having a chair, several faculty members formed a committee to run the department. Although committees have their uses and I’ve had great success with them, they do not shine at running day-to-day activities. If nothing else, communication becomes too slow for action in real time, and then people without authority take initiatives that lead to trouble because “there wasn’t time to check, and decisions had to be made.”
KeywordsHealth Service Research Policy Analyst Health Care Practice Consumer Interest Senior Administrator
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