Rutgers University
Bloustein School of Public Policy
Health Policy and Public Policy
Fall 2011
10:832:338
Professor Marsha Rosenthal, MPA, Ph.D.
Monday and Wednesday, 5:35 – 6:55 pm
Location: Hickman 210
E-mail: mrosenthal@ifh.rutgers.edu
Phone: 848-932-4664
Office Hours: By appointment on MW 4:30 pm in Room 206 Hickman Hall
Office: Rutgers Institute for Health, Health Care Policy and Aging Research,
Room 426, 112 Paterson St. 4th floor
NOTE: This syllabus may change. I will inform students of any changes ahead of
time (e.g.: adding or dropping readings; changes of dates for guest lectures, etc.)
Date of this syllabus: 8/10/11
Overview:
This course is an introduction for undergraduates to the nature of how health
policy is developed in the U.S. This class will give students a better sense of how
health policy affects public health and health care. We will examine policy issues
and the role of government in the health care system. Because of the
government’s role in payment systems, we will look at the policy implications of
how government finances and pays for health care. Students will also be
expected to think about and discuss ethical issues surrounding the delivery and
financing of health care. We will also review the recent and ongoing efforts to
reform health policy at the national and state levels with an emphasis on
Medicare and Medicaid reforms. We will examine health care and disparities in
access for targeted populations, particularly the elderly and the poor.
This course includes lectures, class discussions and group projects. Class
participation will include reading response and media response exercises in
class. If you miss these, it will affect 20% of your grade. Besides the fact that
overall class participation (including attendance) will count for another 10% of the
final grade, students will get a lot more out of the class if they participate.
Take notes. You should take notes whenever the class is in session. You
should take notes when I am lecturing, when we have a guest speaker, during
class discussions, etc. This is an important way for you to “get” the material that
we will cover.
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Readings:
There are 3 books required for this class. These books will be supplemented by
other readings including journal, newspaper or magazine articles and will vary
from week to week. If you already read a newspaper online or in print, good!
This is a fast-moving subject, and we will try to stay on top of some of the current
developments. We will have some in-class discussion of current media coverage.
Some of the supplemental readings will be announced as we progress in the
course. I will provide citations for the articles. It is your job to locate the articles,
read them prior to class and bring them to class for discussion. You will also be
assigned online videos to watch.
Required books: Note that there are two books by Teitelbaum and Wilensky.
They are different but go together.
Teitelbaum and Wilensky. Essentials of Health Policy and Law. Sudbury, MA:
Jones and Bartlett. 2007. ISBN 9780763734428
Listed below as Teitelbaum and Wilensky. Essentials.
Teitelbaum and Wilensky. Essential Reasdings in Health Policy and Law.
Sudbury, MA: Jones and Bartlett. 2009. ISBN 9780763738518
Listed below as Teitelbaum and Wilensky. Readings.
Niles. Basics of the U.S. Health Care System. Sudbury, MA: Jones and Bartlett.
2011. ISBN 9780763769840
Listed below as Niles.
Course Requirements and Grading
We will have 1 midterm, 1 policy memo, 1 group presentation and 1 final exam.
Your class participation grade will be based on your attendance, your assigned
reading responses in class, focused classroom discussion and debates.
Your attendance is a component of class participation. There will be in-class
assignments that will be part of your final grade. You should expect that any
materials covered by the texts, class discussions, videos, special readings,
lectures and guest lecturers will be included on the final exam. I will provide
information about the grading for these other assignments in a separate handout.
Grading will be based on 100 points total, with points allocated as follows:
Reading Responses/ Media Responses
10
Class Attendance/Participation:
10
Midterm
10
Policy Memo:
25
Group Presentation:
20
Final Exam:
25
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Course grades will be assigned based on total points at the end of the term as
follows: A: 94-100: B+:87-93; B: 80-86; C+: 75-79; C: 70-74; D+: 65-69; D: 64-61;
60 or below is a failing grade.
Any questions regarding the grading of assignments or exams must be brought
to my attention within 2 DAYS after receipt back of graded assignment or
exam.
Written assignments
This is a heavy writing course, and inadequate writing will affect your grade. If
you know that writing is not your strong point, you should take advantage of the
resources available to you at Rutgers. This includes the writing centers, which
have tutors and classes in writing. I will give extra credit if you provide written
evidence that you have attended tutoring sessions.
