Health Policy and Public Policy
Spring 2015
10:832:338/833:338
NOTE: This syllabus is subject to change. .
Last Update: 1/12/15
Instructor: Marci Berger PhD
E-mail: mberger@usrealestateacq.com
Phone: 732-603-9375
Office Hours: By Appointment
Overview:
This class focuses on how healthcare policies are created in the public realm and
the ramifications of those policies. We will study the policy process and the
players who impact the decisionmaking process. Then we will look at selected
health issues, with a focus on the Affordable Care Act, and analyze how and why
these policies were created.
We will use readings, news articles, discussions and visual aids including movies
and clips from the internet to examine this process. Since health care reform is
a dynamic process, please note that your assigned readings may change weekly
to capture the up-to-date health reforming happenings.
This course includes lectures, class discussions, group projects, written
assignments, quizzes and a final exam. Discussion and class participation are
key components to this class. I will repeat – DISCUSSION and CLASS
PARTICIPATION ARE KEY COMPONENTS TO THIS CLASS. Class
participation comprises 30% of the final grade.
By the end of the class, students should understand the following:
1. The roles of the three branches of government in the policymaking
process
2. How and Why deliberation is part of the policy process – at least two sides
to each issue
3. The framework of the health care reform law
4. The 5 players in the policy process and how they impact health policy
5. Some theories in the policymaking process and how they apply to health
initiatives
6. Understand how the “case study” issues we discuss in class fit in with
these major themes.
Required Texts and Readings:
Textbook. There is 1 book required for this class. It will be supplemented by
other readings including journal, newspaper or magazine articles and will vary
from week to week.
* Teitelbaum, Joel B and Sara E. Wilensky: Essentials of Health Policy and Law, 2nd
edition. Jones and Bartlett Learning, 2013. ISBN 978-1-4496-0473-8
Additionally, we will view relevant movies or clips from the internet.
Articles: In addition to the text, you will be assigned a number of articles each
week. These articles may be from a newspaper, a website or an academic
journal and vary in length. Newspaper article are often short, while journal
articles tend to run a number of pages. Please bring articles with you to class
each week.
I will provide citations for the articles, not direct links. With few
exceptions, the articles will not be posted on SAKAI. Although this is
not a research class, I expect every student to be able to locate an
article when given the citation. These are skills that college students should
possess. It is your responsibility to print copies of the articles, read them prior to
class and bring them to class for discussion.
Tips on finding the assigned articles: Every student has access to the Rutgers
University Library databases and research tools. Use them! Some of the articles
will not be accessible through Google.
Databases of note:
Websites of note:
Access World News
kff.org (Kaiser Family Foundation)
EBSCO
ncsl.org (National Conference State Leg.)
JSTOR
Pew Research
Westlaw – News and Business Tab
CQ Researcher
FACTIVA (try this for New Jersey Law Journal articles)
Occasionally, an article is particularly difficult to find, or the citation is incorrect.
Please let me know if you have trouble locating a particular article.
Grading
Grading is based on performance on 5 criteria: 1 exam, 1 quest, a Health Policy
Interview paper, a group Debate project and class participation. Expect pop
quizzes on the readings on any given day. A few homework assignments are to
be expected and will be factored into the final exam grade. All materials covered
by the texts, class discussions, videos, special readings, lectures and guest
lecturers are to be expected on the exams.
Breakdown of grading:
Exam:
Quest – ACA
Debate Project
Class Participation:
Health Policy Interview Paper
20%
10%
20%
30%
20%
Quizzes and Homework Assignments: One “final” grade
will be calculated for all quizzes and homework assignments. Based on that grade, extra points
will be added onto your final exam grade. For example, if your homework grade is an A, you will
receive 2 extra points. The grade of B earns you 1 extra point. Any grade of C or below qualifies
you for no extra points.
Any questions regarding the grading of exams, quizzes, group projects or
reaction papers must be brought to Ms. Berger’s attention within 2 DAYS after
receipt back of the grade in question.
A Note on Class Participation:
After each class I assign all students an individual grade based on the following 5
indicators scale: +(91-97); +/- (87-90); - (81-86); -/0 (79-81); 0 (70-75).
Class participation is assessed weekly based on the quality of comments, not
quantity. I am looking for evidence that a student has completed the assigned
readings and arrives to class prepared for discussion. I assess this through the
questions, comments and statements made (or not) by students each week. To
calculate the final class participation grade, I use an average of these classspecific grades.
Grading Rubric:
Please note the correlation between number grades and letter grades for this
class:
A= 91-100
B+ = 90 - 87
B = 86 - 81
C+ = 80 – 77
C = 76 – 70
D = 69 – 61
F = 60 and below
Absences:
Class participation is a key element of this class. Discussions and lectures will
touch on points not covered by the lecture notes, so attending each class is
important as is taking notes during class. If you expect to miss one or two
classes, please use the University absence reporting website,
https://sims.rutgers.edu/ssra/ to indicate the date and reason for your absence.
Unfortunately you will also have to contact me directly as I am not notified by
the website.
Since this class meets only once per week, missing one class means missing a lot
of information. Each student is responsible for making up any missed work as
well as obtaining the class notes for that day from a classmate.
Assignments:
All assignments that are to be handed in are due at the beginning of the class
period. Unless otherwise noted, assignments are to be handed in by hard copy,
NOT e-mail. Late assignments will lose one full grade for each day they
are late. Extension requests must be discussed no less than 3 days in advance
of the due date.
Exam:
The final exam for this class is given on the last regularly schedule day
of class. Exam date clashes must be discussed AT LEAST FOUR WEEKS
IN ADVANCE of scheduled testing date. ONE alternative testing date will be
offered for use by ALL students. Requests for an alternative date received less
than this time period will not be honored except for extreme circumstances.
Only valid exam clashes will be grounds for utilizing the alternative date such as
a conflict with another exam. Family social engagements and volunteer activities
