Brittany La Couture, Health Policy Analyst & Counsel, American Action Forum

Cato Intern Class Spring 2013

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Michael Hamilton: How did you decide to intern at the Cato Institute?

Brittany La Couture: The Cato institute internship program was recommended to me by Ilya Shapiro. Though I ultimately ended up working for Michael Cannon in health policy, I met Ilya at a number of Federalist Society events while I was a summer associate for Fed Soc. I am primarily interested in health law and policy, but during the summer of 2012, surrounding the Supreme Court decision in NFIB v. Sebelius, it was next to impossible for a young libertarian law student not to be drawn into the legal aspects of the law, and even harder not to be impressed by the efforts of people like Ilya.

MH: How did the internship affect the way you think about public policy?

BLC: Though I was already a libertarian, and I had experienced a libertarian‐​leaning internship through KIP, my Cato internship gave me two great intellectual advantages that I doubt I would have gotten anywhere else. For starters, the speaker series was fantastic. For the first time I was in a quasi‐​academic setting where I wasn’t constantly defending my libertarians leanings, and instead had an opportunity to explore why I am a libertarian; this enabled me to much better defend my positions and to recognize different forms of libertarianism, their strengths and weaknesses, and how best to approach people with different mindsets.

The second intellectual advantage I found in my Cato internship was being surrounded by phenomenal peers who were all brilliant thinkers ranging from libertarian‐​conservative types all the way to anarchists. The quality of the discussions and debates gave me an opportunity to engage in the mental jousting that lawyer love, and that libertarians are constantly goaded into by liberal or conservative friends (or frenimies). I went from being someone who studied libertarianism, to someone who had become capable of discussing and defending it because I more fully understood not just the basics, but the nuances I would never have reached through only academic research or debate with non‐​libertarians.

MH: You started working as Michael Cannon’s research assistant immediately following your internship. Can you tell us a bit about your current gig?

BLC: While I was Michael’s RA I was incredibly lucky because I just happened to be at the right place in history where a policy giant like Michael could benefit from an assistant with a different form of education. Because I was a JD I was able to contribute to establishing lawsuits that could have major impacts on American health policy. I did the normal job of an assistant, but also spent a great deal of time doing research that would later establish me as an ‘expert’ on legal issues surrounding the ACA at my future job.

Today I work for the American Action Forum, a right‐​of‐​center think tank where I am a healthcare policy analyst. This job is exactly where I want to be right now because it gives me the freedom to research and write about healthcare issues that I find timely or interesting–and occasionally I find myself in a position to make an interesting issue timely by drawing media attention to it. I have written on issues ranging from the legal challenges I worked on at Cato, to drug pricing and reimbursement programs, CHIP, across‐​state‐​line sale of insurance, the family glitch, medical licensing, Right to Try laws, and recovery audit contractor programs. I am sometimes all over the map, but it keeps my work fresh and interesting, and gives me a chance to become more familiar with areas of the healthcare market that I am not well informed about. I then use what I have learned to try to help individual citizens and policy makers understand not only the discrete issues, but how they are a part of the whole healthcare landscape so they can better appreciate the effects political decisions have on healthcare providers, consumers, and payers.

MH: What projects are you working on right now?

BLC: Currently I am working on a project examining different solutions to expanding medical licenses to help minimize maldistribution of physicians and increase response time in emergencies. I am also looking at 340B program reform proposals, hospital program integrity initiatives and how burdensome they are to providers, and accountable care organization success rates (or lack thereof).

MH: What advice can you offer your fellow alumni on how to secure a policy job like yours?

BLC: The two pieces of advice I would offer is first to network. Obviously, this is DC! Knowing people won’t always get you the job, but it will get someone to at least read your resume.

The more useful piece of advice that I personally learned is not to feel that you are above anything. Getting a job in DC is hard. Getting a first job in exactly the policy area you want is incredibly hard. If you want to work on the Hill, you might have to take a job as an office assistant, even if you have a masters in public health. If you want to work in policy, you might have to be a research assistant, even if you have a JD. It is fatal to look down your nose at a job because you think you are above it or it’s not exactly what you wanted to do, but humbling yourself a little and acknowledging that in this city experience is an incredibly valuable commodity might help you find your way to where you want to be. The upside to this is that turnover in this city is incredibly quick, and it is likely that if you work hard and show that you are qualified and experienced, you will shortly end up with the job you want (and you will have a larger network too!).

MH: If you could force any historical figure—living or dead—to intern at Cato, who would it be and why?

BLC: Gosh this is a tough one! I would really like to see the dean of a large or highly esteemed university like Harvard spend a semester a Cato. I think that one of the biggest challenges for libertarianism is that in order to get most people to understand free‐​market and non‐​aggression –type principles is that we have to first undo years of liberal indoctrination that unfortunately occurs in most school systems. Most people seem to respond to libertarian ideas with a kneejerk negative reaction simply because it goes against what they have been taught for the first 20 years of their lives and it is difficult to get past that‐ if we could show an educational leader the benefits of at least including libertarian thought as an alternative theory on par with other political ideologies, and find a way to work it into a respected curriculum, it might help people to respect libertarianism and be more open to exchanging ideas.