With over 50 million children and youth attending public schools in this country, these systems are a logical entry point for reaching children and their families (GIH 2008). Schools are major institutions in children’s lives, providing oversight for many hours of a typical weekday. Though health improvement is not the primary mission of the education sector, it has extensive influence in shaping children’s health and long-term development outcomes.
Until 2008, health care reform was haunted by the specter of Harry and Louise. Almost single handedly, a TV ad sank the Clinton Health Plan. Paid for by insurance companies, Harry and Louise warned viewers that, “Sometime in the future, the government may force us to pick a few plans designed by government bureaucrats.” The power and influence of this campaign muffled Congressional debate and, while presidents talked, all decision makers steered clear of this minefield. The result? An increasingly disjointed, dysfunctional and expensive system with 45 million Americans without health coverage.
New Hampshire is in an excellent position to leverage national health reforms to create an even higher quality, cost-effective health system in the state. We have made solid progress in our state on work to increase the financial transparency of the health system, promote payment reforms and quality efforts, extend the use of health information technology and expand coverage.
From 1942 through the early seventies, New Hampshire Blue Cross and Blue Shield ruled the New Hampshire health insurance market. No other institution, then or now, has achieved such dominance nor is any company likely to do so in the future.
Then, from this lofty pinnacle of success the Blues fell to earth, landing before a judge of the New Hampshire Probate Court who, with a stroke of a pen, served public notice that the charitable mission of New Hampshire Blue Cross and Blue Shield was no longer sustainable. Thus, the court’s decision gave final approval to a transaction that enabled Anthem Insurance Company to acquire a New Hampshire icon while, at the same time, leaving behind a substantial endowment whose funds are dedicated to sustaining the goals and values of Blue Cross and Blue Shield.
The Endowment for Health has built and evolved an ever-more sophisticated public policy strategy since its inception. The foundation quickly defined its role, found its voice and established its credibility in the public policy arena. Significant inroads have been made on the Endowment’s policy strategies to date and there have been valuable lessons learned from this journey.
The following document tells the story of how the Endowment’s public policy strategy was built from the ground up and the types of projects and initiatives that have comprised our public policy work to date.
The last six years have witnessed a major shift in the priorities of organizations such as the Endowment for Health. Federal and state budgets are becoming increasingly strained. If left unchecked, health care spending will represent nearly 20 cents out of every dollar Americans spend by year 2016, far outstripping the growth of the U.S. economy. This mounting pressure on the system is forcing foundations to use their resources for support of public policies. Endowment for Health President James W. Squires examines the Endowment's first years, its evolution and where it is headed in the future.
For the past year or so, the Endowment has had been talking to internal and external stakeholders about narrowing the social cultural theme to focus on a specific vulnerable population for the next three to five years. In September, our Board voted to approve a revised goal for the social cultural theme: Reduce social and cultural barriers to accessing health and health care for racial, ethnic and linguistic minorities. Our definition of linguistic minorities we include those who are Deaf or Hard of Hearing in addition to Limited English Proficient.