are NOT legitimate conflict reasons.
If there is serious illness or an emergency on the day of the exam, contact Ms.
Berger IMMEDIATELY. Failure to make alternative arrangements prior to
an exam or a paper due date will result in a failure for that exam or
paper. There are no make-up exams for unexcused absences.
Health Policy Interview Paper:
This 3 page, double spaced, 12point font paper is based on an interview you
conduct with a person regarding a specific health policy related event in their
life or an ongoing situation related to healthcare issues. You may interview a
family member, friend, etc… anyone with an interesting story to tell. DUE DATE:
MARCH 24, 9:50 AM AT THE BEGINNING OF CLASS, IN HARD COPY.
You must submit to me, in advance, information about your interviewee and the
topic you will discuss, for my approval. This e-mail is due: February 13 by
10am and must be finalized by the end of class (when I leave class) on February
17.
If I do not receive the appropriate information by the deadline, I will deduct 1/3
of a grade for each day it is late. If the final paper is submitted past the due
date and deadline, I will deduct a full grade for each day the paper is late.
There are 3 sections to this paper.
a. A NOTABLE EVENT. Explanation of the event as described by your
interviewee
b. YOUR ANALYSIS. Your analysis of the experience based on class terms
and discussions
c. POLICY RECOMMENDATIONS. Specific suggestions for addressing the
negative ramifications of the event
Some guidelines to follow for each section:
For Section A- A Notable Event
1. Introduce the reader to your interviewee. For example, what is your
relationship? Why did you choose to interview this person?
2. Describe the event. Make sure you explain it from their perspective, but
DO NOT submit a transcript of the interview as your explanation.
Condense the information into a story about your interviewee’s
reproductive experience. Make sure you touch on some important
questions, such as, why this interaction made an impression on your
interviewee.
3. The event must be relatable to health POLICY, not merely a personal
medical issue. For example, you may interview your grandmother about
her stay at the hospital for a recent heart attack, but the focus of the
paper should be ….a. the lack of qualified nurses to adequately care for
the patients; b. the challenge of getting insurance to cover the cost of
her stay; c. the fact that she couldn’t get an appointment to see her
doctor for 3 months …
4. Make sure you use quotations to show the story from your participant’s
perspective.
For Section B – Your Analysis
1. Analyze the story using terms/themes/factors that we have discussed in
class. For example, can you apply any of the following factors – Health,
Economics, Morality, Politics, Federalism, Issue Framing, ACA … to the
story? How and Why?
2. Use some critical thinking here. Do you think this experience is unique –
why or why not? Did anything about your discussion surprise you?
Explain.
For Section C – Policy Recommendations
1. Based on our readings and class discussions, what suggestions would
you make to address the concerns expressed through your participant’s
story? For example, can the concerns be addressed through the political
process? At what level?
Debate Project:
One theme we will focus on throughout the semester is the idea that there are
always two sides to each issue (and often, more than two). Discussion and
debate are an integral part of the policymaking process. To this end, we will
hear student generated views on two sides of a Health policy topic. Working in
groups of 4, you will choose a health policy topic . Your topic must be approved
by Dr. Berger and you may NOT choose the same topic as for your policy memo.
You may NOT choose a general topic that is covered by the lectures. For
example, you may not choose “abortion” but you may use a topic related to
abortion, such as parental notification. Each group must focus on a different
topic and approval is given on a first come, first serve basis. So, it is to your
advantage to pick a group and topic early.
Once approved, your group will split into pro/con sides of the topic. Your group
will have 20 minutes for their presentation. Please follow the different parts of
the assignment as described below.
Some specifics of the assignment include:
1. Submission of groups and topics by the end of Lecture 3. I MUST have
this information by e-mail
2. Groups and topics must be FINALIZED by Lecture 4.
3. Presentations are scheduled for APRIL 21 and APRIL 28. Groups may
give their preferences for dates.
4. Presentations are limited to 20 minutes per group to follow these
divisions:
a. 5 minute pro
b. 5 minute con
c. 5 minute (2 1/2 minutes per group) rebuttal
d. 5 minute question and answer from the class
5. You must provide specific reasons for your positions, not just “I think” or
“This is good because…” Engage the class and make the presentation
interesting.
6. This project is graded as a GROUP effort – one grade for all group
members.
You are responsible for meeting with your group members OUTSIDE of class
time as needed. Attendance is MANDATORY on BOTH the presentation days,
regardless of when your group is presenting. Points will be deducted from your
final grade if you do not attend these classes.
Please note that required information must be submitted by the
deadline as noted or I will subtract 1/3 of a grade from the final
Debate project grade for every 24 hours the information is delayed.
Use of electronics in class:
Laptops are to be used by students for notetaking only. Cellphones must be
turned OFF during class time. Texting and/or sending e-mails during class time
will not be tolerated.
E-mail:
I do my best to check e-mail daily. Make sure you include the following on any
correspondence with me: a greeting (such as “Dear Professor Berger” or “Hello
Ms. Berger”); the class name (I teach more than one class); and please sign off
with your name.
Please check your e-mail or the SAKAI class site daily. I will communicate with
you via e-mail any updates or changes that will be posted on the SAKAI site. Be
sure to let me know if you see an update on SAKAI but did not receive an e-mail
regarding the information.
Coursework Requirements:
Rutgers University Policy on Academic Integrity applies to all coursework.
Students in this class and in all courses at Rutgers University are expected to
uphold the highest standards of academic integrity. Cheating, plagarism in
written work, receiving and providing unauthorized assistance and sabotaging
the work of others are among the behaviors that constitute violations of the
Policy on Academic Integrity. You are expected to be familiar with this policy.
If you are not familiar with this policy, please review it at:
http://academicintegrity.rutgers.edu/academic-integrity-at-rutgers
SCHEDULE/ASSIGNMENTS
Lecture 1.
January 20 – Introduction To Health Policy
Assignments: Textbook: Chapter 1
Please read and bring the following article to class with you:


Star Ledger (S.L): “Big Pot? The Marijuana Industry is Following the
Trail Blazed by Big Tobacco” by Samuel T. Wilkinson, 1/4/15
SAKAI: Understanding the Policy Process, Center for Health
Improvement. Posted on SAKAI as “Health Policy Lecture 1 reading”
Lecture 2
January 27 – The Policymaking Process, Part 1: The Role of
Government and Checks and Balances
Assignments: Textbook: Chapters 2 & 3
Articles:
NYT:” From Governors, a Mix of Hard Line Acts and Conciliation Over Ebola”
by Jess Bidgood and Kate Zernike, 10/31/14
 Politico.com: “Obama is Not a Monarch” by Sen. Ted Cruz, 11/19/14
 Commonwealthfund. org: “2014: The Health Care Year in Review” by
David Blumenthal and David Squires, 12/23/14
 Aei.org: “Repeal, Replace or Revise? The Choices Ahead for Obamacare
Critics” by Thomas P. Miller, 12/23/14

IN CLASS, VIEW: Jon Stewart, “Plan’s Labyrinth”
Additional Resource: For a good interactive introduction to Health Care reform, check
out commonwealthfund.org’s Health Reform Resource Center
Lecture 3
February 3 – The Policymaking Process, Part 2: Deliberation and
Conflict, Federalism and Morality
Debate Groups and Topics due by the end of today’s lecture
Assignments: No Textbook
Articles:






