COLLEGE OF HEALTH AND HUMAN SERVICES
California State University, Long Beach
Health Care Administration Program
SYLLABUS: Spring, 2012
Course Title:
Day and Time:
Room:
Instructor:
Program Office
Office Hours:
HCA 422I – Global Health Issues
(3 Units)
Tuesdays 4-6:45pm
TBA
Richard L. Tradewell, MBA, Ph.D.
rtradewe@csulb.edu
ET-101; 562 985-5694
Drop in any time two hours before each class session (2-4pm) and by
appointment.
Course Goal and Objectives:
Compare and contrast contemporary problems in health services policy and delivery in the major developed
and selected developing nations. Analyze health system performance from a financial, management,
government, private sector and public policy perspective. Obtain a more complete understanding of the
problems and possible solutions to U.S. health system inefficiencies and inequities by seeking an
international perspective. Identify mistakes of other nations and isolate ideas that have worked to increase
access and to promote quality of health services.
New Catalog Description
This course examines factors that impact global health, including geography, climate, demography, culture,
religion, and social organization. It then analyzes the characteristics of healthcare delivery systems and the
governmental, economic, social and political forces that influence them. Issues are discussed from the
standpoint of individual nations, regions, and the world. Behaviors, over which one can exert control, are
juxtaposed with genetic and environmental factors, over which one has limited or no control.
Expected Learning Objectives & Outcomes; Activities, Assignments & Assessments. The Health Care
Administration Department has adopted a competency-based curriculum, based on the American College of
Health Care Executives (ACHE) Competencies Assessment Tool and the Healthcare Leadership Alliance
(HLA) Competency Directory. The emphasis in this course is on acquiring competencies in HLA Domain
4, knowledge of the healthcare environment.
Learning Objective
Domain
Competency
Describe how environmental,
economic, social and political
forces affect access to health care
in America.
Identify the components of the
health care continuum.
4-Knowledge
of the hc
environment
Socioeconomic environment in
which the organization functions
Activities (A1) ,
Assignments (A2) &
Assessments (A3)
A2: Critical essay (country
paper) and presentation
4-Knowledge
of the hc
environment
4-Knowledge
of the hc
environment
4-Knowledge
of global
healthcare
issues, trends
Organization and delivery of
healthcare
A3: Quizzes and final
exam
Managed care models, structures,
A1: Study reform of NHS
and compare to Kaiser.
Financing mechanisms for
achieving universal access
throughout the world
A2: critical essay and
presentation.
Discuss the pros and cons of
integrated and managed care
delivery systems
Discuss market, mandate, single
payer and other (HSA) systems of
health care in nations
1
Learning Objective
Discuss the problems of the
uninsured in accessing care and
efforts to expand health insurance
coverage
Explain the reasons for the long
term increase in health care costs
Distinguish between public health
and personal medical care and
explain the distinct role of each in
life expectancy and infant
mortality
Appreciate how terrorism and
emergency preparedness have
increased the importance of
partnerships between public
health and public and voluntary
agencies
Define the major health care
professions and the role of health
care administrators within each
Domain
Competency
Activities (A1) ,
Assignments (A2) &
Assessments (A3)
The interrelationships among
access, quality, cost, resource
allocation, accountability and
community
Funding and payment
mechanisms of the healthcare
system
Interaction and integration among
healthcare sectors
A1: Focus discussion
question # 1 and 2
4-Knowledge
of the hc
environ-ment
Interaction and integration among
healthcare sectors
A1: Focus discussion
question 14
4-Knowledge
of the hc
environment
Role of non-clinical professionals
in the healthcare system
A1: Focus discussion
question 14
and
perspectives
(e.g., aging
population,
insurance
costs,
malpractice
crisis, etc
4-Knowledge
of the hc
environment
4-Knowledge
of the hc
environment
4-Knowledge
of the hc
environment
A1: Focus discussion
question 2
A1: Focus discussion
question 13
Expected Outcomes:
Upon successful completion of the course, the student will be able to analyze provision of health care in
several nations and apply theories of market failure and government failure to the operation of these health
services systems. In addition, students will:
A.
B.
C.
D.
E.
F.
G.
H.
Describe supply and demand patterns for health services in several countries.
Analyze how government and politics affect health policy.
