Transforming Health Care Legislation into Reality
As candidates new and old emerge for the 2012 presidential election, one thing is certain: health care reform will be a major topic in the campaign. In the meantime, a 2006 Southwestern graduate is helping turn the health care reform legislation that was passed last year into reality.
At only 27, Dori Glanz works for the Office of Management and Budget evaluating the efficacy of Medicaid policy initiatives. Her responsibilities include overseeing the implementation of health reform and helping develop the president’s budget for Medicaid − tasks even veteran policy analysts and heath care experts would find daunting. But for Glanz, it is the opportunity of a lifetime.
“I love my job,” she said. “I care really deeply about health care, and with the Patient Protection and Affordable Care Act, there is a big vision.” But long before she set her sights on the White House, Glanz was already demonstrating her dedication to a life of civil service. During her time at Southwestern, Glanz was active in service both as a Paideia scholar and as a member of Alpha Phi Omega, the national service fraternity.
“Dori paved the way in showing what Paideia could become by integrating what she was reading and writing about in her classes with what she was doing in the world beyond the university. She is the embodiment of ‘thought into action,’” said Paideia Professor David Gaines. She first became involved with health care policy during a legislative internship with Rep. Mark Strama in her hometown of Austin.
After graduating magna cum laude in 2006 with a double major in political science and French, Glanz went back to work at the state capitol as a policy analyst and executive aid for Rep. Strama. She transitioned from Southwestern to the House of Representatives by integrating the goal of public service with her interests in public policy and health. “I worked on women’s health care,” Glanz said. “It was the first piece of legislation I saw through, from flipping through binders all the way through the committee and on to the floor of the House.” But as the Texas legislative session came to an end, she feared remaining idle. So Glanz applied to graduate school and was accepted at Harvard’s John F. Kennedy School of Government.
While earning her master’s degree in public policy, Glanz served as editor in chief of the Harvard Kennedy School Review, a comprehensive policy review magazine; co-chair of the HKS Health Professional Interest Council; and senior editor of the Women’s Policy Journal of Harvard. “Going into Harvard, I would have been intimidated had I not gone to Southwestern,” Glanz said. “Southwestern taught me to be a good writer and speaker, and public service is a strong aspect of the Kennedy school, just as it was at Southwestern.”
Not long after she graduated from Harvard, Glanz landed a Presidential Management Fellowship at the Department of Health and Human Services before transitioning to her job at the White House. Her current work as a program examiner involves transforming the Affordable Care Act into a reality experienced by millions of Americans. “Congress told us what they want us to do,” said Glanz, “Now we have to ask ourselves, how do we take words on a page and turn them into a whole new system of health care?” This monumental task requires extensive knowledge of existing policy and its efficacy, innovative ways of approaching the same old problems, and of course, a lot of crunching numbers. To improve services and cut costs, all health care analysts rely heavily on data collected from Medicaid patients, doctors and hospitals; but valuable information can be hard to come by.
According to Glanz, health information technology (HIT) has enormous potential to yield useful data by using electronic health records to coordinate patient care. The Recovery Act helps Medicaid doctors and hospitals invest in technologies that improve care by enabling comprehensive medical histories to be available electronically. The data that is being produced by HIT could contribute to effective health care reform. “We know how the money is being spent, but we don’t know what outcomes it is really buying,” explains Glanz. “We know how many kids go to the dentist, but not how many kids have tooth decay, and in the end, what we really want is a health care system that results in healthy people. That is what this is really about.”
Improving the quality of existing coverage is a crucial step towards another goal of the Affordable Care Act − extending Medicaid coverage to an additional 17 million people. Along these lines, Dr. Donald Berwick, administrator of Centers for Medicare and Medicaid Services, advocates patient-centered care that takes the patient perspective as its primary focus. Much of the reform has involved recalibrating the scales to make the health care system work for patients, and not vice versa. Careful planning and endless work must be done before the major parts of the legislation can be implemented in 2014, and it will take several more years to generate the data that will tell analysts like Glanz how well the new system is working and what adjustments are required.
“As long as there is work to do, I’ll stay in health care,” said Glanz, who modestly attributes her early success to hard work and good luck. “I just feel like I got lucky over and over, with Southwestern, the legislative internship, Harvard and the White House fellowship…I’m very lucky.” It is certainly a lucky coincidence that her interests in health care and public policy materialized just as President Obama was unfolding his plans for the largest health care reform since the 1960s. “It’s a unique time, and I’m lucky to be here,” Glanz said.
As the debates among presidential candidates begin, President Obama will face heavy criticism for the controversial legislation that has become synonymous with his presidency. The uncertainties of the oncoming political may leave many in Washington holding their breath, but for as long as she is able, Glanz will continue working to turn “change we can believe in” into change that we can see.
- Shannon Hicks