Values and Morality
Morone, James A. “Morality, Politics and Health Policy” Chapter 1 from Policy
Challenges in Modern Healthcare. Rutgers University Press, 2005. Available
online at www.investigatorawards.org
S.L.: “Crime and Punishment in Norway” in Perspectives Section, 7/31/11
Brett, Allan S.: “’American Values’ – A Smoke Screen in the Debate on
Health Care Reform” in the New England Journal of Medicine, 2009, vol.
361, pp. 440-441. July 30, 2009.
Federalism
www.nationalreview.com: “The Obamacare Anti-Federalists” by John
Daniel Davidson, 8/4/14
www.thedailybeast.com: “Obamacare is as American as the Founding
Fathers” by Sally Kohn, 4/1/14
www.oxfordjournals.org/our-journals/pubjof/pjs050.pdf: Editors Note:
“Introduction to the Publius Virtual Issue: Federalism and Health Policy”
2012. Note: This is a summary of articles focusing on federalism and healthcare. You do not
need to read each article, just understand the summaries.
Lecture 4
February 10 - New Directions in Medical Care: Tough Questions, Few
Answers…The Need for Discussion
Written Homework assignment due; Debate information finalized; Paper information due 2/13
Assignments: Textbook: Chapter 4, pp. 45-48; 53-65
Chapter 7, pp 127-135
Chapter 8, skim chapter, paying particular attention to:
“Demand Changers”
p. 148 “How Economists View Health Care” and
p. 152 “Supply Changers”
p. 153 “Health Insurance Markets”
p. 156 “Government Intervention”
Articles:
 S.L. (Bloomberg News): “Judge Allows Honeywell to Continue Medical Testing”
by Beth Hawkins and Andrew Harris, 11/4/14



NYT Magazine: “Metric Mania: Do We Expect Too Much from our Data?”
John Allen Paulos, 5/16/10
NYT: “Cost of Coverage Under Affordable Care Act to Increase in 2015” by
Robert Pear, Reed Abelson and Agustin Armendanz, 11/14/14
NYT: “Patient, Heal Thyself” by Abigail Zunger, (Book Review)
HOMEWORK ASSIGNMENT: Prior to class, define the following terms and briefly answer
these questions. Bring this assignment with you to class in hard copy.
Terms to Understand: Beneficiary, premium, medically necessary, deductibles,
copayments/coinsurance, asymmetric information, pre existing condition.
Questions to answer:
 Purchasing insurance as part of a large group is most economical. Why?
 What should the role of government be in regulating health insurance?
TO VIEW: PBS Documentary: “Money and Medicine”
Lecture 5
Guest Lecturer
AND
February 17 - The Road to Health Care Reform, Part 1: The Oregon
Plan, The Clinton Plan, Policymaking Theories
Written Homework Assignment due ; Interview paper information finalized
Assignments: Textbook: Chapter 6 pp. 105-111
Chapter 9 pp. 159-165



Articles:
Newsweek: “Health Care As A Civil Right” by Johnathan Alter, 8/24&31,
2009
AVAILABLE ON SAKAI: “Framing Matters” article
Steinmo, Sven and Jon Watts: “It’s the Institutions, Stupid!” Why
Comprehensive National Health Insurance Always Fails in America” Journal
of Health Politics, Policy and Law, Vol. 20 # 2, (1995) (long article!)
HOMEWORK ASSIGNMENT: Who are your representatives? We have spent time
in this class discussing the role of government and its impact on health policy. So it
is important for you to know…who represents YOUR interests on the federal and
state levels? For next week, please find out the following information and bring it
to class to hand in. Please list your address on your homework. If you live in
New Jersey, use your HOME address, not your New Brunswick address. If
you live outside of New Jersey, use your New Brunswick address.
1)
Your federal representatives, namely 2 U.S. Senators and 1
Congressman/woman;
2) Your state representatives, namely 1 State Senator and 2 Assemblypersons.
Please use your home addresses. If you do not live in New Jersey, use your
New Brunswick address.
3) Pick a piece of legislation that is related to health policy on the federal and
state level and find out how your representatives voted on it. OR, see which
health-related bills your representatives have sponsored or cosponsored.
To help you find this information, here are some helpful websites:
www.nj.leg.state.nj.us;
www.house.gov; www.usa.gov; www.congress.org
Lecture 6
February 24 –The Road to Health Care Reform, Part 2: The Patient
Protection and Affordability Act: The end of the road, or just the
beginning?
Assignments: Textbook: Chapter 9 pp. 165-180




