Looking Behind and Ahead to a 200 Year Future:
An Interview with Richard Scheffler, Founder of the Ph.D. program in Health Policy
By Hector Rodriguez, Current Chair of the Ph.D. program in Health Policy
Richard Scheffler has had an illustrious career as a scholar of health economics and public policy. Among his many accomplishments is included founding the Health Services and Policy Analysis PhD program at the UC Berkeley School of Public Health in 1988. He was the founding chair of the program for its first decade. Dr. Scheffler is a Distinguished Professor of Health Economics and Public Policy, with joint tenured appointments in the School of Public Health and the Goldman School of Public Policy. He has been the Director of the Nicholas Petris Center on Health Care Markets and Consumer Welfare since its inception in 1999. He is also the Director of the Global Center for Health Economics and Policy Research and the Co-Director of The Berkeley Forum for Improving California’s Healthcare Delivery System. He has been a Rockefeller and a Fulbright Scholar, has served as the President of the International Health Economists Association 4th Congress in 2004, and has been an advisor for agencies like the World Bank and World Health Organization. With research interests in health care markets, health insurance, the health workforce, mental health economics, social capital and health, pharmacoeconomics, and international health systems, Professor Scheffler has published 200 papers and edited and written twelve books, including his most recent book The ADHD Explosion: Myths, Medication, Money and Today’s Push for Performance with Stephen Hinshaw, published by Oxford Press in March 2014. He was recently awarded the Gold Medal from Charles University in Prague, Czech Republic for his continued support of international scientific and educational collaboration in 2015. In this interview, he speaks with Hector Rodriguez, the current chair of the Ph.D. Program in Health Policy.
Q: Please tell us a little more about your background and how the Ph.D. program came about.
A: My PhD is in Economics, and I had been a professor in an Economics department at UNC Chapel Hill. Occasionally, I received employment offers from public health schools, as I had worked with the UNC School of Public Health from time to time. Back then, however, I didn’t want to be in a professional school, especially because I was very steeped in my academic training. Everything changed when I was invited to come to Berkeley, and I saw this incredible campus with its world class academics. Luckily for me as a social scientist, the medical school was in San Francisco. People weren’t walking around in white coats. We were all academics, which is not the case in most schools of public health. But then, I noticed something surprising. There was great academic potential here, but there was no health-focused PhD program in the social sciences The only PhD programs were in Biostatistics and Epidemiology, and it was surprising to me that there was no PhD program because their was so much strength in the social sciences. So, I decided to create one.
I originally came to Berkeley with an appointment in the Haas Business School and later moved over to the Goldman School of Public Policy. I met with various people in those schools and in Economics, and with their help, I spent two years putting a new program together. Although it’s administered by the School of Public Health, I wanted to construct it so that it would be a Berkeley-wide, interdisciplinary social science program. I got a pretty good reception from the various affiliated departments. Some were hesitant at first because they didn’t think that our students were as good as their Ph.D. students. With a little bit of convincing to get involved with Health Policy Ph.D. program students, they never turned back. They like our students and think that they are as good as or, in some cases, better than theirs. I’ve been pretty happy with how everything has unfolded. We started in 1992, and the program has been going for over 20 years. We have over 100 graduates, who are in excellent positions in academia, universities, and health policy think tanks.
Q: Thinking back to your early years as director, what are some of the successes that you can remember?
A: First, I would say seeing how health-focused scholars have been accepted academically. When the program first began, students were pretty much mentored by faculty members within the School. After a number of years, people outside the School began to actually chair dissertation committees, and that’s a big investment. For example, when you have someone in the Economics department who has had one of our students in their classes and agrees to put in the work of heading their dissertation committee, which doesn’t benefit them much professionally, that’s a testament to how outstanding our students are and how respected we are.
Also, we have been able to expand the core faculty to approximately 30. Of course, every faculty member at Berkeley is a big name, but we keep attracting bigger and bigger names. And this isn’t about me. It is about how impressed these well-known scholars are with the students. If you look at the application pool, the quality is very high.
Finally, I am proud of being the founding director of the Robert Wood Johnson Foundation Scholars in Health Policy fellowship program, which has been in existence for over 20 years and is now in its last year. Overall, I’m happy that the PhD is so strong. I remember having a conversation with Joseph Newhouse [John MacArthur Professor of Health Policy and Management at Harvard University] when he was receiving an honorary award. I said to Joe, “What’s the deal up there at Harvard with your new PhD program in health policy? Why is it taking so long to establish?” He said, “Well, you know, Harvard is very slow.” I said, “What are they thinking about? How the program is going to be working in the next couple of years?” Joe responded quickly, “No, they are thinking about how the program will look 200 years from now because once something is at Harvard, it’s there forever.” When I think of our successes of the Berkeley PhD program in Health Policy, I know the program will continue to be strong and that it will be here 200 years from now as well.
Q: The field has changed in a lot of important ways. What were the hot-button issues and areas of focus for students when the program started, and what developments have you seen?
A: When the program started, there was an intense interest in cost control, payment policy, and, of course, managed care. I think that we were overdosed with those issues because a lot of innovations in those areas happened in California, a state where health policy has been pretty fluid. Things have changed quite a bit, and this state is a natural lab for study. Later on, appropriately, I think people became more interested in access issues, which has been a big area of focus at Berkeley We were influenced by research on the social determinants of health. Not being dominated by a medical school, we pride ourselves on being able to study what some people call the non-medical inputs to health, and we have the ability to think more deeply about the impact of lifestyle, government regulations, and things that effect health care delivery rather than always centralizing what goes on in a doctor’s office or hospital room, although those issues are certainly important as well.
As far as the market goes, more universities now want to hire people in health. On this campus now, there are health economists in the Economics department, in Public Policy, and in the Business school. There is even a medical sociology class that is taught now. None of this existed before. There has been an explosive growth of and interest in health care, and academic departments representing many disciplines all over the country are hiring people with this specialty. Our graduates are doing well in competing for these academic jobs.
Q: What fond memories come to mind when you think about your time as director?
A: My students! I’ve had amazing students throughout the years. Four come to mind: Sean Sullivan, who is the Dean of the University of Washington’s School of Pharmacy; Kathryn Phillips, who is the director of the UCSF Center for Translational and Policy Research and one of the first graduates of the Health Economics track; Dan Gentry, who is Director of the MHA Program at the University of Iowa, School of Public Health; and Tim Brown, who is now a highly valued member of our faculty. I’m proud of them all. I am especially fond of getting together with the students and alumni at the annual APHA [American Public Health Association] meetings. I feel good about coming into a room, seeing all those faces together, and realizing that I helped create this community. That is inspirational for me.
Q: Do you have any final thoughts that you would like to share?
A: I enjoy being an institution builder. I like to start something, get it going well, and then hand it off. I don’t believe that I own anything. I create it, and it moves on. I’m happy to say that this program has stood the test of time. I feel pretty great about the program’s success, and I hope it does last for 200 years. Hector, as the current director I am sure you will help to make this happen.