Health Policy and Public Policy
Fall 2014
10:832:338
NOTE: This syllabus is subject to change. .
Last Update: 8/10/14
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.
Suggested Resource
An awesome resource can be found right in the RU Library system. There is a
special section for PUBLIC POLICY ANALYSIS that provides information regarding
the BIG 5, policy memos, etc…
You can access it by logging into the Library => Find tab => click on “Research
Guides” => then enter “Public Policy Analysis”
Grading
Grading is based on performance on 1 exam, 1 policy memo, a 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:
Policy Memo:
Class Participation:
Mini Lecture:
20%
25%
30%
25%
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 policy
memos 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
scale: +(90-95); - (80-85); 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 class-specific grades.
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.
Policy Memo:
Policy Memo Assignment
DUE DATE: October 28 in hard copy – NO E-MAIL
For this assignment, you are to pretend to be a health aide to a busy
Congresswoman. She will be voting on a health related bill and you must write a
memo to her laying out two important points: 1) A recommendation to vote in
support of or opposition to the bill; and 2) The reasons for your recommendation.
Remember, the Congresswoman has little, if any, background in healthcare policy.
To help you with this assignment, please do the following:
1) You may choose the health policy issue to write about; however, I must approve
the topic and the “bill”. Please submit to me, by 10:00 am on September 28,
, for my approval 3 items:
a) Your proposed topic;
b) A name for your bill; and
c) A 2-3 sentence explanation of the bill.
All topics MUST be finalized by the end of class, September 30.
Some examples of topics include: abortion; insuring the working poor; birth
control; stem cell research; needle exchange; providing free flu vaccines to
the elderly.
For each day that this information is late, I will deduct 1/3 of a grade from
your final memo grade.
2) The memo should be NO LONGER than THREE (3) double spaced, 12 font
pages with margins of 1 inch on the top, bottom, left and right.
If your memo exceeds this page limit (with the exception of a reference
page) I will deduct points from your final memo grade.
Be concise and think about what are the most important items to convey in this
limited space; what does the Congresswoman definitely need to know?
The memo should follow this outline:
To: Congresswoman ----------From: (Your name)
Regarding: (What is the topic/what is the vote about)
I.
Introduction.
The vote is on (name of bill, topic of bill) and I recommend -----
II.
Background
Keep it brief and explain the issue – ex. This issue continues to
be controversial because … or, This issue should not be a difficult vote since
it doesn’t require any federal expenditures…
Since this class focuses on health policy, be sure to include
information regarding the politics involved with the issue.
III.
The Bill
What does the bill say? Keep it brief but explain the bill and its
ramifications. What does it do? Who is impacted by it?
IV.
Pros and Cons
Who is for it or against it? For example, interest groups,
health professionals, the public, etc… Again, remember the political and
policy implications for this topic.
V.
Recommendation.
Based on these factors, I recommend ….. You should reiterate
important points here and explain the reason for your recommendations.
You may have a 4th page with references ONLY.
Keep it short, simple, informative and persuasive. Think about what
information you would need to make this type of decision and the
politics/policy implications.
Suggested Resource to help with writing the Policy Memo
In case you missed this tip the first time:
An awesome resource can be found right in the RU Library system. There
is a special section for PUBLIC POLICY ANALYSIS that provides information
regarding the BIG 5, policy memos, etc…
You can access it by logging into the Library => Find tab => click on “Research
Guides” => then enter “Public Policy Analysis”
There is a section on Policy Memos. This information should complement
my outline, not replace it; hopefully it will provide you with a fuller
understanding of what to include in the memo and how to approach the various
sections.
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 prior to Lecture 3 – by 3:00pm on
Friday, September 12
2. Groups and topics must be FINALIZED by Lecture 3 – September 16
3. Presentations are scheduled for OCTOBER 15 and NOVEMBER 11 …..
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 10/15 and 11/11, 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. WELCOME BACK!!!
September 2 – Introduction To Health Policy
Assignments: Textbook: Chapter 1
Please read and bring the following article to class with you:

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USA Today: Editorial, “All Obamacare Delays Not Created Equal” 3/7/14
SAKAI: Understanding the Policy Process, Center for Health
Improvement. Posted on SAKAI as “Health Policy Lecture 1 reading”
Lecture 2
September 9 – The Policymaking Process, Part 1: The Role of
Government and Checks and Balances
Debate topics/groups due Friday, 9/12 @3:00pm
Assignments: Textbook: Chapters 2 & 3
Articles:
 NYT: “In Poll, South Opposes Health Law, and Repeal” by Sabrina Tavernise
and Allison Kopicki, 4/24/14
 Suderman, Peter. “After Obamacare.” Reason. Vol 45, Issue 9, pp. 36-44.
Feb. 2014
 Msnbc.com: “House GOP Will Sue President Obama Over Health Care
Mandate” by Benjy Sarlin, 7/10/14
IN CLASS, VIEW: Santorum/Dean debate at Cornell University.
(www.cornell.edu/video/dean-santorum-debate)
Lecture 3
September 16 – The Policymaking Process, Part 2: Deliberation and
Conflict, Federalism and Morality
Finalize debate project information
Assignments: No Textbook
Articles:
Values, Morality and Politics
 Brookings Institution: “Here to Stay – Beyond the Rough Launch of the
ACA” by Henry J.Aaron, 5/7/14
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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.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 health care.
You do not need to read each article, just understand the summaries