Articles:
Brookings Institute: “Election Results 2014: Biggest Changes to Health
Care will Happen Outside of Congress” by Stuart M. Butler, 11/6/14
Brookings Institute: Issues in Governance Studies: “Bipartisan Health
Reform ? Obamacare in the States” by James Morone, Number 64,
December 2013
www.wsj.com (Wall Street Journal): “How 13 Million Americans Could Lose
Insurance Subsidies” by Drew Altman, 11/19/14
AVAILABLE ON SAKAI: Excerpts from The Little Blue Book: The Essential
Guide to Thinking and Talking Democratic by George Lakoff and Elisabeth
Wehling pp. 3-10, 13-22, 37-43.
VIEW IN CLASS: youtube: Obamacare for Dummies-The Affordable Care Act
explained
Lecture 7
March 3 – Players in the Process: Interest Groups and The Public
QUEST on Affordable Care Act
Assignments: No text
Articles:

www.propublica.org: “Big Changes in Fine Print of Some 2015 Obamacare
Plans” by Charles Ornstein, Lena Groeger and Ryann G. Jones, 12/4/14
Public
 S.L. (Associated Press): “Cancer Patients Paying to Test Drugs on Their
Own Private Laboratory Mice” by Marilyn Marchioneap, 12/15/14
 S.L. (Associated Press): “Health Care Push Coming to Bars and Nail
Salons” by Ann Sanner, 11/16/14)
Advocacy
 Newsweek: “We Need More Lobbyists” by Nick Allard, 2/22/10
 Suite101.com: “Thank You for Smoking: The Ethics of Spin” by Gaylene
Hill, 1/5/11 @ http://gaylene-hill.suite101.com
VIEW IN CLASS:
Lecture 8
MARCH 10 – Players in the Process: The Media and
Professionals/Researchers
Assignments: No text
Articles:
Media:
* CQ Researcher: Media Bias: Is Slanted Reporting Replacing Objectivity?
By Robert Keiner, 5/3/13, vol. 23, #17 … Focus on the INTRODUCTION section
* NYT: “The News, A La Carte” by Ravi Somaiya, 10/27/14
* S.L.: ‘What Ever Happened to That Ebola Epidemic?” by Paul Mulshine
11/13/14
* propublica.org: “When a Patient’s Death is Broadcast Without
Permission” by Charles Ornstein, 1/2/15
Professionals:
 NYT: “How Medical Care is Being Corrupted” by Pamela Hartzband and
Jerome Groopman, 11/19/14
Suggested Additional Reading – not required, but we will discuss the concept of
‘venture philanthropy’ in class: ncib.nim.nih.gov: Introduction from a workshop
in 2009 at the Institute of Medicine, Forum on Neuroscience and Nervous System
Disorders. Venture Philanthropy Strategies to Support Translational Research.
IN CLASS VIEW:
MARCH 17:
CLASS CANCELLED, SPRING BREAK!
Lecture 9
MARCH 24 – Reproductive Health/Maternal Child Health
Interviewee paper due!
Assignments: Text: Chapter 6, pp. 112-117
Roe v. Wade 1973 Decision by US Supreme Court
Griswold v. Connecticut 1965. Decision by US Supreme Court,
Note: To find these cases, use the Lexus or Westlaw database.
Articles:
 Time Magazine: “Love, Sex, Freedom and the Paradox of the Pill” by
Nancy Gibbs, 5/3/10
 NYT: “Why I am Pro-Life” by Thomas Friedman 10/28/12
VIEW IN CLASS:
Lecture 10
MARCH 31 – The Life Cycle – Eldercare/End of Life Issues





Assignments: No Text.
Articles:
NYT: “Doctor Who Helped End Lives” by Keith Schneider, 6/4/11
NYT: “Panel Urges Overhauling Health Care at End of Life” by Pam Belluck,
9/17/14
bbc.com: “Belgium Divided on Euthanasia for Children” by Linda Pressly,
1/8/14
The Atlantic: ‘Why I Hope to Die at 75” by Ezekiel Emanuel, 9/17/14
S.L.: “Assisted Suicide Laws are Insiduiously Dangerous” by John B. Kelly,
10/31/14
IN CLASS, VIEW: HOW TO DIE IN OREGON / Retro Report on Terry Schiavo /
youtube clip on Brittany Maynard
April 7:
WRAP UP, CATCH UP


In class review for final exam
Use extra time to work on debate project
**** APRIL 14:
Final Exam ****
April 21 –
Debate Presentations Group 1
Attendance is MANDATORY
April 28 –
Debate Presentations Group 2
Attendance is MANDATORY