Health and Medicine Program
Since the founding of our country, Presidential and Congressional leadership has played a critical role in promoting the health of people in the United States. Applying historical perspectives from previous Presidential Administrations and the Congress, the Health and Medicine Program of the Center for the Study of the Presidency and Congress (CSPC) worked to frame health care challenges and opportunities for the federal government to enhance public policymaking. The program examined such health issues as the current federal architecture and governance for health and medicine in America; health reform initiatives; health disparities; food insecurity, obesity, and the growing chronic disease epidemic; biomedical research; health information technology; and advancing global health. Another focus of the program was exploring health diplomacy as a foreign policy tool.
Health and Medicine Initiatives:
The Commission on U.S. Federal Leadership in Health and Medicine: Charting Future Directions
Since November 2008, the Commission on U.S. Federal Leadership in Health and Medicine: Charting Future Directions has been considering critical health and medical policy challenges as well as opportunities to improve health. Comprised of sixty members from diverse sectors, including the health policy community, academia, research, media and the private sector, the Commission draws on its members’ expertise to develop recommendations for policymakers and the American public to advance the health of our nation and world. The Commission is co-chaired by Rear Admiral Susan Blumenthal, M.D., M.P.A. (ret.), Director of CSPC’s Health and Medicine Program and former U.S. Assistant Surgeon General, and Denis A. Cortese, M.D., Emeritus President and CEO of Mayo Clinic. The Commission’s first report, New Horizons for a Healthy America: Recommendations to the New Administration was released on April 20, 2009.
In June 2009, the Commission formed four Working Groups to explore strategies for 1) re-engineering America’s health care system; 2) advancing public health in the United States; 3) strengthening medical and public health research in the United States; and 4) promoting global health and health diplomacy, highlighting ways in which the Federal government and its leaders can partner with the public to achieve a healthier America in the years ahead. The Commission rolled out its second report, A 21st Century Roadmap for Advancing America’s Health: The Path from Peril to Progress,
on May 5, 2010 at the National Press Club. The Commission has convened briefings and utilizes new media strategies to disseminate its findings and recommendations.
SNAP to Health: Improving Nutrition in the Supplemental Nutrition Assistance Program
The Food Stamp Program was established in 1964 to achieve a more effective use of agricultural overproduction, strengthen the agricultural economy, and address hunger and food insecurity in America. In 2008, it was renamed the Supplemental Nutrition Assistance Program (SNAP) to increase the focus on nutrition, yet this name change was not paired with significant policy changes to improve nutrition and prevent obesity for program participants. Today, SNAP is the largest federal food assistance program in the United States, costing $75 billion in FY2011 and enrolling a record 46.2 million Americans (15% of the population) as of April 2012, 50% of whom are children. As currently structured, SNAP does not offer significant incentives to encourage the purchase of healthy, nutritious products, makes little use of its buying power to promote a healthier food marketplace, does not collect data, and places few limits on the types of food or beverages bought. With 1 in 6 Americans experiencing food insecurity and 68% of Americans currently overweight with a threefold increase in childhood obesity since 1980, SNAP must be modernized to address these dual public health threats in America. By promoting strategies to incentivize healthy food purchases and improve program standards at the retail level, this project seeks to promote opportunities for emphasizing health and nutrition in SNAP. The interdisciplinary project team includes experts in federal and state health policy, nutritional epidemiology, agricultural economics, and health communications who conducted activities, including: 1) designed and implemented a survey of stakeholder groups to identify barriers and opportunities for improving nutrition for SNAP beneficiaries; 2) conducted the first statistical analysis of NHANES data to determine the current effects of SNAP on its young beneficiaries, ages 4-19; 3) developed policy recommendations to strengthen SNAP now and in the future; 4) designed and launched an interactive website that serves as a “virtual town hall” (www.snaptohealth.org) for public discourse on improving nutrition in SNAP; and 5) convened a Capitol Hill Educational Briefing on July 18, 2012, where a policy report of the project’s findings was released.
Peace Through Health: The Palestine/Israel Health Initiative
Health can serve as a bridge to peace. Countries cannot achieve political stability or flourish economically with unhealthy people. Over the past decade, however, restrictions on mobility and a tense political climate have rendered cooperative “peace through health” programs between Palestinian and Israeli health experts quite challenging. Yet despite persistent political and geographic constraints, innovative and committed Palestinian and Israeli professionals have continued to work together in the fields of public health and medicine.
