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National Policy Dialogue To Advance
Integrated Health Care:
Finding Common Ground

Convened by
The Integrated Healthcare Consortium

Co-hosted by
American Association for Health Freedom
(Formerly the American Preventive Medical Association)
Bastyr University
Georgetown University School of Medicine

October 31 - November 3, 2001

Members of the Integrated Healthcare Consortium are convening a conference titled "National Policy Dialogue to Advance Integrated Health Care Policy: Finding Common Ground," October 31 - November 3, 2001, at the Georgetown University Conference Center in Washington, D.C. The meeting is being co-hosted by the American Association for Health Freedom (formerly the American Preventive Medical Association), Bastyr University and Georgetown University School of Medicine.

The goal is to create a collaborative report that will help focus the national health care debate and ultimately develop national policy recommendations to ensure that the American public benefits from advancements in the science and understanding of all health care systems, disciplines and modalities. The intent is that the finished report can be used by policy makers, professional associations, academic institutions and others to develop a coordinated national effort to foster appropriate research; to develop appropriate standards for professionals as well as products; to expand and integrate curricula; and to increase consumer access to complementary and alternative therapies. Participants will use several documents as a starting point. These include the National Plan to Advance Integrated Health Care*; the draft report of the White House Commission on Complementary and Alternative Medicine Policy, the five-year strategic plan developed by the National Center for Complementary and Alternative Medicine (NCCAM) entitled Expanding Horizons of Healthcare, and the findings from the Integrative Medicine Industry Leadership Summit 2001.

The Integrated Healthcare Consortium, as well as the Steering Committee for this National Policy Dialogue, consists of (1) faculty from a number of universities and academic health centers, who have credibility in the academic and professional communities of both conventional and complementary /alternative medicine (CAM), law and public policy, and (2) representatives of the conventional and CAM professions who, along with their organizations, have extensive contacts throughout both communities and a comprehensive understanding of the relevant issues facing them. Members of the Steering Committee and others within their institutions/organizations have also worked with legislators, regulators, providers, payers, educational institutions, professional associations, policy makers and the public on CAM and integration issues for many years. In addition, they are experienced collaborators, who know how to bring diverse constituencies together and create a cooperative spirit and focus on shared goals.

The Steering Committee members and their organizations, listed on the opening page of this program description, have agreed to be conference sponsors. Their task is to oversee the design and implementation of the event, secure adequate funding, and determine an agenda that will ensure that this Policy Dialogue will be a remarkable and productive joint effort of all who come to the table.

Participants

The number of attendees will be limited to ensure optimal participation. Approximately 75 individuals representing major stakeholder groups will be invited to attend. They will include educators from accredited conventional and CAM schools and professional organizations; representatives of regulated conventional and CAM practicing disciplines; payers (Medicare, private insurance companies, HMOs, Indian Health Service); natural health care product manufacturers; major employers; consumer advocacy groups; and government agencies.

All of these stakeholders are active in their own spheres of influence and expertise. They are both impacted by and working to shape federal health care policies regarding CAM; however, many are doing it in relative isolation, with little coordination or communication among other sectors of this massive industry. As the health care paradigm continues to evolve, it will become more and more necessary for all stakeholders to communicate with each other regularly about how the changing paradigm affects them and how they would like to see it develop. Policy makers need guidance from the industry; businesses and practitioners need a livable regulatory environment; educational institutions need to understand the environment for which they are preparing students; and consumers need broader access to qualified providers and to safe and effective alternatives. The National Policy Dialogue will provide an opportunity for experts, industry leaders and stakeholders to collaborate in drafting a position statement outlining a shared vision and specific policy direction for creating the health care environment of the future, in which cooperation, accountability and increased understanding will result in optimal benefits for consumers. Identification of a vision, voice, agenda and policy priorities through this partnership of stakeholders will help identify the emerging consensus that will advance integrated health care.

Structure

The meeting will be held over the course of 2 ½ days, beginning with an opening reception the evening of October 31 and running through noon on November 3, 2001. Designed to be a working meeting, Thursday, November 1 will open with a speech from a key government official who will elucidate policymakers' need for a more unified vision of integration and accountability from the health care community.

