13 HoursDirector Michael BayWriter Chuck Hogan (screen.docx

13 Hours
Director: Michael Bay
Writer :Chuck Hogan (screenplay), Mitchell Zuckoff (book)
Production designer: Jeffrey Beecroft
Production companies: Paramount Pictures, 3 Arts
Entertainment,
Bay Films, Dune Films, Latina Pictures
Source
• IMDB link for the credits and cast
https://www.imdb.com/title/tt4172430/fullcredits/?ref_=tt_ov_st
_sm
• The link for the movie
https://www.imdb.com/title/tt4172430/?ref_=ttawd_awd_tt
The Logline
• The concept of the project is to identify the talent used in the
production of the movie and their influence to the audience.
Also,
to identify the differentiating factor that makes the movie good
for evaluating its production schedule, the budget and marketing
of the movie.

The Premise Of The Movie
• The CIA employs ex-soldiers to protect political personnel in
foreign countries. Six of these soldiers find themselves in the
heat
of the war in Benghazi, Libya. The president is killed and
dragged
in the streets as the rebels plan an attack on the American
embassy. Its up to six soldiers to hold the embassy bravely until
help arrives and to them 13 hours felt like days of an ending
war.
The Talent
Michael Bay
The director of the movie 13 hours
Owner of Bay films production company
(imdb.com, 2019)
Michael Bay Credentials
• A renowned director famous for the production of Bad Boys
which
featured Will Smith and Martin Lawrence. Also, directed The
Rock
which featured Sean Connery and Nicolas Cage. Currently

produced the famous TV series The Last Ship (imdb.com,
2019).
• Michael Bay is a natural story teller since his movies are
directed
with vigor and class. The motion picture is accurate and the
story
is always action packed with every part leading to another. His
very creative and the audience always responds positively to his
movies.
The Talent
John Krasinski
Actor
Director
Producer
(imdb.com, 2019)
John Krasinski Credentials
• Known for his role as an actor in the famous NBC TV series
The
Office. Also, stars in the movie A Quiet Place, It’s Complicated
and
Something Borrowed (imdb.com, 2019).
• The actor is a charismatic individual who is able to captivate

the
audience into loving his work and the skill has been rewarded
though winning various awards including the Guild Award for
outstanding performance.
The Talent
Jeffrey Beecroft
Production designer
Art director
Guild award winner for
Designer of the year
(imdb.com, 2019)
Jeffrey Beecroft Credentials
• Beecroft is no stranger with awards due to his stunning
designs.
These include an Academy Award nomination for production
design in Wolves, CLIO awards and Guild awards (imdb.com,
2019).
• He is famous for his designs and the movie industry loves his
work
based on the success he has had in the long list of movies that
he
participated in creating. These include the famous Twelve

monkeys, Transformers and A Quite Place.
Differentiating Factor
• The differentiating factor of the movie 13 hours is based on
uniqueness (Lyons, 2015). The project choice of the movie 13
hours is based on a true story. The movie was produced in 2016.
While the actual events depicted in the movie happened in 2012
in
Benghazi, Libya.
• This makes the movie unique since it is able to tell the story
of
those unsung heroes that risked their lives for their country. As
one actor states in the movie, “are you ready to die for your
country?” Those soldiers were real life heroes.
References
• Imdb.com. (2019, September 6). Jeffrey Beecroft. Retrieved
from IMDB:
https://www.imdb.com/name/nm0066360/?ref_=ttfc_fc_cr18
• Imdb.com. (2019, September 6). 13 Hours (2016). Retrieved
from IMDB:
https://www.imdb.com/title/tt4172430/?ref_=ttawd_awd_tt
• Imdb.com. (2019, September 6). John Krasinski. Retrieved
from IMDB:
https://www.imdb.com/name/nm1024677/?ref_=ttfc_fc_cl_t1
• Imdb.com. (2019, September 6). Michael Bay. Retrieved from

