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2008 IPE addresses issues of health care reform

Friday, February 15, 2008

Not long after ringing in the New Year, the Masters students at the Ford School of Public Policy traded in their party hats for business casual suits as they prepared to tackle the hefty problem of health care. January 3rd, 2008 marked the first day of a 3-day policy simulation known as the Integrated Policy Exercise (IPE), which would test these future leaders' and policy-makers' abilities to make sound, responsible decisions under "real-world" time constraints and pressures. The annual IPE, a staple of the Ford School experience, alternates its focus between issues of domestic and international significance. Past topics have included an AIDS global forum, urban revitalization, and reform of the International Monetary Fund and World Bank.

This year, Ford School Professor Elisabeth Gerber designed the IPE to evaluate options that provide affordable, accessible health coverage to low and moderate income families within the state of Michigan. She selected health care reform because she believes it is "necessary to prepare students to be familiar with this urgent issue as it will probably consume the policy agenda in all levels of government." Having led the IPE three times now, Professor Gerber believes strongly in the IPE's curricular value, viewing it as "a unique opportunity to integrate the knowledge and skills [students] are acquiring during their Master's program" in a believable policy setting.

In the opening keynote address, former U.S. Congressman Joe Schwartz set the tone for the health care debate by discussing how his time as a physician impacted his own political belief in the importance of increased access to coverage. The following three days were packed with student-led breakout sessions and panels comprised of 24 representatives from organizations such as Sinai-Grace Hospital, Washtenaw Community Health Organization, the Urban Institute, Health Access California, and the University of Minnesota School of Public Health; each organization described its stakes in the healthcare debate and provided strategic planning advice to student participants.

From the start, the students enthusiastically jumped into the simulation. Briefed by prior readings and informative workshops, they adopted the perspectives of their assigned stakeholder roles—including professional organizations, elected officials, and lobbyists and advocacy groups—to negotiate a resolution that would ideally mimic what might occur in the real world. What began with a host of disparate reform efforts ranging from universal insurance and employer mandates for insurance provision, went through hours of meetings, mark-ups, hearings, revisions, amendments, lobbying, and voting to result in a bipartisan bill. The final legislation advocated expanded criteria for government coverage and the creation of a clearinghouse to facilitate the exchange of affordable health insurance products. While this initiative expanded the scope of health care coverage in Michigan, many stakeholder groups pushed the button further with a ballot initiative for a single-payer, universal health insurance system, which ultimately failed by two votes.

Would those same outcomes have been achieved in the real policy world? It is hard to tell. But the 2008 IPE provided participants with the opportunity to delve into the intricacies of the legislative decision-making process and understand the difficulties of creating effective policy as well as the importance of coalition-building and negotiation. Matthew Borus, a first year MPP student and dual degree candidate with the School of Social Work, was assigned the role of a conservative state senator. While intellectually familiar with the legislative process, he commented that "participating in the IPE solidified my understanding, because I was able to see how laws and policy develop in practice." For Borus, who has worked as an organizer and activist, the simulation exercise opened his eyes to how "easy it can be for certain constituents to be ignored" and for issues to be put on the backburner by decision-makers; he emphasized that this experience illuminated the direction he should take to best influence leaders and impact change in his future advocacy work.

Despite grumbling about a slightly shortened holiday break, many students look forward to the Integrated Policy Exercise as a valued tradition of the Ford School. Though the topics and proceedings may be serious, participants still manage to enjoy the moment, laughing at themselves during the satirical morning newscasts or building new friendships with classmates. The Ford School's IPE is more than just a compulsory course; it is unifying experience that strengthens each student's understanding of the complexity and challenges of the policy world.