Draft:Walter McClure
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Walter J. McClure is Distinguished Senior Fellow and Chairman at Center for Policy Design. Dr. McClure received a BA in philosophy and physics from Yale University in 1959 and a PhD in theoretical physics from Florida State University in 1967. His dissertation research, on nuclear cluster theory, was performed at the University of Tübingen in Germany; he co-authored a book on the subject with his professor, Karl Wildermuth.
In 1969, Dr. McClure switched from physics to health care reform policy for reasons having to do with relevance. He worked at InterStudy under Dr. Paul M. Ellwood Jr.’s leadership from 1969 to 1981. At InterStudy, Dr. McClure worked with colleagues on the HMO strategy for health care reform, among other tasks drafting much of the Federal legislation.
Subsequently, Dr. McClure left to start the Center for Policy Studies (now the Center for Policy Design). He directed the Center until his retirement for medical reasons in 1990. At the Center, Dr. McClure developed Large System Architecture, which is a general theory of why organizations do what they do, and a set of methods to strategically redirect their behavior toward the goals society desires of them. With these methods, Dr. McClure and his colleagues at the Center developed a health care system reform strategy to get better care for less, and developed a National Health Insurance proposal consonant with this strategy. He assisted Medicare, Pennsylvania and Cleveland to implement the first step of the strategy, severity-adjusted outcomes assessment of providers, before his reluctant retirement.
Dr. McClure remains chair of the board of the Center but for many years was no longer active in its professional work or management. Recently he resumed some of his professional work.
Professional Biography[edit]
Dr. McClure founded the Center for Policy Design where he developed his Large System Architecture theory. If the organizations in a macrosystem are chronically malperforming—not performing as society wants—it is almost always because the fundamental system structure is flawed and rewards the undesired performance and punishes the desired performance. Difficult as it is, there is no enduring remedy except to restructure the larger system (“macrosystem redesign”) so that it rewards the desired performance and punishes the undesired performance. The policy discipline to accomplish this is what Dr. McClure calls Large System Architecture (LSA)—the idea being that if one wishes a system to perform well for society, one must intentionally architect it to do so rather than let the system develop by topsy and historical happenstance.
Dr. McClure’s scholarship garnered the support of numerous leaders and professors in higher education and beyond.
Dr. Julio Frenk, President of University of Miami, wrote: “To effectively address the complex policy challenges facing society—in health, the economy, education, social justice and more—we need to think both in terms of large, interconnected systems, and in terms of leadership to change them. When I was early in my career, I was influenced by Walter McClure’s approach to analyzing health systems. His theory Large System Architecture and concept of macrosystem design laid out in these essays are important contributions and provide valuable guides for this work.”
Dr. David T. Ellwood, Isabelle and Scott Black Professor of Political Economy and Former Dean at Harvard Kennedy School, wrote: “It is time to think big! Sick of never-ending incremental “solutions” that lead nowhere while things keep getting worse? Read Walter McClure. He thinks systems: when everything and everyone seems to be behaving badly, stop blaming them, and start looking for the larger, self-reinforcing, system-wide incentives that reward this behavior. And rather radically, he argues that even massive systems and their incentives can be changed. When the effect of most efforts “come a cropper,” it is time to change the rules. Decide what outcomes society wants. Then ensure that those behaving well win rather than lose. Think health care is frighteningly expensive, variable in quality, and unevenly distributed —pay people for the outcomes they achieve rather than for simply creating more services. Unhappy with education outcomes—reward good ones. Worry about inequality —reshape market incentives. He has the genius to show how real transformation can be achieved with the right tools for thinking comprehensively, and then plotting the steps that lead to the land we keep promising our children.”
Dr. Alain Enthoven, Marriner S. Eccles Professor of Public and Private Management at Stanford University Graduate School of Business, wrote: “In the 1970’s a group of health system reformers met regularly in Jackson Hole, Wyoming. It became known as “The Jackson Hole Group,” and was a place where a diverse group of researchers, policy makers, and medical leaders came to discuss issues and new approaches to reform of the American healthcare system. As part of that group, and in the wider health reform movement Walt kept us focused on the essential role of competition, properly structured, as a tool of incentives. This book is a major contribution to thinking about system reform—health systems and beyond.”
Personal History[edit]
Dr. McClure has learned a great deal from his mentor, Dr. Paul Ellwood. As such, Dr. McClure became a generous mentor, and his prodigies achieved remarkable success under his tutelage.