Responsibility and Academic Integrity
My goal is for you as the student to learn an important and interesting aspect of
American public policy. To do this, you must take responsibility. I am willing to
advise you if you are confused about the readings, etc. I am also willing to work
with you so that you can complete assignments. To do this, you must 1) come to
class; 2) complete the assigned readings prior to each class; 3) if you miss class,
make up any missed work and get any class notes you need from a classmate;
4) turn in assignments on time; 5) if you are having a problem, communicate with
me in a timely fashion. Most often, we can work it out. I will have office hours as
listed above, and you can reach me by email; 6) Read the section below on
Plagiarism and Academic Integrity.
Class Assignments
You should submit all the assignments below on the course site in Sakai (in
Assignments). You should ALSO submit them on paper hard copy to me at the
beginning of the class when it is due. If you don’t submit both versions at the
time they are due, you will lose points.
Reading responses. Will be assigned separately in the first week of class.
Media responses. Will be assigned separately in the first week of class. There
will be some additional brief, written assignments.
Policy Memo. You will have one 5 page policy memo to write during the
semester. This is a valuable skill in policy analysis, and harder to do than writing
a longer paper. A separate handout detailing this assignment will be distributed in
class.
Topics due Oct. 24. Drafts due Oct. 31. Final policy memo due Nov. 7.
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Group Presentation. You will have one final group project to be presented at
the end of the semester. I will give you some limited time during class to work
on this project but you will be responsible for meeting with your group outside of
class time. Attendance is MANADTORY for all students on the designated final
presentation days whether you are presenting or not. A separate handout
detailing this assignment will be distributed in class.
Topics will be assigned. Drafts will be due Nov. 24. The specific date for your
group’s presentation will be assigned later.
Specific classroom issues:
Late assignments - Don’t do it. 10% of points will be deducted from
assignments received late after the in class due date and assignments more than
five days late will not be graded (i.e.: you will only be assigned half of the
available points if you turn it in; no points if you do not). On the due date, you
are required to post to Sakai AND turn in the hard copy of the assignment
in class. If you need a special accommodation because of illness or disability
you should contact me as far before the due date as possible.
Class absences – Come to class. Attendance and active participation are critical
parts of the course experience. Excuses for missing classes will not be accepted.
Your class participation grade will be evaluated based on attendance, your
reading responses as evidence that you have completed assigned reading prior
to class, and the degree to which you engage in class discussion.
Students are expected to attend all classes; 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. An email is automatically
sent to me.
Please note: My policy for missed papers and missed exams is that it is your
responsibility to contact me ahead of time. Failure to make alternative
arrangements prior to an exam or a paper due date will result in a failure for that
exam or paper. If you have a serious illness or an emergency on the day of the
exam, contact me IMMEDIATELY [that means BEFORE class]. There are no
make-up exams for unexcused absences.
Exam date conflicts – These conflicts must be discussed AT LEAST ONE
WEEK IN ADVANCE of scheduled testing date. Please note that your final exam
is scheduled for the last regular meeting date of the class. ONE alternative
testing date will be offered for use by ALL students (unless a student has a preestablished disability accommodation). Requests for this alternative date
received less than 7 days in advance will not be honored. Only valid exam
conflicts will be grounds for utilizing the alternative date such as a conflict with
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another exam. Family social engagements and volunteer activities are NOT
legitimate conflict reasons.
Using electronics in class - You may use laptops for note taking only. It is rude
to me and unfair to fellow students to surf the net or send e-mails during class.
Cell phones must be turned OFF during class time. Texting during class time will
not be tolerated. We will be working in groups much of the time. This will make it
difficult if not impossible for students to use cell phones, etc.
E-mail communication with me: I will have a schedule for checking the email
from this class, and will let the class know this schedule. Please make sure you
include a greeting (such as “Dear Professor Rosenthal”); the class name (Health
Policy and Public Policy) and Bloustein (I teach more than one class); and please
sign off with your name. Also, if you mostly use an email address other than your
Eden account, check your Eden account regularly. This is how you will be
receiving the general emails I will send to the entire class.
Special needs: I take special needs seriously, but if you need accommodations,
you should notify me during the first week of class and provide me with a Letter
of Accommodation (LOA). You will need to be registered with the Office of
Disability Services (http://disabilityservices.rutgers.edu).
University and Bloustein School 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, plagiarism in
written work, receiving and providing unauthorized assistance and sabotaging
the work of others are behaviors that constitute violations of the Policy on
Academic Integrity. You are expected to be familiar with this policy.