IMDB:
https://www.imdb.com/name/nm0000881/?ref_=ttfc_fc_dr1
• Lyons, J. (2015). Anatomy of a Premise Line: How to Master
Premise and
Story Development for Writing Success. Focal Press.
https://content.taylorfrancis.com/books/download?dac=C2014-
0-33109-
0&isbn=9781317558958&format=googlePreviewPdf
Contemporary Issues in Public Health Policy
© 2018 Laureate Education, Inc. 1
Program Transcript
JOEL TEITELBAUM: I think that there are quite a few trends
that we can see in
the future that will be greatly influencing health policy-making
and
implementation. One of them is an increased call for better
mental health care.
Another one is an increased call for universal insurance.
The Affordable Care Act got us probably about half way to
insuring the 50 million
people that were uninsured before the Affordable Care Act was
passed and
implemented. You're still looking at probably 20 to 25 million
people uninsured.
So I think the Affordable Care Act, while putting us on the path
toward universal

insurance, we're still a long way from it. And I think there will
be a movement to
keep heading in that direction.
And I worry that future politicians will wonder if this kind of
major reform is
something that is not worth trying because of the political
pitfalls potentially. I
think if that happens, we will be thrown back into an era of
incremental reform,
which is what we really saw between the 1960s and passage of
the Affordable
Care Act in 2010.
Another future trend I think is going to be a focus on how the
social determinants
of health are affecting not only individual healthful population
held. So by social
determinants, I mean those things that influence where we live,
where we work,
where we play. And this is getting a lot more attention in the
past couple of years,
than we have seen in the past.
I work on a project called the National Center for Medical Legal
Partnership,
which is a project that aims to embed legal services as part of
the health care
delivery team. The idea being that there are many social
determinants of health
that are better addressed by a lawyer then they can be addressed
by a
physician.
Regardless of how adequate the care and how compassionate the
physician,

there's nothing a physician can do necessarily to ameliorate, say
a moldy
apartment that keeps sending a child with asthma back to that
physician. But if
you include, as part of the health care delivery team, a lawyer,
who can go out
and actually do something about remediating the mold in that
apartment through
housing laws, then perhaps you could see a real change in that
child's health.
And then through individual health that way, you could more
broadly impact
public health.
Another future trends that we will likely see greatly influencing
health policy-
making is in fact climate change. Very likely that we're already
seeing the effects
locally and nationally of climate change, to the point we're
going to have to be
thinking about what it's going to mean for our food security and
other aspects of
the health policy-making process.
Another trend that I think we're likely to have to grapple with is
the increase in
antibiotic-resistant bacteria. This has clearly become a problem
in hospitals
across the country. We don't have a great answer for this one

yet from a policy
making perspective. But there's no question that what we're
hearing from the
CDC and other national organizations, this one is going to have
to be dealt with
and relatively quickly as well.
My advice to students who are interested in health policy and
politics is to get the
most well-rounded education that you can. What I have learned
in my 17 years in
teaching in the health policy department is that you need to
understand so many
various disciplines and aspects of policy and the health care
system. We're not
only talking about the policy-making machinery in the policy-
making process, but
policy advocacy, law, medicine, public health, politics, and ever
increasingly
complex health care delivery system.
So the one thing that I would tell my own students if they're
entering a program,
is you have to really go into this knowing that you're not just
studying policy as a
stand alone project or topic, but rather you have to really grasp
law and
economics and public health and everything that connects to
with health policy-
making in the health care delivery system.
One last thing I would add for students who are studying health
policy is it they
must understand the critical link between policy-making and
law. If you think
about public policy in this country-- putting aside health policy

for a moment-- if
you're going to make any major change to public policy, the
only way to really
achieve that is through law.
If you think about what a policy is, it's really just a decision.
There's a problem
that you might want to address, and you think about what the
options are for
addressing that problem. And you settle on what you think is
the best choice.
That's a policy choice. That's a policy decision. But then how
do you implement
it? How to effectuate that?
And the way you normally do that, especially with major public
policy, including
health policy, is through law. And so really understanding how
the law operates,
how the legal system operates, and the influence that law has
over policies even
after you think you've got a decision, is critically important.
Additional Content Attribution

MUSIC:
Creative Support Services
Los Angeles, CA
Dimension Sound Effects Library
Newnan, GA
Narrator Tracks Music Library
Stevens Point, WI
Signature Music, Inc
Chesterton, IN
Studio Cutz Music Library
Carrollton, TX
Peter Beilenson: Population Health
Program Transcript
[MUSIC PLAYING]
PETER BEILENSON: Your zip code that you live in makes
more difference in
your health and well-being than the genetic code that you're
born with.
[MUSIC PLAYING]