During the first phase of its work, the Palestine/Israel Health Initiative (PIHI) of the Center for the Study of the Presidency and Congress (CSPC) (supported by a planning grant from USAID), identified and mapped over forty cooperative health projects between Palestinians and Israelis that are operating in the region, many of which were unaware of other organizations’ existence and mission. Faced with significant physical barriers to intergroup peace efforts in the area, some organizations in other sectors of development—such as youth education—have turned to the Internet and to web social networking tools to facilitate cooperation across divides. However, these tools have been underutilized in the health sector, but hold promise to promote peaceful and productive cooperation between Palestinian and Israeli professionals and scientists. CSPC’s Health and Medicine Program undertook a two-pronged project that 1) mapped forty health initiatives between Palestinians and Israelis underway in the region, and 2) explored the power of information technology (IT) to bring together medical professionals in the area with the goal of advancing health. The project produced the publication: Peace Through Health: A Mapping of Cooperative Health Programs in Palestine and Israel.
Health and Bioethics
Health and professional students graduating today will face a complex, challenging health care environment full of ethical dilemmas. These students will encounter age old ethical challenges that scientists and clinicians have experienced – including truth telling in difficult situations such as informing a patient when they have made a mistake or that the patient has only a short time to live. They will also face a new wave of ethical dilemmas emerging from the explosion of scientific knowledge and technology that challenges our ethics to keep pace with scientific discovery. Now more than ever our health care professionals need a strong moral compass and leadership skills to guide their decision-making and to navigate the complex health landscape of the 21st century.
Rear Admiral Susan J. Blumenthal, M.D., M.P.A., Director of the Health and Medicine Program at the Center for the Study of the Presidency and Congress (CSPC) and former Assistant Surgeon General of the United States, gave a presentation on ethical challenges facing scientists and health care providers today to an audience of high school and college educators at CSPC’s National Consortium for Character-Based Leadership. These educators are working to incorporate ethics curricula into the high school and university classrooms to help ensure a future generation of scientists, clinicians and health care consumers who will act ethically and who will have the skills to address the challenges in health care and scientific research ahead in the 21st century.
The websites listed below provide useful resources and curricula for teachers and students interested in discussing bioethics in the classroom:
ETHX on the Web - Offers over 210,000 citations to journal and newspaper articles, books, book chapters, reports, audiovisuals, and other documents.
High School Bioethics Project - Offers news, outreach, resources, briefs and digital materials.
Kennedy Institute of Ethics, High School Bioethics Curriculum Project(link) - Offers bioethics curriculum units, meetings and conferences, bioethics in the news, bioethics library, video-lending library, science classroom, social science classroom, and humanities classroom curricula.
National Reference Center for Bioethics Literature (NRCBL) - Offers education/teaching resources, publications, educational opportunities, current topics, and a syllabus exchange catalog.
Northwest Association for Biomedical Research - Offers educational materials including an ethics primer, ethics in the science classroom learning materials, teacher-developed action plans, and teacher-developed lessons.
President's Council on Bioethics - Offers reports on topics of concern to the Council and an overview of bioethics issues.
Health and Medicine Resources
Listed below are selected helpful government and private sector resources on health policy issues.
U.S. Government Health Policy Resources
U.S. Department of Health and Human Services - The U.S. Department of Health and Human Services (HHS) is the U.S. government’s principal agency in protecting the health of Americans and is comprised of over 300 different programs covering a wide range of health programs, activities and issues.
Agency for Healthcare Research and Quality, HHS - The mission of this agency within the U.S. Department of Health and Human Services is to improve the quality, safety, efficiency, and effectiveness of health care in America.
Centers for Disease Control and Prevention, National Center for Health Statistics, HHS - The National Center for Health Statistics provides a broad range of data, reports and other useful information for analyzing health trends in the United States.
Center for Medicare and Medicaid Services, HHS - Provides detailed Medicare and Medicaid information, including guidance and regulations, research and statistics as well as materials for outreach and education.
Health Resources and Services Administration, HHS - The Health Resources and Services Administration (HRSA) is the primary Federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable.
