2. 2008 Synergy Workshop Institute of Medicine Washington, DC

3. Advocating Change in Health Policy You can’t tell the players without a scorecard

4. Success inside the Beltway Understanding the Drivers Who’s Who in the Iron Triangle of Health Policy Strategy Success

5. The Environment Economy Mounting Federal Deficit Politics –Democratic Control of Congress –Republican President’s Popularity –Election Cycle

6. Who Makes Federal Policy? Administration Congress Stakeholders

7. The Administration Executive Office of the President Office of Domestic Policy Office of Management and Budget

8. Administration Health and Human Services Veterans Affairs Defense

9. ADMINISTRATION Health and Human Services –Center for Medicare and Medicaid Services –National Institutes of Health

10. HHS –Food and Drug Administration –Health Resources and Services Administration –Substance Abuse and Mental Health Services Administration –Centers for Disease Control –Indian Health Service

11. The Congress Senate Majority Leader Speaker of the House

12. Senate Committees Finance Health, Education, Labor and Pension Appropriations

13. House Ways and Means Energy and Commerce Appropriations

14. Stakeholders

15. Voluntary Health Associations March of Dimes American Heart Association National Cancer Society American Diabetes Association Disabled American Veterans National Alliance Mentally Ill

16. Trade Associations American Hospital Association Association of American Medical Colleges Federation of American Health Systems Pharmaceutical Research and Manufacturers Association Business Coalitions

17. UNIONS AFL-CIO UAW SEIU

18. Professional Societies American Medical Association National Medical Association American Nurses Association American College of Physicians

19. Academia/Think Tanks Every University Heritage Cato Urban Institute Opportunity Agenda Brookings Institute

20. Secrets to Success Academics vs Politicians

21. Understanding and Strategy

22. Thought Processes Scientific –Problem Statement –Literature Search –Methods –Data Analysis –Results –Limitations –Summary and Conclusions Political –The issue –Current Law –Positions The member The party Relevant Stakeholders Budget Impact and Distribution Staff recommendation

23. Values Academic –Publish or Perish –A Mile Deep –Peer Review –Teaching –Research/Grants –Community Service –Endowed Chair –Tenure The Hill –The Power of the Press –A Mile Wide –Public opinion –Meet and Greet –Fundraising –Jurisdiction (A/B) –Committee Chair –Reelection

24. PREFLIGHT CHECKLIST LEGAL TECHNICAL POLITICAL JURISDICTIONAL PERSONAL

25. Rules of the Road Rule #1 --- be honest Rule #2 --- seize the initiative Rule #3 --- never get between a big dog and a fire hydrant