Health Policy and Public Policy Spring 2013 10:832:338 NOTE: This syllabus is subject to change. . Last Update: 1/14/13 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, including the new health care reform law 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 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 1 exam, 2 reaction papers, a mini lecture presentation and class participation. Expect pop quizzes on the readings on any given day. In-class assignments are to be expected and will be factored into the final 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: 15% 2nd paper) quizzes Exam: 2 Reaction papers: 20% 25% (10% 1st paper, Class Participation: 30%- Mini Lecture: 25% may include 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. 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 TWO 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. Reaction Papers: You will have two short reaction papers to write during the semester based on the lectures of your choice. The first paper must address readings covered in your choice of Lectures 3-5 and is due at the beginning of the lecture for which the readings apply. The second paper must address readings covered in your choice of Lectures 7-9 and is due at the beginning of the lecture for which those readings apply. Having read the week’s assignment, please frame a good question about the topic overall or a particular reading and briefly wrestle with an answer. For example: What was the author’s argument? Were you convinced by the author’s argument? Why or why not? Has “X” factor been overlooked? Might “Y” be a better way to approach the issue because … Did this article make you view this issue in a different way? The key here is not to simply summarize the article but to tell me what you thought about the article and why. These are just some examples of approaches to take in your reaction papers. However, specific parameters to follow must include: You MAY NOT simply summarize the article. Critical thinking is required. Your papers may not be longer than TWO PAGES in length, double spaced. I will allow a third page for references only. Papers will be accepted only at the beginning of class. I will not accept papers via e-mail, they must be in hard copy. Mini Lecture Project: Working in small groups, students will lead a short presentation and discussion based on the health policy topic of their choice that is NOT a focus of our class discussions. You will research the topic in depth and, from your research, choose 2 articles to assign to the class that you feel reflect the focus of your lecture. Here are some specifics to guide you: a. You will break into groups of 3-5 students, depending upon the final class size. Each group will chose a particular health policy topic/lecture to focus on that has NOT been covered in class but is related to one of our lectures. b. I must approve all groups, topics and articles. Groups and topic proposals are due to Dr. Berger: before Lecture 4, due date = Friday February 8 by 10am Article submissions suggestions are due to Dr. Berger: before Lecture 5, due date = Sunday, February 17 by 5pm c. Choose articles from peer reviewed journals, major newspapers or national news magazines such as Time or Newsweek. The articles must come from two different sources. d. All groups must address the following topics (and may include other facts as they are appropriate to your issue): Brief overview of your specific topic Which lecture does your topic relate to and how does it connect? How do the articles you chose to have the class read connect with your topic? Why did you choose these articles Discuss and review the articles, maintaining the connection to the topic throughout your discussion Explain how your topic connects with our discussions regarding health policy YOUR PRESENTATION SHOULD BE NO LESS THAN 10 MINUTES AND NO MORE THAN 15 MINUTES PLEASE NOTE: You will be responsible for meeting with your group outside of class time. Attendance is MANADTORY for all students on the designated mini lecture presentation days whether you are presenting or not. 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 22 – Introduction To Health Policy Assignments: Textbook: Chapter 1 Please read and bring the following article to class with you: NYT: “This Election, A Stark Choice in Health Care” by Abby Goodnough and Robert Pear, 10/11/12 Lecture 2 January 29 – The Policymaking Process, Part 1: The Role of Government and Checks and Balances Assignments: Textbook: Chapters 2 & 3 Articles: NYT : “Obama Facing Critical Choice After Shooting” by Peter Baker, 12/19/12 NYT Magazine: “Taking the Hill” by Matt Bai, 6/7/09 Campaignstops.blogs.nytimes: “We Are the 96 Percent” by Suzanne Mettler and John Sides, 9/24/12 NYT: “A Life’s Value? It May Depend on the Agency” by Binyamin Appelbaum, 2/17/11 IN CLASS, VIEW: “THIS WEEK” DEBATE ABOUT SIZE OF GOVERNMENT Lecture 3 February 5 – The Policymaking Process, Part 2: Deliberation and