National Health Information Center, HHS - The National Health Information Center (NHIC) is a health information referral service. NHIC puts health professionals and consumers who have health questions in touch with those organizations that are best able to provide answers.
National Institutes of Health, HHS - The National Institutes of Health (NIH) is the primary government agency that supports biomedical and behavioral research.
National Library of Medicine, HHS - The National Library of Medicine, located on the NIH campus, is the world's largest medical library. The Library collects materials and provides information and research services in all areas of biomedicine and health care.
U.S. Government Health Information Portals
Listed below are some helpful health information portals sponsored by agencies of the U.S. Federal government.
Private Sector Health Policy Resources
Academy Health - Academy Health is a nonpartisan resource for health research and policy that provides information for health services researchers, policy analysts, and practitioners. Academy Health promotes interaction across the health research and policy arenas by bringing together a broad spectrum of players to share their perspectives, exchange knowledge, and strengthen their working relationships.
Center for Health Improvement’s Health Policy Guide - The Center for Health Improvement is a national, nonpartisan, nonprofit health policy center that is dedicated to advancing policies and providing technical assistance to improve population health and encourage healthy behavior. The Health Policy Guide provides evidence-based, peer-reviewed policy guidance and resources to support advocacy and decision-making at the state and local levels.
Center for Studying Health System Change - A nonpartisan policy research organization that conducts studies focused on the U.S. health care system with the goal of informing policymakers, the Center for Studying Health System Change provides issue briefs, community reports, and links to journal articles. The organization receives funding by the Robert Wood Johnson Foundation.
Commonwealth Fund - The Commonwealth Fund is a private foundation that aims to promote a high performing health care system. The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. Results of this research can be found on their website.
Health Affairs - Health Affairs is a leading journal of health policy thought and research. Published since 1981, Health Affairs is nonpartisan and presents a wide range of timely research and commentary on health issues of current concern in both domestic and international spheres.
Health and Medical Care Archive - A project of the Inter-University Consortium for Political and Social Research dedicated to preserving and disseminating data collected from research projects funded by The Robert Wood Johnson Foundation, the largest philanthropy devoted exclusively to health and health care in the United States.
Health Policy Picks - A monthly selection from KaiserEdu.org of recent publications from organizations and government agencies that conduct research and policy analysis on health issues.
Henry J. Kaiser Family Foundation - A non-profit private organization that provides data and analysis on significant health care issues in the United States and globally, including: daily health policy reports; state health data and comparisons; education materials (tutorials, libraries and issue modules on health policy topics); and global health data, including country specific information on TB, malaria, HIV/AIDS and others diseases.
Institute of Medicine - A component of the non-profit National Academies of Science, the Institute of Medicine provides evidence-based scientific reviews of issues in medicine, biomedical science and health.
Kaiser Permanente Center for Health Research - Kaiser Permanente's Center for Health Research is a non-profit research institute with the mission to improve individual health and inform health policy. The Center brings together scientists from many fields who conduct research and demonstration projects across a broad range of health care issues.
National Academy for State Health Policy - The National Academy for State Health Policy is an independent organization of state health policymakers working together to identify emerging issues, develop policy solutions, and improve state health policy and practice. NASHP provides a forum for constructive, nonpartisan work across branches and agencies of state government on critical health issues facing states.
National Committee for Quality Assurance - The mission of NCQA, an independent, non-profit organization, is to improve the quality of health care. This website provides information about the quality of the nation’s managed care plans.
National Health Policy Forum - A nonpartisan organization that seeks to inform the public policy process by helping participants, including federal health policymakers in the legislative and executive branches and in congressional support agencies, engage in rigorous, constructive, and respectful dialogue. The website provides issue briefs, background papers and basic information on health policy topics.
RAND Health - For more than 50 years, RAND has been working to improve policy and decision-making through research and analysis. RAND Health continues that tradition, advancing understanding of health and health behaviors and examining how the organization and financing of care affect costs, quality, and access.
World Health Organization - The World Health Organization is the United Nations specialized agency for health. WHO's objective, as set out in its Constitution, is the attainment by all peoples of the highest possible level of health.
Historical Perspectives on Presidential Health Initiatives
"Remembering How Far Health Care Has Come Since George Washington's Time" by Daniel J. Glunk, M.D., from Medical News Today, February 6, 2006.