Identify different approaches used to bring health care to the poor and underserved.
Analyze the relationship between economic/industrial development and health care delivery.
Examine how resources are expended on hospitals, physicians, nurses, preventive and sanitation
services in various countries.
Describe the role of indigenous healers in several countries.
Relate social and political change to consequent reforms in health care and changes in health
status.
Identify issues affecting underserved population’s health in the United States and abroad.
Textbooks (Free downloads)
Reid, T.R. 2008. “Sick Around the World” PBS Home Video. We will watch DVD in class together. PBS
offers a free online version here: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ or you may
read the transcript here: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/etc/script.html.
Website also offers many learning resources, all from a socialist democracy perspective.
2
Tanner, Michael D. 2008. The Grass Is Not Always Greener: A Look at National Health Care Systems
Around the World. CATO Institute. Policy Study No. 613. Available online and Beach Board:
http://www.cato.org/pubs/pas/pa-613.pdf. A critical look at the various socialist democracy attempts to
provide universal health care in several nations and the criticisms that these systems are unsustainable and
tend to compromise quality and freedom of choice.
Tanner, Michael D. 2011 (Revised from 2010). Bad Medicine: A Guide to the Real Costs and
Consequences of the New Health Care Law. CATO Institute, Washington, D.C.
http://www.cato.org/pubs/wtpapers/BadMedicineWP.pdf.
A critical but comprehensive examination of ObamaCare’s (PPACA) impact on health care access, costs,
taxes and business.
White, E.B. 2006. The Elements of Style. Paperback (about $3.00) or online http://www.bartleby.com/141.
Instructor has Chapter II posted on BeachBoard. This short classic writing guide is considered the best ever
produced; keep it at your desk throughout your career. You are tested on Chapter 2.
http://owl.english.purdue.edu/owl/resource/560/01 The Purdue University Writing Lab’s free guide to
putting your paper in APA format.
Schaeffer, Adam B. 2010. “They Spend WHAT? The Real Cost of Public Schools.” March 10, 2010 CATO
Policy Analysis no. 662 http://www.cato.org/pub_display.php?pub_id=11432
Faber, David. 2009. “Untold Wealth: The Rise of the Super Rich.”
Thu 11 Jun 09. David Faber inside the exclusive world of the new super rich.
http://video.cnbc.com/gallery/?video=1157133460
Texts (Recommended) 1:
1. Johnson, J.A. & Stoskopf, C.H. (2010). Comparative health systems: Global perspectives. Sudbury,
MA: Jones & Bartlett.
2. Levine, R. (2007). Case studies in global health: Millions saved. Sudbury, MA: Jones & Bartlett, or:
http://www.cgdev.org/section/initiatives/_active/millionssaved/studies.
3. American Psychological Association Publication Manual, 6th Ed., 2009.
4. Strunk, W. and E.B. White. The Elements of Style, Fourth Ed. 2000
Required Publications: Provided on BeachBoard:
Survey: “The Health of Nations.” The Economist. (July 15, 2004). (All chapters are required).
Freidman, Milton. “How to Cure Healthcare”. The Public Interest, Winter, 2001. (Word copy of
article on BeachBoard).
Getzen, Thomas E. 2007. Health Economics and Financing. John Wiley & Sons. Chapter 17:
“International Comparisons of Health and Health Expenditures”, pp 396-423. Excellent summary
of recent problems in German health system at pages 415-418.
Goodman, Musgrave and Herrick. 2005. Lives at Risk: Single-Payer National Health Insurance
Around the World. Chapter 24: Designing Ideal Health Insurance.
Gratzer, David. 2006. The Cure: How Capitalism Can Save American Healthcare. Encounter
Books.
1
Course texts are on reserve in the library under instructor and course name; APA manual is in
general reference.
3
Herzlinger, Regina E. 2005. Harvard Case Study: “Hospital for Special Surgery” (9-305-076).
Harvard Business School. Note especially reading starting page 12, “The United Kingdom.”
Herzlinger, Regina. 2007. Who Killed Healthcare? New York: McGraw-Hill.
Klein The Health of Nations. American Prospect
http://www.prospect.org/cs/articles?articleId=12683
“A Survey of the World Economy: The Future of the State.” The Economist (September 20,
1997). (Part 1 in e-reserves).
