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