You should review the University guidelines at
http://teachx.rutgers.edu/integrity/policy.html. You should also read the Bloustein
School policy below.
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Academic Misconduct: A Bloustein School Perspective
Academic misconduct includes cheating, plagiarism, failure to cite sources,
fabrication and falsification, stealing ideas, and deliberate slanting of research
designs to achieve a pre-conceived result. We talk abut misconduct and ethical
behavior in classes and expectations are set forth in student handbooks and
catalogues. Penalties for misconduct can range from failing an assignment/exam
or dismissal from the university.
The Bloustein School is appending this memorandum to your course syllabus
because we recently have detected obvious cases of plagiarism. We have found
far fewer cases of other forms of academic misconduct, but we find several every
year. It is imperative that you understand that unethical academic conduct is
intolerable, and it is completely preventable.
Academic misconduct almost always happens for two reasons. One is ignorance
of academic rules and practices. For example, in virtually every recent plagiarism
case in the School, material has been taken from an Internet site and placed in
text without appropriate note or attribution. You must learn the proper rules for
attribution. If you are not sure, ask your instructor! If you do not know the rules
that govern the use of data sets, attribution, analysis and reporting of these sets,
the faculty will help you. There is no such thing as a stupid question regarding
this subject.
Pressure is the second common reason for academic misconduct. Students,
faculty, every one of us is subject to deadline, financial, self-worth, peer, and
other pressures. If you are potentially allowing pressure to drive you to
misconduct, please step back and resist that urge. You can cope with pressure in
a positive way by reaching out to friends, counselors, and faculty members.
Within the Bloustein School community, you will find understanding people and
positive direction.
The Bloustein School plays an important role in the planning and public policy
agenda. Our work and our students must be above reproach.
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SCHEDULE/ASSIGNMENTS
Class 1
Sept. 7
Course introduction + overview of health policy process
Class 2
Sept. 8
Overview of the health policy process
Required viewing for Class 2 on Sept. 8:
Watch the first section -“Pre-existing Conditions” - of this 3 part online
video: PBS Special Report on Health Reform http://www.pbs.org/now/shows/health-care-reform/index.html
There will be a group assignment in class: groups will write a paragraph about
this video to turn in at end of class.
Written assignment: Personal essay (required assignment to hand in at Class
2 - but not graded) – Provide a very brief resume/vita/something that describes
who you are, employment experience (if any), and career goals (if any). Why are
you taking this course? Please include your contact info (name, address, phone
numbers, other email address that you use, your major, etc. (and anything you
want me to know).
Class 3
Sept. 12
Overview of the health policy process
Teitelbaum and Wilensky. Essentials.
Ch.1 Intro: Understanding the Role of and Conceptualizing Health Policy
and Law
Ch. 2 Policy and the Policymaking Process
Niles.
Ch. 3 The Role of Government in Health Care
Class 4
Sept. 14
Required viewing for Class 4:
1-New Jersey - Go to the website for the NJ State Legislature. Read the
webpage for how a bill becomes a law: http://www.njleg.state.nj.us/
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2- United States - Go to the following webpage for the Human Genome
Research Institute at NIH, for the overview of how a bill becomes a law in the
U.S. Congress: http://www.genome.gov/12513982
Required viewing for Class 4: Former Michigan governor Jennifer Granholm’s
speech to the American Public Health Association, on problems of the American
health care system:
http://www.youtube.com/aphadc#p/c/1/VdMpqJstJFE
There will be a group assignment in class: groups will write a paragraph about
this video to turn in at end of class.
Class 5
Sept. 19
Public Health and the Law
Required reading:
Teitelbaum and Wilensky. Readings.
Reading 1 What is Public Health
Reading 2 The Law and the Public’s Health
Niles.
Ch. 4 Public Health’s Role in Health Care
Class 6
Sept. 21
Structure of the U.S. Healthcare System
Required readings:
Niles
Ch. 1 Overview of the U.S. Health Care Delivery System
Ch. 2 Current operations of the Health Care Delivery System
Ch. 5 Inpatient and Outpatient Services
Ch. 6 Health Care Professionals
Guest speaker on NJ state legislative process: Ms. Elizabeth Boyd, Esq.,
senior staff, Office of Legislative Services, NJ Senate Health, Human
Services and Senior Citizens Committee.
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Class 7. Sept. 26
Introduction to Health Economics and Health Care Financing
Required readings:
Teitelbaum and Wilensky. Essentials.
