Priority Area 9: Engage the Public in Policy Development and Implementation

The public remains confused about how health reform will affect them. The large number of people eligible for Medicaid and CHIP but not enrolled demonstrates that simply creating opportunities for coverage does not mean people will take advantage of them. Fundamentally, health reform can only succeed if it is more about culture and norms than it is about mandates and penalties.

The public also includes the large health sector and employers, who will also face significant changes. The most successful efforts to improve the performance of the health system have been multi-sector, public and private initiatives that set goals and plans for concrete improvements. This framework is particularly essential when pursuing payment changes, which can only have their intended effect if they are adopted across purchasers.

The sheer number and scale of the tasks to be accomplished means the resources of each state’s people and institutions must be brought into the implementation discussion. No amount of talent and goodwill in the state capitol can develop answers and policies that work for an entire state.
States must develop a clear approach to achieving effective information flow between an engaged public and their elected representatives to weigh in on options before one is chosen, and to provide information back on how things are going so they can be improved.