Robert M. La Follette School of Public Affairs
Thursday, June 19, 2014

Weimer explores institutional design, policy craft

 David Weimer David Weimer

The cost and quality of health care are often on David Weimer's mind — and he frequently proposes ways to contain those costs.

The La Follette School political scientist's research often tackles the structural elements of health care, from the Organ Procurement and Transplantation Network to report cards that provide data on health-care providers' outcomes.

A March 2014 article Weimer published in Annual Review of Public Health assessed research on the effectiveness of two methods for addressing the quality and cost of health care in the United States: report cards and regulation.

"Regulation is a top-down approach to improving health care, while report cards are a bottom-up approach," says Weimer, who is co-author of the book Organizational Report Cards. "Although we have considerable evidence on the effectiveness of report cards, there is surprisingly little on the impact and cost of direct regulation."

Weimer also has studied the Organ Procurement and Transplantation Network, publishing Medical Governance: Values, Expertise, and Interests in Organ Transplantation in 2010. He concluded that having a private organization allocate organs for transplant is more efficient and fair than giving the task to a government agency. In a 2013 La Follette Policy Report article, he applied those observations to suggest a way to make surgeries funded by Medicare more evidence-based and cost-effective.

In addition to his research on policy craft and institutional design, Weimer is well-known in the academy, the classroom and around Wisconsin for his expertise with cost-benefit analysis. An elected fellow of the National Academy of Public Administration, he served as president of the Society for Benefit-Cost Analysis in 2013 and as president of the Association for Public Policy Analysis and Management in 2006. He is the author of the textbook Cost-Benefit Analysis: Concepts and Practice. In recent years, he has provided cost-benefit expertise in a number of for a, including the Wisconsin Criminal Justice Coordinating Council's Evidence-Based Practices Subcommittee, the U.S. Department of Energy's Global Threat Reduction Initiative Expert Panel on Nuclear Replacement, the Vera Institute of Justice's Cost-Benefit Analysis Methods Working Group, and the Expert Review Panel for Pew Charitable Trusts Results First 50-State Project. In 2013, he also coached the La Follette School's national championship team in the Policy Solutions Challenge USA.

A new project will combine Weimer's expertise in health systems and cost-benefit analysis. He will use the La Follette School's Daniel Louis and Genevieve Rustvold Goldy Faculty Fellowship to study the strength of harm done by addiction. "Neuroscience evidence is accumulating that consumption of addictive substances results in physical changes to the brain," Weimer says. "Other behaviors, such as gambling and sexual compulsions, may also change the brain. Public policy toward addiction has not fully incorporated such neuroscience research."

He will use the fellowship funds to hire a neuroscience graduate student to conduct two literature reviews related to valuing the effect of addictive behavior on the brain. Neuroscience literature focuses on strength of addition, while medical and social science research explores the harm addition causes. "I anticipate using these reviews to formulate a coherent rationale for public policies toward addiction and begin moving toward practical advice about how to treat changes in addictive consumption in cost-benefit analysis," Weimer says.

The cost-benefit analysis course Weimer teaches for the La Follette School is recognized for its advancement of the Wisconsin Idea. Since 2005, Weimer has made his course available to professionals seeking assistance with maximizing economic efficiency. His graduate students take on criminal justice reform, environmental regulations, child welfare, mental health treatment, and other policy areas.

"The class contributes to a better Wisconsin by helping to identify policies that are likely to provide more in benefits than they cost," says Weimer, who was awarded a 2012 Wisconsin Alumni Research Foundation professorship in recognition of his distinguished contributions to research and teaching.

The clients with which students in Weimer's fall 2013 section worked included the Wisconsin Government Accountability Board, Health First Wisconsin, Global Livingston Institute, Wisconsin Department of Natural Resources, and the Wisconsin Energy Institute and the Green Exchange Madison. "I am always receptive to requests from clients for analyses on interesting and challenging topics," Weimer says.