Ch.4 Understanding Health Insurance
Teitelbaum and Wilensky. Readings.
Reading 24 Can Markets Give Us the Health System We Want (Thomas Rice)
Niles
Ch. 7 Public and Private Financing of Health Care
Class 8
Sept. 28
The Role of Managed Care and Intro to Government Health Coverage
Required readings:
Niles
Ch. 8 Impact of Managed Care
Teitelbaum and Wilensky. Essentials.
Ch.6 Government Health Insurance Programs: Medicaid, SCHIP, and Medicare
Required viewing:
Watch the middle section of this 3 part online video: PBS Special Report
on Health Reform – “The Bottom Line” about the struggles of small businesses to
offer health insurance to their employees:
http://www.pbs.org/now/shows/health-care-reform/index.html
Class 9
Oct. 3
Government Health Programs
Required readings:
from the Kaiser Family Foundation – read
“Medicare: A Primer” Issue Brief
http://www.kff.org/medicare/upload/7615-03.pdf
“Medicaid: A Primer” Issue Brief
http://www.kff.org/medicaid/upload/7334-04.pdf
TBD: Guest speaker on children’s health coverage in NJ:
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Ms. Mary Coogan, Esq., Advocates for Children of NJ
Class 10
Oct. 5
Problems of the Uninsured Population and Health Reform
Required readings:
Teitelbaum and Wilensky. Essentials.
Ch.7 The Uninsured and Health Reform
Kaiser Family Foundation, The Uninsured: A Primer, December 2010.
http://www.kff.org/uninsured/upload/7451-06.pdf
Required viewing:
Watch the last section of this 3 part online video: PBS Special Report on
Health Reform – “Obesity”
http://www.pbs.org/now/shows/health-care-reform/index.html
Class 11
Oct. 10
Intro to Health Reform and the Patient Protection and Affordable Care Act
(ACA - 2010)
S. Schoenbaum S, A. Audet, and K. Davis, “Obtaining Greater Value from Health
Care: The Roles of the U.S. Government,” Health Affairs (November/December
2003): 183-190.
AARP overview of key points in the ACA: “The Health Care Law at a Glance”
http://assets.aarp.org/www.aarp.org_/articles/health/hcr_education_chart_06-1410.pdf
Required viewing: “Health Reform Hits Main Street” (9 minutes)
http://healthreform.kff.org/the-animation.aspx
Required viewing: the federal government website about the Affordable Care Act.
Watch the video and become familiar with the website – you’ll need it for your
term papers:
http://www.healthcare.gov/law/introduction/index.html
Class 12
Oct. 12
10
MIDTERM EXAM
Guest speaker: “What does a Congressman’s home office do? Constituent
services of a Federal legislator”. Ms. Alexandra Maldonado, Office of
Congressman Frank Pallone.
Class 13
Oct. 17
Doing research in health policy
Lesson: 1) How to write a policy memo. 2) Handout on policy memo
assignment.
Required readings:
Teitelbaum and Wilensky. Essentials.
Ch.10 The Art of Structuring and Writing a Health Policy Analysis
Class 14 Oct. 19
LIBRARY TUTORIAL
We will have a guest lecture and hands on class with Dr. Karen Hartman,
Rutgers University librarian.
Note: This class will be held at Douglass College library. You must show
up there at the regular class time. Dr. Hartman will be demonstrating skills
and resources you will need for your policy memo assignment.
Class 15
Oct. 24
Legislative history and health reform / Patient Protection and Affordable
Care Act (2010)
Policy Memo Topic is Due
Required readings:
Morone, James,” Presidents And Health Reform: From Franklin D. Roosevelt To
Barack Obama”, Health Affairs, 29, no.6 (2010):1096-1100:
http://content.healthaffairs.org/content/29/6/1096.full.html
Patel and McDonough, “From Massachusetts To 1600 Pennsylvania Avenue:
Aboard The Health Reform Express”, Health Affairs 29:6:
http://content.healthaffairs.org/content/29/6/1106.full.html
Required viewing:
Watch this online video: update on health reform with HHS Secretary Sibelius
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Write a one-paragraph summary
http://www.pbs.org/newshour/bb/health/july-dec10/healthcare_08-02.html
Required viewing: video on political forces leading up to the ACA:
http://video.nytimes.com/video/2009/09/06/us/politics/1247463911101/healthcare-reform-then-and-now.html?scp=2&sq=health%20reofrm&st=cse
(keep in mind the NY Times video is from Sept. 2009 – before the law was
passed in March 2010)
Class 16
Oct. 26
Putting Issues into a Policy Framework
Teitelbaum and Wilensky. Readings.