Realclearpolitics.com: “Obamacare Proves the Virtues of Federalism” by
Steve Chapman, 11/14/13
Lecture 4
September 23 - New Directions in Medical Care: Tough Questions,
Few Answers…The Need for Discussion
Memo topics due 9/28 @ 10 am; 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:
 Wall Street Journal: “Hospitals’ Prices For Common Services on the Rise”
by Stephanie Armour, Christopher Weaver and Melinda Beck, 6/2/14
 NYT Magazine: “Metric Mania: Do We Expect Too Much from our Data?”
John Allen Paulos, 5/16/10
 NYT: “Treatment Cost Could Influence Doctors’ Advice” by Andrew Pollack,
4/18/14
Great background information and data on initial implementation of insurance
exchanges, kff.org or ncsl.org
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
September 30 - The Road to Health Care Reform, Part 1:
The Clinton Plan, Policymaking Theories
Memo topics finalized;; 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
 NYT: “Obamacare Bashing of Bust” by Charles Blow, 4/19/14
 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
October 7 –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:
 Cnn.com: Kaiser Health News: “FAQ: What the Obamacare Court Decisions
Mean for You” by Mary Agnes Carey, 7/23/14
 S.L.: (MCT News Service) “2015 Obamacare Prices in the Works” by Tony
Pugh, 5/23/14
 Brookings Institute: Issues in Governance Studies: “Bipartisan Health
Reform ? Obamacare in the States” by James Morone, Number 64,
December 2013
 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: Obamacare for Dummies: The Affordable Care Act Explained
(youtube)
OCTOBER 14 – First groups for debate project –
Attendance is MANDATORY for all students
Lecture 7
October 21 – Players in the Process: Interest Groups and The Public
Assignments: No text
Articles:
 NYT: “Ruling on Health Law Could Deepen US Divide” by Margot SangerKatz, 7/24/14
Public
 Gallup.com: “Most Americans Remain Satisfied with the Health Care
System” by Frank Newport, 6/16/14
 *American Viewpoint (amview.com): “Problems in Polling on Health
Policy Issues” by Gary A. Ferguson
 NYT: “When Beliefs and Facts Collide” by Brendan Nyhan, 7/7/14
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: THANK YOU FOR SMOKING
Lecture 8
October 28 – Players in the Process: The Media.
Policy Memos due
Assignments:
No text
Articles:
* CQ Researcher: Media Bias: Is Slanted Reporting Replacing
Objectivity? By Robert Keiner, 5/3/13, vol. 23, #17 … Focus on the
INTRODUCTION and OVERVIEW sections only
* Journal of the American Medical Association (JAMA): “The
Media and Health Care Reform” by Noam Levey, 2013, 310(18) pp. 1941-42
* NYT: “Obamacare Fails to Fail” by Paul Krugman, 7/14/14
* journalistsresource.org: “Informing the News: The Need for
Knowledge-Based Reporting” by Thomas E. Patterson
IN CLASS VIEW: Interview from journalistsresource. org
Lecture 9
November 4 – Reproductive Health/Maternal Child Health
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: “Advocates Shun ‘Pro Choice’ to Expand Message” by Jackie Calms,
7/29/14

The Atlantic: “Supreme Court: Companies Can’t Be Required to Pay for Birth
Control” by Emma Green
VIEW IN CLASS:
November 11 – Second groups of debate
projects Attendance is MANDATORY for all students
Lecture 10
November 18 – The Life Cycle – Eldercare/End of Life Issues
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Assignments: No Text
Articles:
NYT: “Doctor Who Helped End Lives” by Keith Schneider, 6/4/11
NYT: “Aid in Dying Movement Takes Hold in Some States” by Erik Eckholm,
Time.com: “Belgium Extends Euthanasia Law to Kids” by Charlotte
McDonald-Gibson, 2/13/14
S.L. “Wise to Wait on Assisted Suicide” Editorial, 6/30/14
S.L.: “There is No Dignity in Doctor Assisted Suicides” by Michael Douglas,
2/20/13
IN CLASS, VIEW: HOW TO DIE IN OREGON
November 25 – Thursday classes meet – no
class and Happy Thanksgiving.
December 2 – Catch Up and Review for Exam
December 9 – LAST CLASS! FINAL EXAM