Universal Health Care
Technical Advisory Committee (UHCTAC) Recommendations by Subject
1. Role of the Study
a. Simulate the impact of major (universal
health coverage) policy options and highlight the tradeoffs
among competing options that provide varying levels of coverage,
access and costs.
b. In short term, focus on outcomes that
lend themselves to quantitative analysis (e.g., levels of coverage,
overall costs, financing and sources of revenue, administrative
costs, winners and losers by sector and sub-group of the population).
c. Qualitative measures serve important
role in informing policy. Qualitative analysis of remaining
SCR 100 criteria can and should be investigated within the SB
480 timeframe (e.g., incentives for preventive care, monitoring
of consumer satisfaction and outcomes, incentives and financing
for medical innovation, research and training of medical professionals.)
d. Criteria of importance to the State of
California should be investigated even if not identified in
SCR 100.
e. Look at a variety of options including
those that do not necessarily aim for universal coverage.
2. Role of SB 480
a. Health and Human Services Agency is to
make a report to the Legislature on options for financing universal
health coverage by December 2001.
b. Most appropriate that client for the
study be a public sector body since the impetus for project
came from the Legislature and the goal is to inform policy making.
c. To meet SB 480 timeframe:
- Study should be completed by June 2001.
- Analyses should be subcontracted to an
existing entity with modeling capacity.
3. Role of Stake Holders
a. Health system stakeholders must be involved
in developing the options to be studied, in refining and specifying
details of the options and in assessing whether the behavioral
assumptions of the research team are realistic.
b. Reform option development is best addressed
by advocates or authors of a particular approach rather than
by independent researchers.
c. There must be an ongoing component for
stake holders in the analytic effort.
d. Stakeholders include legislators, members
of government administrative agencies, health industry members,
health care consumers and providers, employers and health policy
analysts.
4. Role of RFP/Competitive Bid
a. Selection of appropriate research team
and commercial modeling entity.
b.
c. Identification of technical approach to analyze
behavioral responses of individuals, employers, providers and
the State.
d. Identification of approach to uncertainty in
data sources and behavioral assumptions.
e. Identification of documentation of analytic
results the research team will provide.
f. Identification of approach for bench marking
national data to California-specific parameters and adjusting
for California-specific data.
g. Identification of references and examples of
similar work, particularly in projects for public sector clients
that involved working in very open process.
h. Identification of willingness to accept input
from outside groups and allow for outside review.
i. Identification of ability of researchers and
modelers to adhere to SB 480 timeframe.
5. Role of Transparency
a. Transparency and outside review are essential
to any effective analytic process.
b. Analysts must allow for open discussion
of assumptions and analytic methods with stakeholders and other
researchers.
c. Analysts must keep assumptions clear
and transparent or risk drastically affecting results.
6. Role of the Model: Existing Model vs.
Model from Scratch
Consider developing a model from scratch
only after completing further investigation including:
a. Determination of start-up costs.
b. Assurance of sufficient ongoing funding
and demand for model development and maintenance.
c. Investigation of tradeoffs of larger
national data sources vs. California-specific data, which California
data sources would actually be available, and to what extent
a California-specific data would be used for determining behavioral
parameters.
d. Determination that 480 timetable is not
important to policy makers.
e. Utilize competitive bid or funding entity
decision if model-from-scratch found valuable and viable.
7. UHTAC Panelists
Larry Levitt, Chair, Kaiser Family Foundation,
Jose Escarce, Rand/UCLA/Harvard
Judith Feder, Georgetown University
Laurence Baker, Stanford University
Linda Bilheimer, Robert Wood Johnson Foundation
Paul Gertler, UC Berkeley
