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The Health Care System: A Costly Bureaucracy

Assistant Professor of Health Policy and Medicine Dr. David Blumenthal '70 is one of 47 non-government health policy experts chosen to review the soon-to-be-released Clinton health care plan. Since his graduation from Harvard nearly 25 years ago, he's been dealing with one of the nation's sickest patients:

Dr. David Blumenthal '70 pauses during an interview to gesture to a confidential fax lying innocently on his desk in his Massachusetts General Hospital office.

"That's actually what this is," said Blumenthal, assistant professor of health policy and assistant professor of medicine at the Medical School.

"This" may have been preliminary comments on Hillary Clinton's much-touted health care task force, scheduled for release June 15, sent to Blumenthal because of his involvement with a select group of 47 non-government health policy experts chosen by the government to make recommendations on the commission's plan.

Blumenthal has devoted his career to studying health care policy from vantage points as diverse as that of a Kennedy School of Government faculty member, a primary care physician, and a staff member for Senator Edward M. Kennedy '54-'56 (D-Mass.).

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"[Kennedy] has been a major proponent of health care reform since 1968 when he introduced comprehensive health care reform legislation," says Blumenthal, who was one of three doctors on Kennedy's staff at that time.

A government concentrator and associate editorial chair of The Crimson while at Harvard, Blumenthal weighed several career options, including journalism, Asian studies and medicine. But in the midst of the Vietnam War, with a very good chance of being drafted, Blumenthal decided to enter Harvard Medical School.

"I went into medicine knowing that I would probably use it as a spring board into policy-related issues, and I've done that ever since I started medical school," says Blumenthal, who graduated from the Medical School in 1975. "I'm interested fundamentally in the large social issues of our time, especially when they affect the health care issue."

In the middle of his medical training, he took time off to get a degree in public policy at the Kennedy School of Government. Blumenthal then took two-and-a-half years away from his residency training to work in the trenches of health care policy as a member of Kennedy's staff.

He returned to finish his residency in internal medicine and then returned to the Kennedy School, this time to remain for seven years as a faculty member and as executive director and later director of a health care policy center.

Among his duties, Blumenthal recalls teaching up-and-coming civil servants the legislative process and the ins and outs of Congressional health care policy.

"I drew a lot on my own experience on the Hill, and also did a crash course in the history and function of the Congress," he says. "It was a lot of fun."

From the Kennedy School, Blumenthal moved on to yet a third facet of the medical complex by becoming the senior vice-president of Harvard-affiliated Brigham and Women's Hospital.

Blumenthal had always wondered about the management side of the table, and at the Brigham he was exposed to all aspects of hospital life. "There I did a lot of work on quality management," he says, working directly with the legal office, managing the pharmacy and the psychiatric unit.

"I enjoyed it, but after four years I decided that I wanted to go back into policy," he says.

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