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Executive Summary

HCFA ADMINISTRATOR NOMINEE VLADECK BRINGS ADMINISTRATIVE AND POLICY BACKGROUND to the top position at the Health Care Financing Administration at a time when both Congress and President Clinton are focused on cutting health care costs. The White House announced Bruce Vladeck's nomination for the position of HCFA administrator on March 5. Vladeck, 43, has been president of the United Hospital Fund of New York since 1983, directing the fund's involvement in grant-making, health services research and policy development. Vladeck is also a director of the New York City Health and Hospitals Corporation. Additionally, he serves as co-chair of the New York State Council on Health Care Financing. At the national level, Vladeck has served on the federal Medicare Prospective Payment Assessment Commission since 1986, chairing ProPAC's Subcommittee on Hospital Inpatient Services. He was acting ProPAC chairman during the Clinton transition period, while Stuart Altman headed a health care policy development group for the incoming administration. Before joining the United Hospital Fund of New York, Vladeck was assistant VP of the Robert Wood Johnson Foundation. From 1979 until 1982, he was assistant commissioner for health planning and resources development of the New Jersey State Department of Health. A good portion of his experience is in regulatory-oriented programs. For example, Vladeck directed New Jersey's State Health Planning and Development Agency, where he oversaw the implementation of the state's all-payer, DRG-based hospital prospective payment system. Vladeck received a BA in government from Harvard and an MA and PhD in political science from the University of Michigan. From 1974 to 1979, he was an assistant and associate professor of public health and political science at Columbia University. Among his many advisory affiliations, Vladeck is a member of New York State's AIDS Advisory Council and the Governor's Health Care Advisory Board. He published a book entitled Unloving Care: The Nursing Home Tragedy. Among the policy options put forward by the Clinton Administration and Congress for reducing the national deficit, many target Medicare and Medicaid spending. Clinton's economic plan, unveiled Feb. 17, includes proposals to repeal the prohibition against restrictive state Medicaid formularies and to reduce Medicare reimbursement to dialysis centers for Amgen's Epogen ("The Pink Sheet" Feb. 22, p. 8).

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