In the world of healthcare reform, where ideology often collides with reality, Stuart Altman has long stood as a steady, pragmatic voice for more than 50 years.
A Bronx-born economist considered one of the most influential people in American health care, Altman currently serves as the Sol C. Chaikin Professor of National Health Policy at the Heller School for Social Policy and Management at Brandeis University, where his career spanned nearly half a century. His teaching résumé includes prestigious institutions such as Brown University, the University of California at Berkeley, and the University of North Carolina. Anchoring his career has been his work at Brandeis, where he will retire this June. Altman’s academic foundation began at City College of New York and continued at UCLA, where he earned both his master’s and doctoral degrees in economics.
His fascination with labor and economics began at a young age. Raised by Depression-era parents, Altman’s mother, a feisty woman who challenged mid-century gender norms, joined the workforce as soon as her youngest child was a teen. Her tenacity and drive to join the workforce inspired his dissertation on the impact of unemployment on married women.
That early research opened the door to Washington, DC, where he was offered a position at the Federal Reserve, then at the Defense Department, working on labor issues like the creation of an all-volunteer military.
Soon, Altman found himself at the Department of Health, Education, and Welfare, pulled into a conversation about nurses and workforce shortages.
“That’s how I got into health care,” he recalls with a chuckle. “Completely by accident.”
Creating a Bridge Between Academia & Policy
For more than five decades, Altman has stood at the forefront of American health policy, shaping the economic frameworks that govern how health care is delivered, funded, and improved. A nationally recognized health economist, Altman has played a vital role in bridging the worlds of academia, government, and the private sector, leaving an indelible mark on U.S. health policy.
During that time, he would find himself immersed in debates around national health insurance, eventually serving in the Nixon administration and going on to craft proposals that would later echo through the Affordable Care Act.
“I technically had political appointments, but I really was not political. The people who I worked for just wanted me to be a good analyst,” he explains. “I’ve always taken a conservative approach to reform. Not politically conservative, but structurally. You can't just tear everything down and start over—especially in a country like ours where the labor market and institutional structures are so different from England, Germany, or Canada.”
This grounded philosophy has guided Altman throughout his decades-long career, which transitioned seamlessly back-and-forth from academia to public service and back again.
Over the years, Altman has been “in the room where it happens” as a trusted advisor to five U.S. presidential administrations. From 1971 to 1976, he served as Deputy Assistant Secretary for Planning and Evaluation/Health at the U.S. Department of Health, Education, and Welfare. He later chaired the influential Prospective Payment Assessment Commission (ProPAC) from 1984 to 1996, which advised Congress on Medicare payment reform. In 1997, President Bill Clinton appointed him to the National Bipartisan Commission on the Future of Medicare, underscoring his central role in national health care debates.
“I was in the room when we created the National Health Insurance Plan for Nixon. I was in the room when he discussed it with his Cabinet. Those were fascinating experiences for a young analyst,” Altman recalls. “It’s only looking back now that I realize how close I was to power in my 30s.”
Throughout his career, he has consistently advocated for incremental reform that builds upon what already exists—most notably, the employer-based insurance system that has long underpinned U.S. health care.
His charisma and sense of humor have made him a beloved professor and a respected leader. He credits much of his effectiveness to an ability to keep meetings “light but substantive”—a balance that’s helped him lead countless working groups, commissions, and policy teams.
Altman has also managed to navigate across party lines with uncommon grace. Though he served under both Republican and Democratic administrations, he’s never been known as a partisan figure. His journey reflects the complex evolution of American health care—and his own deep-rooted belief in building change slowly, one brick at a time.
“I’m not political; I’m an analyst. I just want to understand the problem and help solve it,” Altman said. “I do know that it is politically very hard to both expand coverage and control costs. Trying to do both at once has killed more than one reform plan.”
He points to the Affordable Care Act as a rare example of success, not because it reinvented the system, but because it built strategically on what was already there. However, it took some time for his ideas to be implemented into policy.
In his book Power, Politics, and Universal Health Care: The Inside Story of a Century-Long Battle, Stuart Altman recounts pitching his vision for healthcare reform to President Bill and First Lady Hillary Clinton at their home in Little Rock, Arkansas, during the Clinton administration. To his surprise, Ira Magaziner—an American policy advisor who now serves as CEO and vice chairman of the Clinton Health Access Initiative—also presented a competing plan. The Clintons ultimately chose Magaziner’s proposal, which called for broad, sweeping, and complex changes to the healthcare system but ultimately failed. Later, Hillary Clinton personally told Altman that they regretted not choosing his plan. Many elements of Altman's original proposal were eventually incorporated into the Affordable Care Act, which remains in effect today.