His first prodigy, Mr. Tim McDonald, is a Senior Fellow at the Center for Policy Design, where he was mentored by Dr. McClure. Mr. McDonald has a B.A. in political science from Hamline University, an M.P.P. in business and government from the Harvard Kennedy School, and a Ph.D. in policy analysis from the Pardee RAND Graduate School. Mr. McDonald is an assistant policy researcher at the RAND Corporation and a visiting researcher at the Program on Negotiation at Harvard Law School. His research focuses on approaches to designing and implementing policy strategy for reforming large systems and applying the methods to socially important systems such as those impacting health and education, the economy, and the national defense. His current projects include analysis of consumer-oriented approaches to changing incentives in the U.S. healthcare system and approaches to U.S. strategic competition.
His second prodigy, Mr. Abdulrahman Bindamnan, is a contributing author at Psychology Today, and some of his editorials appeared in Star Tribune. Mr. Bindamnan earned a B.A. in psychology and religious studies from University of Miami, M.S.Ed. in international educational development from University of Pennsylvania Graduate School of Education, and is pursuing his Ph.D. studies at the University of Minnesota Twin Cities. Mr. Bindamnan met Dr. McClure through mutual publications at the Star Tribune. Mr. Bindamnan is a prolific writer, despite the fact that he is nonnative English speaker and writer. Mr. Bindamnan thus far published 90 articles and essays, 48 of which appeared in Psychology Today.
Public Professional Publications[edit]
Dr. McClure published a number of publications on newspapers in Minnesota, where he resides in Edina, namely in Minnesota Reformer and Star Tribune. His influential publication appeared in Star Tribune, titled, “A friendly letter to pro-life believers” which garnered robust comments and reviews on the newspaper. Dr. McClure has also published two essays on Free Inquiry.
Selected Academic Publications[edit]
• Karl Wildermuth and Walter McClure: Cluster Representations of Nuclei. Springer Tracts in Modern Physics, Volume 41 pp 1-172; DOI:10.1007/BFb0045473
• Walter J. McClure: National Health Policy for the 1980s. Competition in the Marketplace: Health Care in the 1980s, 01/1982: pages 73-76; , ISBN: 978-94-011-7395-7, DOI:10.1007/978-94-011-7393-3_7
• Walter McClure, Alain Enthoven, Tim McDonald: How Universal Health Coverage Can Be Done Right. Health Affairs Blog, https://healthaffairs.org/do/10.1377/hblog20171109.973715/full/ • Walter McClure, Alain Enthoven, Tim McDonald: Universal Health Coverage? Why? Health Affairs Blog, http://healthaffairs.org/blog/2017/07/25/universal-health-insurance-why/
• Jon B. Christianson, Walter McClure: Incentives For Quality In A Restructured Medical Care System. Policy Studies Journal 09/2005; 9(2):271 - 278., DOI:10.1111/j.1541-0072.1980.tb02203.x
• W McClure: Good And Bad Models Of Market Reform For Managed Care. Health Care Management (Philadelphia, Pa.) 11/1995; 2(1):237-60.
• W McClure: Health Care Reform Under The 'Buy Right' Strategy. Medical Group Management Journal / MGMA 03/1992; 39(2):16-23, 76, 78-80 passim.
• W McClure: Health Care Delivery Systems. Transactions of the Association of Life Insurance Medical Directors of America 02/1988; 71:144-50., DOI:10.1525/maq.1973.4.3.02a00050
• W McClure: Competition And The Pursuit Of Quality: a conversation with Walter McClure. Interview by John K. Iglehart. Health Affairs 02/1988; 7(1):79-90.
• W McClure: Buying right: Will Good Medicine Drive Out Bad?. The Psychiatric Hospital 02/1988; 19(2):57-62.
• W McClure: Unleashing The Potential: Current Trends And Future Policy Directions. Bulletin of the New York Academy of Medicine 01/1988; 64(1):84-100.
• W McClure: The view from the eye of Minnesota's health care hurricane: an interview with Walter McClure, Ph.D., by Richard L. Reece. Minnesota Medicine 01/1988; 70(12):679, 681.
• W McClure: The Consequences Of Glut. Michigan Hospitals 02/1987; 23(1):11-5.
• W McClure: Buying Right: How To Do It. Business And Health 11/1985; 2(10):41-4.
• W McClure: Buying right: The consequences of glut. Physician Executive 09/1985; 13(5):7-10.