In advance of the meeting, participants will be given four documents to review, as outlined on page one. They may also be asked to complete a short survey designed to identify key concerns, perspectives and expectations. This will give us a common base from which to launch our discussion, thus freeing for other uses the time that would normally be devoted to discussing the present state of the health care system.

The meeting will be run by a professional facilitator empowered/responsible to keep the conversation on track. Unlike typical conferences, this working conference will include no speeches by participants or expert panels. It will be a dialogue among key decision makers on the front lines of integrated health care. All attendees are expected to contribute their expertise on behalf of both their stakeholder group(s) and integration experience and needs with other groups, in both the general sessions and small working groups. At some times attendees will be assigned to homogeneous working groups, at other times they will self-select small groups.

Much of the meeting will be devoted to focused discussions on major policy areas of concern. These may include:

1. Research Issues and Goals
2. Education, Training and Accountability
3. CAM Use in Underserved and Special Needs Populations
4. Regulation and Access to CAM Products and Services
5. Federal Benefits Programs: CAM Access
6. Clinical Practice, Quality of Care, and Delivery Systems

After discussing their respective areas of concern, the working groups will prepare reports that include policy goal statements and background information; identify barriers in the present health care system; and outline action steps to achieve agreed-upon policy goals and establish priorities and sequences for activities. Throughout the meeting, a graphic recorder will summarize the reports and discussions and map the information on large panels placed on the walls for all to review and refer to.

Through this process, we will broaden the discussion, learn about one another's perspectives, identify common ground and, ultimately, identify those policy goals that we can advance together.

Outcome

We expect two reports to come from the meeting: first, a summary of the discussion and goals taken from the graphic history prepared during the event, which can be disseminated to participants shortly after the meeting; and second, a more thorough report that will be disseminated to the Committee of the Whole for editing, and finalized as a white paper or position statement reflecting the views of the participants. This new and improved National Plan will be an educational document as well as a blueprint for policy change, and will be disseminated widely to policymakers, the media and stakeholder groups. It is our expectation that this report will be used by policymakers to determine how the Federal Government can encourage a more integrated health care system; by the media as a guide to the players and the issues; and by stakeholders as a strategic plan for implementing their own piece of the puzzle and for further cooperative activities.

Any post-meeting efforts to implement portions of the report will be the responsibility of individual stakeholders or coalitions formed by participants. It is generally accepted that political clout comes from coalition building, especially multidisciplinary coalition building, so we expect that participants will benefit from the new relationships and cohesive vision that will germinate at this event.

While we do not anticipate the formation of an over-arching organization comprised of National Policy Dialogue participants, we do hope to have a follow-up meeting by 2004 to assess progress and to review and update the plan. It has been suggested that, in subsequent years, similar meetings be convened to discuss discrete aspects of the white paper, such as research or education. At these meetings, stakeholders with a vested interest in a specific area would have an opportunity to flesh out the broad topics identified at the National Policy Dialogue, determine targeted public policy goals, and set collaborative action plans for achieving those goals.

Budget

The budget for the two and a half day event is approximately $60,000. This will cover the cost of the conference facility; supplies; on-site conference costs; pre-conference organizing/administration; printing; breakfast, lunch and break-out sessions for participants each day; audiovisual equipment; a professional facilitator; writing and editing of the final report; and part-time administrative assistance. Attendees will be expected to cover their own travel, hotel and dinner expenses.


Relationship to the White House Commission on Complementary and Alternative Medicine Policy

A legitimate question is how this meeting and end product will differ from or relate to that of the White House Commission. The Commission has been charged with surveying the CAM landscape and reporting to HHS "on legislative and administrative recommendations for assuring that public policy maximizes the benefits to Americans of complementary and alternative medicine." In its two-year life span, the Commission will hear testimony from a wide range of individuals to elicit their perceptions on topics ranging from access to research. It will then write a draft report, receive comments, and prepare a final version for presentation to HHS. To date, the Commission has done a tremendous job of reaching out to a wide range of stakeholders and, we have no doubt, it will produce a thoughtful, thorough and useful report which will help direct policy makers faced with many conflicting demands for changes in the health care system. Its end product, however, will be its own, and may or may not be taken up and implemented by the stakeholder organizations.