To address the decline in public service and interest in the history of the Presidency, the Center invites 85 of the nation's top college and university students yearly to Washington to participate in the Presidential Fellows Program, a series of leadership conferences in the fall and spring that provide the opportunity for Fellows to interact with high-level government officials from the Executive and Legislative branches and the policy community. The centerpiece of the program is the research, writing and defense of original papers on the Presidency and their publication in A Dialogue on Presidential Challenges and Leadership.
Good leadership is based on trust. In response to character failures routinely witnessed in government, business, education, religion, and athletics, in 2006 the Center established the National Consortium for Character-Based Leadership, an organization of more than 40 high schools, colleges, service academies, business schools, and independent institutions. The Consortium aims to unite the often disconnected fields of ethics and leadership education by providing tools for students who struggle with morally complex leadership situations.
For more information, please contact Andy Steele, Director of the Presidential Fellows Program, via
or at 202-872-9800.
Energy and the Environment
As part of the Strengthening America’s Future Initiative, the Center for the Study of the Presidency and Congress (CSPC) periodically gathers experts from the Executive and Legislative branches of government, corporate and university research, the public policy community, and capital market firms to examine and create policy recommendations on energy production, technology, efficiency, investment and climate impacts. Sessions to-date have focused on developing a federal climate change policy and implementing an R&D investment strategy. Future sessions will examine options for domestic energy production, energy and international finance, and U.S. multilateral and bilateral agreements on technology transfer. Findings will be shared with the President, Congressional leaders and the public policy community.
No "silver bullet" exists to improve energy supplies, security or climate policy. The best course of action would be to work with Congress, industry, research organizations, environmental groups and capital markets to: increase domestic energy production to maintain economic growth and national security, and articulate a domestic and global climate policy comprised of four inter-related pathways: mitigation, adaptation, technological innovation and finances and markets.
Efficiency gains need not be high-tech. Federal and state efficiency standards can drive job growth and efficiency gains. Stiffer building codes and large tax breaks to local businesses, home owners and governments that insulate their buildings or install more efficient HVAC equipment would create jobs, reduce imports, and increase U.S. energy security.
Finally, 85 percent of the U.S. energy production and distribution system is investor-owned; 90 percent of the ROW’s energy systems are wholly or partially owned by governments. Both economic models tend toward economic and/or environment excess. Cooperatives, by contrast, harness economic incentives (produce/buy in bulk), build a sense of community, produce economic returns (shares/dividends/credits) and can foster environmental stewardship.
The group is co-chaired by David G. Victor, Director of Stanford University’s Program on Energy and Sustainability, and Jonathan Lash, President of the World Resources Institute, with other participants including: Carl O. Bauer, Director of the National Energy Technology Laboratory at the U.S. Department of Energy; William Bonvillian, Director of the Washington Office of the Massachusetts Institute of Technology; Ralph J. Cicerone, President of the National Academy of Sciences; Wayne Clough, former President of the Georgia Institute of Technology; Richard A. Meserve, President of the Carnegie Institution; Patrick Mulloy, Advisor at the Alfred P. Sloan Foundation; David Myers, Vice President of Engineering and Technology at the Research Triangle Institute; Frederick C. Smith, Vice President of the U.S. Chamber Institute for 21st Century Energy; Charles M. Vest, President of the National Academy of Engineers and Vice Chairman of the National Research Council; Gerry Waldron, Chief of Staff of the Select Committee on Energy Independence and Global Warming; Lew Watts, President & CEO of PFC Energy; and Timothy Wirth, President of the United Nations Foundation and Better World Fund.
As the nation's only think tank that systematically examines lessons from Presidential and Congressional history and applies them to current policy making, CSPC reaches out to members of Congress and their staff to provide support and advice for a wide array of policy areas. Drawing upon the vast resources of the Center, CSPC works behind the scenes, frequently briefing Members of Congress and their staffs to contribute non-partisan analysis of the political issues facing the President and Congress.
What Congressional Relations Does:
- Provides in-office briefings on Capitol Hill about key policy issues, citing the lessons of history.