The bottom line that we use all the time "is place matters." The
place that you
grow up matters hugely. And if there's a four-legged stool of
things that supports,
that allow for people to grow healthfully and into decent social-
economic
wellness, if you will, it's access to health care, it's access to
decent education, to
decent, safe housing, and probably most importantly access to a
livable wage
paying jobs. It's those four things that if you do have them,
you're going to turn
out much, much better in general than if you don't have them.
I can give a perfect example of this in real life. A neighborhood
in Baltimore
called the Oliver neighborhood, which is a particularly
decimated, vulnerable,
underserved left-behind neighborhood. It used to be where a
working class
African-American, It's now a drug-infested area. There's
dilapidated housing with
lead-poisoned kids. There's housing that has fallen down.
The broken window theory of once a couple of houses have
broken windows, the
neighborhood tends to go downhill because it looks like things
aren't being taken
care of. And so more crime occurs. So it's heavily crime-
infested.
There are a lot of uninsured adults who don't get their health
care taken care of.
So there's a lot of chronic disease-- diabetes, high blood
pressure, strokes, et

cetera. So there's lack of decent housing, lack of health access.
The schools that serve this neighborhood, Oliver, are
particularly poor. And
lastly, not only is it a food desert in terms of not having good
produce and fresh
foods available because there are no supermarkets in the
neighborhood, it's
literally a wage desert. I can't think of any business in the
Oliver neighborhood
that pays a livable wage job.
So that's a perfect crystallization of having nothing of the four-
legged stool of
social determinants of health. Compare that with Howard
County, Maryland, 12
miles away, maybe three or four zip codes away, where the vast
majority of the
population has access to great recreation facilities, excellent
housing. There's
been one lead-poisoned kid in the entire county of 300,000
people in the last
couple of years, total. The percentage of folks who are
uninsured in that county is
about 7% to 8%, 9%, compared to 30% of the adults in this
neighborhood in
Baltimore.
The school system is ranked the best in the state, probably one

of the top 10 in
the country. And there are innumerable living wage jobs. And,
not surprisingly,
the healthiest county in the state of Maryland is Howard
County. And the poorest-
- the least healthy county in the city/county in the State of
Maryland is Baltimore.
[MUSIC PLAYING]
So the paradigm that the Institute of Medicine put out--
probably now it's 15, 18
years ago-- but it's looking at health problems and health policy
with a three-step
process. And epidemiology is particularly important in the first
and third steps.
The first step is doing a needs assessment of whatever
population you're
serving. You assess the needs of the population that you're
serving. And that's
where epidemiology comes in-- statistics, data, et cetera--
depending on what
issue you want to deal with.
And when we picked priority areas when I was in Baltimore
City, the Baltimore
City Health Commissioner, we looked at areas that had large
numbers of years
of productive lives lost. Basically means if the average life
expectancy is, let's
say, 75 in the community, and something tends to kill people in
their 30s, like
AIDS did several years ago, that's 40-something years of
productive life lost. And
so that's an important thing to focus on similarly. Infant
mortality, that's 75 years

of productive lives lost.
So the paradigm needs assessment can be done in looking at
years or
productive lives lost. It can also be in a specific policy area,
like immunization.
The needs assessment might be what part of your population is
particularly
unimmunized, and then go after that.
And then the second phase of this paradigm is policy
development. So you
assess the needs of your population. And to deal with them, you
come up with
policy. It can be legislation to address the issues that you've
found. It can be a
program that you start up. It can be advocating for a change in a
certain area to
get that need addressed.
And the third component is assurance, which is basically
evaluation. We almost
always in my work-- whatever initiative that we launch, we
always build in an
evaluation tool at the end so you can see if what you did, the
policy you
developed, met the need that you assessed.
There are three classic examples that I've worked on in the last
15 years or so
that highlight the use of this paradigm the Institute of Medicine
uses in terms of
looking at ways to look at public health problems of needs
assessment, policy
development, and assurance. And the first is an immunization
issue.