In contrast, the National Policy Dialogue will provide a collaborative forum on national policy (we believe the first of its kind) in which stakeholders from all parts of the health care community will have a chance to discuss and debate their perceptions about the future of integrative health care and federal policy with individuals who are not normally part of their network. For example, instead of medical schools talking to medical schools about the best way to design an integrative curriculum, they will have the opportunity to speak with professionals in the CAM community, consumers, insurers and others who will have much to contribute to the task at hand. CAM professionals will have an equal opportunity to hear the perspectives of the many stakeholders who have an impact on their ability to practice, but with whom they have not had a useful dialogue. Instead of the Balkan States, we will have the United States. Realistically, if we are to achieve the best integrative system possible, all the stakeholders should be working together or, at the very least, be cognizant of how the rest of the puzzle will affect them.

By launching this landmark dialogue and crafting a broad position paper that recognizes areas of shared concern and mutual goals, we will have succeeded in advancing the debate and helping to create a successful, effective integrated system in a more timely fashion. By getting all the parties to the table, opportunities will exist for new relationships to develop and new coalitions to be fostered, and a sense of ownership of the finished product will be generated by the participants that may lead to more effective implementation.

Summary

These are ambitious goals for such a short meeting. Decision makers (many of whom have never met) are being asked to debate a large and potentially divisive topic and identify common ground. We are confident that we can succeed for two reasons: First, individuals will only come if they want to work to advance integrated health care, so we can assume that participants share at least that overarching goal. Second, participants are being asked to help draft a broad position paper and to identify common ground, not commit to a specific, tailored legislative agenda or formal scientific consensus statement.

It is vital to begin the dialogue and quite appropriate to begin by examining the subject from the widest possible perspective. In contrast, expecting to solve the concerns in one area, such as research, without benefit of the big picture, would necessarily result in a skewed and less successful final product. Each area affects the others. It would be premature to address integrating medical school curricula, for instance, without also considering credentialing. It would be impossible to address issues regarding access without also considering research.

The Integrated Healthcare Consortium members are aware that other groups are also interested in addressing the challenges of creating an integrated health care system. In addition to this National Policy Dialogue and the White House Commission activity, other efforts are underway in various sectors of the health care community to debate some of the same questions. The Integrative Medicine Industry Leadership Summit, for instance, is focusing for a second year on the business aspects of integration. We view these efforts as mutually supportive. Among our team are conveners of the industry gatherings who also see the need for our National Policy Dialogue. There is no harm in multiple efforts, and no cause to fear duplication. The job is so immense that it will take multiple efforts and diverse perspectives to be successful. Each participant brings a unique perspective to the discussion, and may take separate roads to the same destination. What matters is that we raise the level of the debate and begin the dialogue. With hard work, intention, and some luck, we will all find places at which our paths cross and ways we can work together to achieve mutual goals.


* The National Plan was drafted at the request of Senator Tom Daschle, Senator Tom Harkin and Rep. Peter DeFazio, who requested an overview of the health care environment and the identification of the barriers to creation of an integrative health care system. The Plan is the result of numerous interviews with a wide range of stakeholders over the course of more than a year. The authors of the National Plan are: the Hon. Berkley Bedell, former Congressman, Iowa; Candace Campbell, Executive Director, American Association for Health Freedom (formerly the American Preventive Medical Association); Sheila Quinn, Senior Editor, Institute for Functional Medicine (Executive Director, American Association of Naturopathic Physicians at the time the National Plan was drafted); and Pamela Snider, N.D., Associate Dean of Naturopathic Medicine, Bastyr University. The goal of the National Policy Dialogue is to broaden the discussion and identify common ground, in an effort to craft national policy which reflects the needs of all stakeholders.


June 21, 2001

 



Copyright © 2001
American Association for Health Freedom
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