- Involves Members of Congress and their staffs in CSPC activities
- Helps synergize Legislative-Executive relations
- Promotes bi-partisan policy to further America's interest
CSPC has been approached by Members of Congress to work on several issues of national importance:
Foundation for International Understanding (FIU)
Advancing Trust and Reconciliation in Israel and the Palestinian Territories
Iraq Study Group
The Domestic Nuclear Detection Office
CSPC has also involved Members of Congress and their staffs in other policy activities:
Strengthening America’s Future Initiative and Agenda 2008
Afghanistan Study Group
Declaration on Civility and Inclusive Leadership and Mount Vernon Compact
For more information, please contact John Boyer, Director of Congressional Relations, via
or at 202-872-9800
CSPC works on a variety of pressing national issues.
Religion plays a major role in American public life. From the relationship between Church and State to the principles of religious freedom and tolerance, questions about religion have greatly influenced U.S. public policy and the evolution of the broader society.
To further understanding of the historical and contemporary role of religion in the American public arena, CSPC launched its initiative “Religion and the American Experience” in 2012. This initiative is focused on four broad themes: Religion and Civil Society, Religion and Public Policy, Religion and Foreign Affairs, and Religious Extremism and Violence in America.
This initiative grew out of the Center’s commitment to a renewal in character-based leadership in government. In an attempt to address the breadth of current national and domestic challenges facing the United States, the Center has formed the bipartisan National Committee to Unite a Divided America. This group, comprised of 200 prominent Americans, is working closely with Members of Congress to move beyond partisan debate and toward a civil and inclusive environment on Capitol Hill.
The Center works closely with Members of Congress and their staffs on initiatives that would benefit from Congressional attention. The Center is currently engaging Members of Congress on its Strengthening America’s Future Initiative (SAFI), Civility and Inclusive Leadership Initiative, and Congressionally-mandated Foundation for International Understanding, as well as monitoring current legislative and political activity.
While there is no perfect remedy for improving energy supplies, CSPC believes that working together with Congress, industry, research organizations, environmental groups and capital markets can lead to improved energy production and economic growth. Under the leadership of co-chairs David G. Victor, Director of Stanford University’s Program on Energy and Sustainability, and Jonathan Lash, President of the World Resources Institute, the Center aims to create policy recommendations that support cooperatives, produce economic returns, and foster environmental stewardship.
For nearly forty years, the Center has sponsored a unique non-resident program that offers up to 85 select undergraduate and graduate students from leading colleges and universities a year-long opportunity to study the U.S. Presidency, the public policymaking process, and our Chief Executive’s relations with Congress, allies, the media and the American public. This, the Presidential Fellows Program, along with the Center’s National Consortium for Character-Based Leadership, a group of more than 40 schools, colleges, and service academics, aims to develop a new generation of national leaders committed to public service.
Since 1999, the Center has worked with the Executive Branch, private sector, and think tank community on homeland security issues ranging from nuclear defense to the strategic partnership between the U.S. and Canada. From 2006 to 2008, the Center hosted the Project on National Security Reform with a $2.4 million appropriation supported by Congress.
For nearly a decade, the Center has stood as one of the only institutions offering in-depth case-studies of the modern Presidency. Beginning with the publication of Triumphs and Tragedies of the Modern Presidency: Seventy-Six Case Studies in Presidential Leadership, the Center has worked with leading Presidential historians and journalists to document past Presidential successes and failures and present these findings to the current Administration.
In addition to the Center’s ongoing scholarly examination of past Presidential transitions, it has been working closely with the current Administration on its Strengthening America’s Future Initiative (SAFI). The first SAFI report (released on Capitol Hill in March 2009), combined with the Center’s close work with members of European governments and policy communities, assisted the President’s approach to critical issues facing the country.
The Center works jointly with distinguished technology experts on confronting the post-Cold War environment. CSPC is currently partnering with the National Academy of Sciences, American Association for the Advancement of Science, National Science Foundation, and Defense Science Board to address the development of alternate energy sources, delivery of affordable health care, and security of an array of economic benefits through each endeavor.
In 2005, at the behest of Congressman Frank Wolf, CSPC played a critical role in developing the Iraq Study Group, a commission whose findings were presented to both Congress and the White House in 2006. Since then, the Center has launched the Afghanistan Study Group, a health and developmental initiative between Israel and the Palestinian territories, and a 2009 dialogue between the U.S. and Syria. Currently, the Center is working with European leaders to enhance NATO’s involvement in Afghanistan and plans to meet with European officials in early 2010.