In the mid- to late 1990s-- 1996, '97, to be exact-- we had
worked with the
Agency for International Development. And at that time, Vice
President Al Gore
wanted to choose an American city to show that the lessons that
were learned
outside our borders by the AID COULD be brought to bear on
third-world parts of
the United States. And we were chosen first here in Baltimore.
So the Vice President came along with the mayor and myself,
and we went
around about the vulnerable areas. And he was talking about
some of the
success stories that AID had had internationally. And one of
them was that the
immunization rate in several impoverished developing
countries, including
Kenya, were significantly better than the immunization rates we
had in our
schools here in Baltimore. Even though there is a law that
requires kids to be
fully immunized before they go to school, it just wasn't being
enforced. Only 62%
of kids in the school system were fully immunized or had
records there of.
So the policy that we developed was multi-pronged, one of

which was to do a lot
of public relations communication to parents saying, hey, we're
going to be
dealing with this. We're going to start holding you responsible.
We had huge
clinics in the school system buildings prior to school starting in
the '96-'97 school
year where we had thousands and thousands of kids coming in
to get
immunized. And by the way, at the same time, not just school-
aged kids, but their
little siblings. So we hoped it would make a difference for kids
coming up.
So we instituted these two policies. And again, this is
something we could do
ourselves. It was both communications-based as well as offering
services. And
we went from 62% of kids at the beginning of that school year
to 99.8%
immunized within three months.
And because we enforced this-- so we went from something like
40,000 of the
100,000 kids unimmunized at the beginning to about 200. And
as far as we could
tell from a lot of heavy work, most of those 200 actually moved
out of-- they just
were incorrect information that the school system had about
them. They actually
weren't even in the school system anymore. So we basically
went from one of the
worst immunized cities in the country to one of the very best.
And it stayed that
way for the last 12, 14 years because the enforcement tools have
been kept in

place.
So needs assessment in this case, pretty simple. You just look at
the data from
the school system that show we were very under immunized.
Policy
development, communications, legal ramifications, and offering
clinics to
immunize kids. And assurance, following up to make sure that
the law was
enforced, that the rules were enforced at the school system
level, and keeping
track of the kids going forward that were immunized.
So a good public health success story and a little bit unusual in
that most public
health problems from AIDS to chronic disease take decades to
develop and
usually take a while to fix. In this case, it took a decade to
develop. But it took
three months to fix.
Early in 1998, the CDC, the Center for Disease Control and
Prevention, comes
out with their national rankings on syphilis. And Baltimore not
only ranks first in
the country, but we have one out of every 20 cases in the entire
United States in
Baltimore City. You've got to assess what's the epidemiology

behind this
outbreak.
And it was very interesting. We actually, by the way, had hit the
trifecta of being
number one in the country not only in syphilis, but gonorrhea
and chlamydia, too.
Obviously you would think somewhat related, but in reality not.
And that was because gonorrhea and chlamydia were tending to
hit 13- to 25-
year-olds if you looked at the data. Serially monogamous, which
many nurses
know having taken care of it, especially if you've taken care of
teens, serially
monogamous means basically you're talking to the teenager,
how many partners
do you have? One. How many partners in the last seven weeks?
Five. Well,
you've been serially monogamous.
But they tend to know their partner. And so it's easy enough to
do contact tracing
and to get the partners notified and medicated so that you can
deal with the
gonorrhea/chlamydia outbreak. And so that was being done a lot
through the
school system and through our family planning clinics for teens.
Syphilis, when you looked at the data, was very, very different.
It was 25 or older,
more like 30- to 50-year-olds who were involved in drug for
sex, particularly
crack, and were in crack houses, and barely knew the person's
first name, if that.
And so it was much harder to track, and much harder to deal

with.
And looking at the epidemiology of it, it actually looked like it
was dispersed
around the city, which was surprising. But if you followed
Baltimore's history, you
knew that the year before a lot of the high rises that were
disastrous, that
concentrated a lot of impoverished drug-using population, were
torn down. And
so they shredded the populace and placed them all over the
place.
And so that was actually, we think, part of the reason for the
spread because
there was more-- it wasn't concentrated in one, or two, or three,
or four places.
But it was all over the place. And so your chances of coming in
contact with
someone with syphilis was greater. And once enough of the
population,
particularly the drug-using population of that age, were
infected, then you reach a
tipping point where by which you're more likely to come in
contact with someone
who's infected and therefore get infected yourself.
So the policy we developed was multi-pronged again. Partly it
was
communication. So we wanted patients, or individual citizens,
as well as