Reading 23 Morality, Politics, and Health Policy (James Morone)
Krugman, Paul. A Tale of Two Moralities. New York Times. Jan. 13, 2011.
Leonhardt, David. Opposition to Health Law is Steeped in Tradition. New York
Times, Dec. 14, 2010.
Class 17
Oct. 31
Immigrants and other vulnerable populations
Policy memo drafts due at beginning of class
Teitelbaum and Wilensky. Readings.
Reading 26 Health Reform and the Safety Net
Required viewing: go to the website below and watch the video on health
care for immigrants in Minneapolis:
http://video.nytimes.com/video/2009/03/28/health/1194838918148/translatin
g-health-care.html?scp=1&sq=health%20care&st=cse
Rosenthal, Marsha. State Practices in Health Coverage for Immigrants: A Report
for New Jersey. June 2009.
Go to: http://www.cshp.rutgers.edu/ look under Publications; Reports
Center for State Health Policy report: “Health, Coverage, and Access to Care of New
Jersey Immigrants” : www.cshp.rutgers.edu/Downloads/8880.pdf
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Class 18
Nov, 2
Aging, Long Term Care, and Home and Community-Based Care
Natalie Graves Tucker, Enid Kassner, Faith Mullen & Barbara Coleman. Fact
Sheet: Long-Term Care. Washington DC: AARP Policy Institute. May 2000.
Independence, Dignity and Choice in Long Term Care Act. Annual Report 2010.
NJ Dept. of Health and Senior Services. November 2010.
Watch this online video -- only 14 min long - good review of basic concepts.
Write a one-paragraph summary
Risa Elias, Tutorial on Financing Long-Term Care, Kaiser Family Foundation
http://www.kaiseredu.org/tutorials/longtermcare/longtermcare.html
Class 19
Nov. 7
Policy memos due at beginning of class
Aging, Long Term Care, and Home and Community-Based Care
Required reading:
Mary Jo Gibson and Ari Houser. Valuing the Invaluable: A New Look at the
Economic Value of Caregiving. Issue brief # 142. Washington DC: AARP. June
2007.
Edward A. Miller and Vincent Mor. Out of the Shadows: Envisioning a Brighter
Future for Long-Term Care in America. Providence RI: Brown University.
(Executive Summary only).
TBD: Guest speaker Susan Lennon, AAA of Sussex County. “ARDC in New
Jersey: Olmstead Act in Action.”
Classes 20
Nov. 9
Health Care Quality for Everyone (part 1)
Assignment of Group Presentations
Required readings:
“A Push to Ban Soda Purchases with Food Stamps”. New York Times. Oct.
2010.
Op Ed: “No Food Stamps for Sodas”. New York Times, Oct. 2010.
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Class 21
Nov. 14
Health Care Quality for Everyone (part 2)
Teitelbaum and Wilensky. Readings.
Reading 7 Executive Summary from Crossing the Quality Chasm
Reading 9 Summary from Unequal Treatment
K. Baiker, A. Chandra, J. Skinner, et al., “Who You Are and Where You Live:
How Race and Geography Affect the Treatment of Medicare Beneficiaries,”
Health Affairs - Web Exclusive (7 October 2004): VAR33-44.
Guest speaker on health disparities: Dr. Shawna Hudson, Cancer Institute
of New Jersey
Class 22
Nov. 16
Health Care Policy and Law
Reading response:
Teitelbaum and Wilensky. Essentials.
Ch.8 Individual Rights and Public Health
Ch.9 Health Care Quality, Policy and Law
Niles
Ch. 10
Legal Aspects of Health Care Delivery
TBD: Guest speaker on organ transplants: Ms. Jessica Melore, NJ Organ
Transplant organization.
Class 23
Nov. 21
Health Care and Ethics (part 1)
Reading response:
Teitelbaum and Wilensky. Readings.
Reading 13 Public Health Ethics
Class 24
Nov. 28
Health Care and Ethics (part 2)
Group presentation drafts due
Niles Ch. 11
Ethics and Health Care
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Class 25
Nov. 30
Final Exam review
Class 26
Dec. 5
Final group presentations
Class 27
Dec. 7
Final group presentations
Class 28
Last class
Dec. 12
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