SPH Class Hosts President Shereef Elnahal and Governor John Kitzhaber for a Unique Session on Health Reform and Financial Stewardship

Students in HSMP 587: Financial Management of Health Care Services experienced a rare and memorable evening last Thursday as two of Oregon’s most influential health leaders—OHSU President Shereef Elnahal and former Governor John Kitzhaber—joined the class for a wide-ranging discussion on the future of health care, the realities of financial stewardship, and the history of reform at both the state and federal levels.

President Elnahal opened the session by grounding students in a core message of the course: organizations must achieve a margin in order to achieve their mission. He emphasized that financial sustainability is inseparable from the ability to pay staff fairly, maintain critical infrastructure, and deliver on the commitments that define a health care institution. His clarity on the relationship between margin, mission, people, and long-term viability resonated deeply with the class.

He also reminded students that Oregon’s reform legacy is rooted in leadership—highlighting Governor Kitzhaber’s central role as, in his words, “the most important Oregonian” in driving modern health policy. The framing proved to be a perfect setup for the conversation that followed.

Governor Kitzhaber then transported the room into the heart of national reform debates, recounting his discussions with White House Chief of Staff Jack Lew and CMS officials during the development of Oregon’s innovative Medicaid program – Coordinated Care Organizations. His storytelling left students feeling as if they were present during high-stakes meetings in Washington, D.C.—including one pivotal session President Obama missed due to a sudden trip to Afghanistan, leaving the real negotiating to a behind-the-scenes operative few outside the room would ever know.

Students left the session challenged, and inspired—grounded by President Elnahal’s insights on financial stewardship and moved by Governor Kitzhaber’s firsthand account of policymaking at the highest levels.

HSMP 587, taught by Professor Bob Winthrop this Fall term, explored the intersection of finance, policy, and health system performance, this session served as a powerful reminder of why the work matters—and what thoughtful, mission-driven leadership looks like at the moments when it is needed most.