providers, docs and nurses, to know the signs and symptoms of
syphilis because
it was actually relatively rare before.
And so we were seeing a lot of patients coming in from
emergency rooms who
had been treated for a fungus when actually they didn't have a
fungal infection,
they clearly had syphilis. But the doc or nurse practitioner had
not seen a syphilis
patient ever. And so they were misdiagnosing.
And so we actually encouraged people to send folks with genital
lesions to our
STD clinics because just as with heart bypass, the more you do,
the more you
know. And the more you see, the better you are treating it. So
we did that.
We actually trained our disease trackers in blood drawing and
sent them out. We
didn't do this terribly much, but we sent them out to crack
houses to draw blood.
Why? Because that's where you do syphilis testing. And then we
would come
back and either shoot people up with penicillin there or bring
them back to our
clinics.
And then the third thing we did, which was actually the biggest
yield, was, if you
think about it, because they're involved in the sex-for-drugs
trade, a significant
portion of this population is going to some way get arrested

during a given year,
either for possession charges, or distribution charges, or
prostitution charges, or
whatever. And so we did stat testing for syphilis at the central
booking center,
which is where everybody comes in who gets arrested in
Baltimore. And we had
a huge yield of syphilis-positive individuals.
And so they were at least-- although, you're supposed to get
three shots of
penicillin, they at least got one before they were released within
a day, or two, or
three. And then we tried to follow-up with many of them. But
one shot at least
makes a difference.
So within a year, we had an 82.4% drop in our syphilis cases
from 660 to
something like 100-- low 100s, mid 100s. And it has stayed at
or below that level
virtually the entire time since because we've done a lot of
outreach and are
making sure that people who are in vulnerable populations are
tested. We're still
too high.
But we dropped out of the trifecta. And we are no longer
number one in
gonorrhea, chlamydia, or syphilis. And so it's a significant
success story.
Although certainly, we did not eliminate syphilis.
[MUSIC PLAYING]

Trowell‐Harris, I. (n.d.). Various Photographs [Photograph].
Used with permission
of Irene Trowell-Harris.
Wakefield, M. (n.d.). [Photograph]. Used with permission og
Mary Wakefield
WAL_NURS6050_NIH-SenatorDanielInouye
Official White House Photo by Pete Souza
Working with Legislators
Program Transcript
FEMALE SPEAKER: The people who you are talking with in an
elective office or
their staffs are extremely bright. Having said that, do not

assume that they know
what you know. That's what you bring to the table.
[MUSIC PLAYING]
These may be individuals that have never been in the hospital
except for the day
that they were carried out in their mother's arms. They may not
have had
ongoing, extensive exposure to the challenges of the
populations you're serving.
So you're the voice to that. So bright people, but do not
underestimate what you
bring to that conversation.
FEMALE SPEAKER: I've always told students, if you ever go
into a legislator's
office and heart conditions are your thing, don't ever talk about
all the CABGs
that have been done. That's a coronary artery bypass graft. They
don't know
what a CABG is. They think a CABG is something that looks
kind of like a lettuce,
only it's tougher.
We know not to use that kind of terminology with patients. We
know not to use it
with legislators, even though they may be lawyers and
attorneys. They don't
understand medical terminology.
FEMALE SPEAKER: So it's really important for people that
you're talking to know
your background, to know that you're a registered nurse, that
you have a
master's degree, and your specialty is in a particular area. So

you're talking
about the population you work for and maybe even where you
work. That's
information that they need to know about you, because how they
process the rest
of what you tell them will be informed and influenced by their
knowledge of your
background.
So be sure that that's the first thing you say to them. This is my
name. This is
what I am. And here's where I'm from.
It's really important to have your facts down, and that if there's
a question you're
asked and you don't know the answer to it, to know that that's
OK, that you do
the follow up coming back to them and letting them know, I
don't know the
answer to that question. But I'll be sure to get it for you. And
then do it, and do it
quickly.
We also should never stretch the truth, deviate from fact. If
what we're sharing is
an opinion, we ought to let them know it's an opinion. Now, I
would say it's an
expert opinion, probably, on health care, because of our
background. But be able
to distinguish, my opinion is this, or based on my experience,
this is what I see.