• W McClure: Incentive Reform: Finding An Alternative To All-Payer Rate Controls. Healthcare Financial Management Journal 04/1985; 39(3):19-23, 26-32.
• W McClure: On the Research Status of Risk-Adjusted Capitation Rates. Inquiry 02/1984; 21(3):205-13.
• W McClure: On "Health Care In Canada: Patterns Of Funding And Regulation". Journal of Health Politics Policy and Law 02/1984; 8(4):822-3.
• W McClure, D Shaller: Variations in Medicare expenditures per elder. Health Affairs 02/1984; 3(2):120-9., DOI:10.1377/hlthaff.3.2.120
• W McClure: Redesigning Benefits Stimulates Cost Consciousness. Business and Health 12/1983; 1(1):23-6.
• W McClure: When You Offer People A Free Lunch, They Don't Eat At McDonald’s. They Go To The Ritz. Across the Board 10/1983; 20(8):46-9.
• Walter McClure: The Competition Strategy for Medical Care. The Annals of the American Academy of Political and Social Science 08/1983; 468(468):30-47., DOI:10.1177/000271628346800103
• W McClure: Competition: Necessary Market Reform. Bulletin of the American College of Surgeons 05/1983; 68(4):2-4.
• W McClure: Directing The Future Of Health Care Costs: Developing A Competitive Market. OH. Osteopathic hospitals 07/1982; 26(6):18-20, 22 concl.
• W McClure: Directing The Future Of Health Care Costs: High Vs Low Style Procedures. OH. Osteopathic hospitals 06/1982; 26(5):8-11 contd.
• Walter McClure: Implementing a Competitive Medical Care System through Public Policy. Journal of Health Politics Policy and Law 02/1982; 7(1):2-44., DOI:10.1215/03616878-7-1-2
• Walter McClure: Structure and Incentive Problems in Economic Regulation of Medical Care. The Milbank Memorial Fund Quarterly Health and Society 02/1981; 59(2):107-44., DOI:10.2307/3349753
• W McClure: The Role Of Competition. Bulletin of the New York Academy of Medicine 01/1981; 57(1):45-50.
• W McClure, L K Ellwein, D Aquilina: Competition: theory and practice in Minneapolis-St. Paul. The Internist 12/1980; 21(10):8-11.
• W McClure, L Kligman: Reducing excess capacity: closing down or converting hospital facilities may be easier said than done. Cost containment 06/1980; 2(10):3-6.
• Walter McClure: An Incentive Tax for Medicare, Medicaid, and National Health Insurance. Journal of Health Politics Policy and Law 02/1980; 5(1):10-24., DOI:10.1215/03616878-5-1-10
• W J McClure: Indications, Process And Implications Of Hospital Closure. Proceedings of the Health Policy Forum. Health Policy Forum 02/1980.
• W McClure: Reorganize The System To Set Up A Competitive Structure, Review - Federation of American Hospitals 10/1979; 12(5):25.
• W McClure: Cost containment: choices for medical care. Pennsylvania Medicine 07/1979; 82(6):14-23.
• W McClure: "You don't have a choice between change and no change". Interview by Merian Kirchner, Medical Economics 04/1979; 56(5):143, 147, 149 passim.
• W McClure: Choices For Medical Care. Minnesota Medicine 05/1978; 61(4):261-71.
• Walter McClure: On Broadening the Definition of and Removing Regulatory Barriers to a Competitive Health Care System. Journal of Health Politics Policy and Law 02/1978; 3(3):303-27., DOI:10.1215/03616878-3-3-303
• W McClure: Regulation Only Choice If Private Sector Cannot Control Health Costs. Hospital Progress 01/1978; 58(12):6, 10.
• W McClure: Benefits Of Reducing Excess Hospital Capacity. Hospital Progress 08/1977; 58(7):7, 10-1.
• W McClure: Too Many Beds, Not Enough Market Pressures Fuel Hospital Cost Rocket. Hospital Financial Management 02/1977; 31(1):10-2, 14, 16 passim.
• Walter McClure: The Medical Care System Under National Health Insurance: Four Models And Their Prospects. Journal of Health Politics Policy and Law 02/1976; 1(1):22-68., DOI:10.1215/03616878-1-1-22
• W McClure: National health insurance and HMOs. Nursing Outlook 02/1973; 21(1):44-8.
• Walter Jackson McClure: The Ground State of Lithium7 and Beryllium7. Dissertation 1967, Florida State University