“We didn’t throw out employer-based insurance,” he notes. “We improved on it. And we got more people covered than ever before.” He particularly celebrates the gains made among historically uninsured populations, including minority communities.
Altman’s contributions to state-level reform are equally substantial.
In Massachusetts, Altman chaired a state commission focused on cost containment—another example of his practical approach: fix the system from within.
“You have to work with what people trust. Radical change sounds exciting but usually fails,” Altman noted.
In 2012, Massachusetts Governor Deval Patrick appointed him chair of the state’s Health Policy Commission, a position he continued to hold under Governor Charlie Baker. Under his leadership, the Commission has worked to control healthcare spending and promote system innovation. He also co-chaired the Massachusetts Government/Legislative Health Care Task Force and served on advisory boards including the Robert Wood Johnson Foundation’s Clinical Scholars Program and the Council on the Economic Impact of Health System Change.
His service and expertise have earned Altman a host of accolades. Modern Healthcare consistently named him among the “100 Most Powerful People in Health Care” between 2003 and 2011, and in 2006, included him among the 30 most influential individuals in health policy over the preceding 30 years. He has received the William B. Graham Prize for Health Services Research, the Distinguished Investigator's Award from AcademyHealth, and the Robert M. Ball Award for Outstanding Achievements in Social Insurance. In 2018, the National Academy of Medicine honored him with the Gustav O. Lienhard Award for his advancement of health care.
Altman is a member of the National Academy of Medicine (formerly the Institute of Medicine), where he has chaired multiple committees, including the Committee for the Evaluation of the Future of Nursing Campaign for Action. He was also a member of the Board of Trustees at the Beth Israel Medical Center and the Tufts New England Hospital and currently co-chairs the Schneider Institute for Health Policy at the Heller School for Social Policy and Management at Brandeis University.
His scholarly contributions are as expansive as his policy work and service. He has authored numerous influential books and articles on health policy, including Power, Politics, and Universal Health Care: The Inside Story of a Century-Long Battle (2011) which he co-wrote with David Shactman and Beyond Antitrust: Health Care and Health Insurance Market Trends and the Future of Competition (2017). His research focuses on both federal and state health policy, with a particular eye toward the economic forces shaping the healthcare system.
Despite his achievements, Altman remains modest about his legacy.
“I’m not big on philosophy,” he says. “I just want to be a good person. A good friend. A good teacher.”
Meeting the Moment
Asked whether he remains optimistic about American health care, Altman notes the progress that was being made in increased coverage and lower insurance rates before the most recent election.
He remains realistic about looming challenges, particularly the sustainability of programs like Medicare and the growing demand for long-term care.
“It’s not just medical,” he explains. “It’s housing, feeding, supporting people. And right now, it falls heavily on families—especially daughters.”
He points to the outdated Medicare fee structure and the looming exhaustion of the trust fund as signals that reform is overdue. Still, he notes with cautious optimism that policy tweaks have already extended Medicare’s solvency from 2017 to 2036.
He is concerned about the current political climate and is unable to predict the future of healthcare policy efforts at the federal level, but finds hope in local efforts, like the work of JHF, which he praises as a model for solving community health challenges.
Throughout his career, Altman has surrounded himself with people who share his passion for progress—none more so than Jewish Healthcare Foundation President and CEO Karen Wolk Feinstein, PhD, who was a student of his at Brandeis and has since become a colleague and friend.
He speaks warmly of their shared commitment to hospital and patient safety and policy reform, noting their difference in approach – him focusing on incremental reform, while Dr. Feinstein is known for her activist philanthropy and commitment to challenging and disrupting systems in an effort to create systemic change. Despite these differences, what binds them is their shared commitment to make health care safer, more accessible, and function better for all.
“She’s a unique motivator,” he says. “She’s taken a small foundation and turned it into a national resource. She brings together people who care and helps them do good work.”
Despite the twists and turns of his career, Altman remains clear-eyed about the work still to be done but grounded in the belief that thoughtful, compassionate reform is always possible.
“You can’t fix everything,” he says, “but you can leave things a little better than you found them”.
