"Non-Magical Thinking" and the Best of the Annual Research Meeting

Recipients of AcademyHealth’s Presidential Scholarship for New Health Services Researchers were invited to blog about their experiences during the 2012 Annual Research Meeting. The following post is written by Rob Lieberthal, Ph.D., Jefferson School of Population Health, Thomas Jefferson University.  AcademyHealth’s 2012 Annual Meeting was filled with a wide range of content. That is to be expected, since health services research is a discipline with a wide range of subfields and practitioners. However, it was possible to see many deep connections between the sessions I attended. The main theme I saw was “no magic.” My awareness of magic as a buzzword was stimulated by Reed Tuckson’s remarks at the opening lunch plenary. He urged us to consider that this was our moment, and that now was no time for magical thinking. After that lunch, I started to see “no magic” everywhere. At a session on the “Impact of ACA Competition,” Laurence Baker mentioned the magic point in economics, marked with a star, when marginal cost equals marginal benefit. In health care, that competitive point exists on the blackboard, but often does not in reality. In a session on “Insurance Exchange Implementation: What Can We Learn From Abroad,” Sarah Thomson noted that there are no magic bullets in benefit design. She was speaking about the promise and limitation of value-based benefit design, but she could have been talking about almost any solution pitched as a panacea. So where can we find solutions that lead to sanity in our system? It turned out that, for someone willing to be realistic, there were an amazing number of unexpected interconnections between sessions. At the Health Economics Interest Group meeting, Rick Kronick called for interventions that were actionable, not just interesting. A perfect example came to me the next day at the “Economics, Law, and Population Health” session. Sarah Shelton presented data that was interesting—a return on investment calculation of the impact of a tobacco tax increase. As she pointed out, it is also actionable, because tobacco tax changes have a low cost and because Missouri has the lowest tobacco tax in the United States. Agree or disagree, I had a way to put Sarah’s specific policy to Rick’s general suggestion. There were many other “coincidences” for me. A session on “Insurance Exchange Implementation: What Can We Learn Abroad” provided a one-page summary of international health policy, created by Wynand Van De Ven and colleagues, just days before I start teaching comparative health care systems in my health economics class. The meeting of the Health Services Research Learning Consortium reminded me that many of my colleagues face the same educational opportunities and challenges that I do. So much that I learned reminded me that I do belong at AcademyHealth. And how did I end up here? It wasn’t magic either—I followed the lead of people that had achieved something that I wanted. That’s the beauty of non-magical thinking. Sometimes, when we do the thing that makes the most sense, we get the best outcome. We don’t need magic for that best outcome to be even better than we planned.