Additionally, it's so important for us to be members of
professional nursing
organizations. It's important, because it's so challenging these
days to stay
abreast of the issues, challenges, problems, policies that are
resonating at state
and federal levels. So I stay in close touch through email
communication that I
get from the professional associations of which I'm a member.
And when they
ask me to do something, I act on it.
It doesn't mean you have to be full-time in health policy to do
this. It does mean
that on occasion, spending five minutes to read up on an issue
and then sending
an email consistent with what my professional association is
asking me to do,
that might be at least as important as what you do for a patient
or for family or for
a community that day, because engaging there might actually be
part of the
trigger to get a policymaker to do something different than they
may or may not
have done otherwise.
FEMALE SPEAKER: It's fine to disagree. But let's work on
what is going-- that
we can get done successfully together, though. And that's been
my whole thing
with policy, collaboration across parties, working together to
get things done.

When we have a disagreement, we disagree without hostility,
but we certainly
disagree clearly and reinforce our position with data, anecdote,
things that will
help communicate why we believe so fervently in the
importance of a particular
piece of legislation, a particular regulation, a particular program
or policy.
So you can let them know that their position is not one that you
agree with, that
you have a different view. And you'd want to give them the
information about why
your view is different. But a tone of hostility is not helpful.
The other point I'd make is starting with common ground, trying
to establish
common ground. I know you care deeply about your
constituents. I know you
care deeply about mothers who are struggling as single parents
and who
frequently are living in environments that are impoverished,
where it's difficult for
them to put food on the table and also pay for medications for
their children. I
know you care about that. And then taking that issue from there.
So starting with
common ground is important.
And absolutely thanking members of Congress and being there
for them, or state
legislators, when you think they've done the right thing. I can't
begin to tell you
how much public thanks, and private thanks too, matter to
people who are really
working hard, from their vantage point, trying to do the right

thing.
Communicating what the positions are of individuals, whether
they're for a
position or they're against it, it's really important for us to
communicate that, not
just to the individual but more broadly to the public, in part
because the public
can help us leverage members of Congress and state legislators
to do the right
thing too. So don't keep it to yourself. Don't even keep it within
the nursing
community. Push it out.
[MUSIC PLAYING]
.
Trowell‐Harris, I. (n.d.). Various Photographs [Photograph].
Used with permission
of Irene Trowell-Harris.
Wakefield, M. (n.d.). [Photograph]. Used with permission og

Mary Wakefield
WAL_NURS6050_NIH-SenatorDanielInouye
Official White House Photo by Pete Souza
GettyLicense_769805145
Akepong Srichaichana/EyeEm / EyeEm / Getty Images
An Introduction to Health Policy and Law
Program Transcript
JOEL TEITELBAUM: Politics plays a huge role in the
development and
implementation of health policy.
NARRATOR: Joel Teitelbaum is the associate professor and
vice chair for
academic affairs in the Department of Health Policy at the
George Washington
University. He's also the school's director of the Hirsch Health
Law and Policy
program. Professor Teitelbaum co-authored The Essentials of
Health Policy and
Law for students studying law and policy as a component of
their public health
studies.

As a university professor and an academic lawyer, Joel has
influenced health
policy and the policymaking process.
JOEL TEITELBAUM: Two of the three branches of government
are by intent by
design political. So the executive branch and the legislative
branch, the two
branches of government that are tasked with designing and
implementing health
policy and laws, are by their design political, because we elect
them. They're
imbued with power as a result of federal and state elections.
So you from that starting point, you have to understand that
anything that goes in
the policy making and the legal process is going to be political.
The Affordable
Care Act, for example, passed without any Republicans
signatures. And you can
see, after it was passed and it's being implemented that fully
half of the states,
most of them led by either Republican governors or legislatures,
are actively
challenging or ignoring the law.
So it's clear that obviously politics is playing a very important
role in both the
design at the outset and now the implementation of the
Affordable Care Act.
Over the past century or so, there have been many examples of
important health
policies that have really changed the delivery of public health
services in this
country. I think a good starting point is with the Public Health
Service Act in 1944,