Conflict, Federalism and Morality Reaction Paper 1; Groups and Topics due Feb. 8 Assignments: No Textbook Articles: Nathan, Richard. “Federalism and Health Policy” Health Affairs, Vol. 24 # 6 (2005): 1458-1466 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 NYT: “Employees Sues for Benefits to Cover Same Sex Spouse” by Sharon Otterman, 6/20/12 www.americanprogress.org: “The New Values Voters: Health Care” by Eleni Towns, 10/3/12: The Center for American Progress Lecture 4 February 12 - New Directions in Medical Care: Tough Questions, Few Answers…The Need for Discussion Reaction Paper 1; Articles due February 16 for Mini Lecture; Written Homework assignment due; 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: Technology NYT: “In Medicine, Falling for Fake Innovation” by Ezekiel Emanuel, 5/28/12 NYT Magazine: “Metric Mania: Do We Expect Too Much from our Data?” John Allen Paulos, 5/16/10 Doctors, Hospitals and Insurance NYT: “Doctors Warned on ‘Divided Loyalty’” by Robert Pear, 12/27/12 NYT: “A Possibly Fatal Mistake” by Nicholas Kristof, 10/14/12 NYT: “When the Doctor is Not Needed” Editorial, 12/16/12 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 February 19 - The Road to Health Care Reform, Part 1: The Oregon Plan, The Clinton Plan, Policymaking Theories Reaction Paper 1; Written Homework Assignment due 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: 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 26 –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: Abcnews.com: “Supreme Court Health Care Ruling: The Mandate Can Stay” by Matt Negrin and Ariane De Vogue, 6/28/12 S.L: “Angst over Health Insurance Overhaul” by Bill Barrow, 12/31/12 (Associated Press) S.L: “Companies Saddled with Insurance Fee from Health Law” by Richard Alonso-Zaldivar, 12/11/12 (Associated Press) NYT: “The Conservative Case for Obamacare” by J.D. Kleinke, 9/30/12 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: The Great Healthcare Debate – This Week with George Stephanopolus – 7/1/12 CLASS CANCELLED – MARCH 5 March 12 – First Group of Mini Lectures – Attendance is MANDATORY for all students RUTGERS SPRING BREAK – NO CLASS MARCH 19 Lecture 7 March 26 – Players in the Process: Interest Groups and The Public Reaction Paper 2 Assignments: No text Articles: Public NYT: “On Street, Crowd Gives Louder Side of Argument” by Sabrina Tavernise, 3/28/12 NYT: “Opinion of Health Care Law Reflects Ad Spending” by Abby Goodnough, 6/21/12 NYT: “Next Challenge for the Health Law: Getting Public to Buy In” by Abby Goodnough, 12/20/12 KFF.org: Policy Insights: “What Issues Are Most Important to Voters in This Election? The Answer Depends On the Question” 11/1/12 Advocacy Newsweek: “We Need More Lobbyists” by Nick Allard, 2/22/10 NYT: “Interest Groups Push to Fill Margins of Health Coverage” by Abby Goodnough 12/6/12 Suite101.com: “Thank You for Smoking: The Ethics of Spin” by Gaylene Hill, 1/5/11 @ http://gaylene-hill.suite101.com VIEW IN CLASS: THANK YOU FOR SMOKING Lecture 8 April 2 – Players in the Process: The Media. Reaction Paper 2 Assignments: No text Articles: * “The Influence of The Mass Media on Health Policy” by Alan Otten. Health Affairs, Winter 1992 * “A Study of Media Coverage of Health Policy 1997-2000” Columbia Journalism Review, Jan/Feb 2002 by Mollyann Brodie et al. * “A Content Analysis of News Coverage of the HPV Vaccine by U.S. Newspapers, January 2002-June 2005” Journal of Women’s Health Vol. 14, # 7, 2006 by Crystal Calloway, Cynthia Jorgensen et. al * NYT: “Who Controls the Story?” by Margaret Sullivan, 9/30/12 * S.L.: “How Propaganda Took Over the Movies” by Stephen Whitty, 10/21/12 * AVAILABLE IN SAKAI: “In Fox News and Obama Nemesis Redux” by Jeremy Peters, 7/20/12, International Herald Tribune * Kaiser Family Foundation: “Hollywood and Health: Health Content in Entertainment Television” www.kff.org. Specifically, read the following pieces: - “News Release” - “Television as Health Educator: A Case Study of Grey’s Anatomy” paying particular attention to the Introduction and Results section. IN CLASS VIEW: GREY’S ANATOMY EPISODE Lecture 9 April 9 – Reproductive Health/Maternal Child Health Reaction Paper 2 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 NYT: “Tests of Parents Are Used To Map Genes of a Fetus” by Andrew Pollack, 6/7/12 April 16 – Second Group of Mini Lectures – Attendance is MANDATORY for all students Lecture 10 April 23 – The Life Cycle – Stem Cells and Eldercare/End of Life Issues Assignments: No Text Articles: NYT: “Doctor Who Helped End Lives” by Keith Schneider, 6/4/11 NYT: “Four Myths About Doctor-Assisted Suicide” by Ezekiel Emanuel, 10/28/12 NYT: “When Care is Worth It, Even if End is Death” by Peter Bach, 12/13/11 New Jersey Law Journal: “Who May Pull The Plug?” Editorial, 5/17/10 S.L.: “End-of-Life Ethics” Editorial, 5/12/10 NYT: “Push for Right to Die Grows in Netherlands” by David Jolly, 4/3/12 IN CLASS, VIEW: HOW TO DIE IN OREGON April 30 – LAST CLASS! FINAL EXAM