Best Careers 2009: Health Policy Specialist

Overview. Everyone is scared. Already, our medical system is overtaxed—more than 100,000 Americans die every year because of medical-provider errors. Countless more people suffer illness and pain caused by medical providers.

And now, that same system is going to try to provide healthcare for 47 million currently uninsured people, a group with above-average healthcare needs. Even if we survive, will we have to wait far longer still to see a doctor when we're sick or even in need of surgery?

We're already paying a fortune for our healthcare. And if we're now going to insure those 47 million, many of whom will pay little into the system, will healthcare become even more unaffordable for the middle class, especially in America's weak economy?

If anyone is going to save the day, it will be health policy experts. Working for government, nonprofits, and the healthcare industry, they will need to figure out the needed compromises: Should a person over 70 be allowed to get a hip replacement? What if his heart disease means he'll probably live only a few more years? Will rich and poor get the same coverage, or should the people who have contributed more into the system get, for example, access to expensive but potentially lifesaving treatments? If profit is removed from the healthcare system, will the cost savings be outweighed by the lack of the profit motive?

Because healthcare reform is a high priority both for the public and the new administration, it's highly likely that demand for health policy experts will be great.

And there are few nobler missions than trying to craft a plan that will yield the best health for America's 300 million people. They will be true, if unsung, heroes.

A Day in the Life. (This describes but one of many variations of and days in this career.)

Hired recently by the federal government as a part of its new effort to reinvent healthcare, today you're putting the finishing touches on a computer model predicting the impacts of various non-free-market physician pay schemes on key outcomes.

Payment schemes

§ per patient

§ per visit

§ per visit adjusted by physician specialty and complexity and stressfulness of case

§ per minute of patient time

§ per minute adjusted by physician specialty and complexity and stressfulness of visit

§ per patient, capped, adjusted for physician specialty, patient income and complexity and stressfulness of case

§ per year

§ per year, capped, adjusted for inflation or growth in gross domestic product , physician specialty, number and complexity of patient contact hours, seniority, local cost of living, in-service training, and quality of patient outcomes

Outcome measures

§ average wait time

§ patient satisfaction

§ patient outcomes

§ excess costs — for example, extent of defensive medicine practiced

§ quantity of and quality of people entering the profession

§ number of physicians likely to leave the profession

§ number of physicians likely to leave the government-paid component of the system

Next in your day, you meet with your boss to plan a presentation to a staffer to a senator who's on the healthcare subcommittee.

Finally, you present your data to the staffer along with the physician payment scheme that appears to offer the best ratio of benefits to liabilities. Your 30-minute presentation yields a mere five-second response: "Go back and find an approach that yields greater benefits to the poor."

It's back to the drawing board.

Salary Data

Median (with eight years in the field): $77,700

25th to 75th percentile (with eight or more years of experience): $59,100-$125,000

(Data provided by PayScale.com)

Smart Specialty

Health policy analyst. The government and nongovernmental nonprofits hire many people with this job title, and it affords a wide range of responsible work while often requiring only a bachelor's or a master's degree.