which at that point consolidated a lot of the health policies that
were in existence
and greatly expanded the role of the Public Health Service.
From there, you can look to the 1960s when we had the passage
of Medicare
and Medicaid, which of course gave health insurance and really
did a lot to
improve the public health for the elderly and for the
disadvantaged and poor. The
Community Health Center program, which has really influenced
public health,
was passed in 1965, was when the first health center opened.
From there, you can look at the Affordable Care Act of course
in 2010. I think the
Affordable Care Act has very much influenced the notion of
health care as either
a right or a privilege. I think it has taken us further away from
the idea of health
care as a privilege and closer to the idea of health care as a
right. Now, the way
that the Affordable Care Act mainly did this was through the
creation and the
regulation of new health insurance markets.
And there is clearly not a one to one correlation between having
health insurance
and health care as a right, because even with health insurance,

there's no
guarantee that someone will get quality health care or any
health care at all if
they can't access it. But I do you think that the Affordable Care
Act has played a
large role in helping the country move toward understanding
that what it means
to have an equitable and fair health care system means having
access to
insurance which then in many cases will then lead you to health
care access.
Even after implementation of the Affordable Care Act, there's
going to be 10s of
millions of people without insurance. So the idea that we're
somehow close even
to universal insurance leading towards a right is still pretty far
away. My
experience in influencing health policy I think I can talk about
in two different
ways.
The first is what I have learned about what it means to be a
health policy
advocate or influential health policy maker or someone who can
help influence
the design of health policy. Broadly speaking, I think you have
to have a lot of
stamina, you have to be a very good team player understand that
no one
individual given the multifaceted nature of health policy making
can have as great
an influence as they can if they're working with, say, lawyers
and economists and
others. I think you have to have a fertile political environment,
because again, as

we've seen, something like the Affordable Care Act barely even
passed even
though it is something we've been working toward for many,
many decades in
this country.
In terms of my own experience, my role in thinking about health
policy and law
and the research and teaching and writing that I've done has
spanned several
topical areas. I started off working on behavioral health care
issues in law and
policy-- so substance abuse and mental health issues. That
transformed into
work around managed care law and policy, which then morphed
into an interest
that I brought the job which was health care civil rights, and
after that into health
care reform and implementation.
So along the way, I've been able I think to influence health
policy in each one of
those areas through articles, through presentations, I've testified
before the DC
council, I've written testimony for Congress. So there have been
a lot of different
ways I think as a university professor and as an academic
lawyer that I've been
able to influence the policy making process.
So what are some of the pearls and pitfalls of writing a health
policy analysis? I'll
give you a handful. The first one is that you should not go into
the writing a policy
analysis with an outcome in mind. You've got to be open
minded and be able to

really take a look at what the data says, what the literature says,
and be thinking
creatively about what all the various options are, as opposed to
going in with one
outcome in mind.
The second thing is that the advice that you give, the final
recommendation that
you make to the policymaker, whoever that may be, has to be
within that
policymaker's power to achieve. There's no point in giving
advice that there is no
either political environment for or is within the power of the
policymaker to
actually carry out. Another one is that you have to address all
sides of a policy
issue.
When you're writing a policy analysis, it's not enough to look at
two or three, even
if they're good, options. You have to address all sides of the
issue. Otherwise,
the policymaker won't really be able to make an informed
decision. You can't be
giving superficial advise. As the policy analyst, as the writer of
a policy analysis,
you have to be very well informed, oftentimes better informed
than the
policymaker him or herself.

It's you they're going to be relying on. And you have to be
incredibly informed. So
the giving of superficial advice is really something that you
shouldn't do in crafting
a policy analysis. Oftentimes students forget in writing a policy
analysis that
giving the recommendation to do nothing is an option. In fact, it
is an option.
So when what you're doing is considering a policy question and
thinking about
what the options are, sometimes doing nothing, leaving things
as they are, the
status quo, is the best thing to do. A lot of times, students
believe that they need
to recommend a change just for change sake. I don't think that's
always the best
advice.
Teitelbaum, J.B., & Wilensky, S.E. (2013). Essentials of Health
Policy and Law
(2nd Ed.). Burlington, MA: Jones & Bartlett Learning.
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