This is The Simon Review Paper #46.


As fourth year students in the program, students at SIU School of Medicine have enrolled in classes at the Institute and have spent a rotation studying public policy choices that impact the delivery of health care services and the profession itself. The choices made by these public entities will have ramifications for physicians, nurses, administrative support staff and most importantly, for patients and their families. Students have studied state healthcare policy formation up-close and have learned a great deal about the forces and factors that shape their fields of study. Common to all students’ findings and much of the literature generally is a need to bring about a greater alignment of public policy and actual practice in medicine. After observing the healthcare policy formation process, these students have all written about their experiences, pointing out issues of concern, and offering suggestions for improvement. In lieu of a single paper prepared on one topic, I am including three reports to share with the reader each of the students’ observations on the intersection of health care and public policy. Isaac Tan makes an interesting proposal to assist physicians with the costs of providing indigent care. He offers a plan to allow physicians to receive a tax credit for indigent care provided during the course of a year, which would offset a significant share of the overall cost. Clare Zimmerman assesses deficiencies in nutrition among children in Illinois’ foster care program. Her assessment led her to suggest incorporating nutritional education and a monitoring system into the overall foster care regime. Rustin Meister assesses the ongoing challenges to childhood immunization regulations and proposes removing or reducing the number of available exemptions. Each of the papers was developed with the idea of proposing systemic reforms in Illinois healthcare service delivery, designed to address problems that the students witnessed firsthand.