World Development Report: Investing in Health (free download). 1993. Oxford University Press
and World Bank. Chapter 3 provides an excellent short summary of market and government
failure in health care.
http://www.dcp2.org/file/62/World%20Development%20Report%201993.pdf
Chapter 4: “Infectious Diseases” in Merson, R Black, A Mills, International Public Health,
Gaithersburg: Aspen Publishers, Inc. 2001. (e-reserves).
Chapter 8: “Limits to Public Intervention: Government Failures” in Weimer, David L. and Aidan
R. Vining. 2005. Policy Analysis: Concepts and Practice. Prentice Hall.
Schieber, George J., Pablo Gottret, Lisa K. Fleisher, and Adam A. Leive. “Financing Global
Health: Mission Unaccomplished.” Health Affairs. 26, no.4 (2007):920 Ju l y/Au g u s t 2 0 0 7.
Stonebraker, Robert. Joy of Economics. Chapter “Health Care” in free, online textbook
http://faculty.winthrop.edu/stonebrakerr/book/medicalcare.htm .
World Development Report: Investing in Health (free download). 1993. Oxford University Press
and World Bank. Chapter 3 provides an excellent short summary of market and government
failure in health care.
http://www.dcp2.org/file/62/World%20Development%20Report%201993.pdf
Methods of Presentation
A.
Lecture/Discussion. PowerPoints and articles are posted on BeachBoard prior to each class
B.
Variety of video materials
C.
Discussion of student critical essays
Use of Academic Technology in this Class
This course makes use of several forms of academic technology, including the web, e-reserves and
BeachBoard. Students are required to use of this technology to fulfill the requirements for this course. To
participate in the academic technology elements of this course, students must have access to, and be able to
use:
 A computer, equipped with Adobe Acrobat Reader 5.0 or newer and word-processing software
capable of reading Microsoft Word XP files.
 The internet. Specifically, the World Wide Web. Whatever internet service provider is used must
be capable of accessing Web pages, BeachBoard and Acrobat files.
 An account on BeachBoard.
Expectations of Student Skill Performance
To complete the requirements for the course, students are expected to:
Write clearly and concisely, using correct grammar, punctuation and spelling.
Communicate articulately in oral presentations.
4
Be proficient in using PowerPoint for presentations.
Search the web and research publication, then apply the information found.
Analyze information, both numeric and text.
Apply internationally-accepted metrics to compare health and healthcare.
Synthesize information about factors that impact health and health care.
Compare and contrast countries, situations, historic and current times.
Participate in class discussions.
Submit all assignments on time.
Submit assignments on line and provide professor with a paper copy during class.
Student Responsibilities and University Policies
(1) CSULB policies on cheating and plagiarism shall apply, as delineated in California State University,
Long Beach Policy Statement 85-19, December 13, 1985. One or more of the following academic actions
are available to the faculty member who finds a student has been cheating or plagiarizing.
(a) Review -- no action.
(b) An oral reprimand with emphasis on counseling toward prevention of further
occurrences;
(c) A requirement that the work be repeated;
(d) Assignment of a score of zero (0) for the specific demonstration of competence,
resulting in the proportional reduction of final course grade;
(e) Assignment of a failing final grade;
(f) Referral to the Office of Judicial Affairs for possible probation, suspension, or
expulsion.
(2) Students who need accommodation for any type of disability must inform the instructor in advance.
(3) Withdawal is the responsibility of student. Withdrawal after the posted date is allowed only for serious
and compelling reasons and requires the approval of the dean.
(4) Absences are excused consistent with University policies.
(5) Students are expected to have CSULB email accounts and to check their email and BeachBoard
regularly for class announcements.
Methods of Evaluation and Grading
A.
Critical Essay and Oral Presentation
B.
Objective Quizzes (5 @ 20 pts each)
C.
Debate Team
D.
Take Home Final Examination
100 points
100 points
20 points
80 points
300 points
Grading
90 % and higher:
80 % and higher
70 % and higher
60 % and higher
Below 60%
A
B
C
D
F
COUNTRY CRITICAL ESSAY GUIDELINES
You will prepare a 4-5 page, double-spaced, essay with reference sheet on a nation of your choice that is
NOT on our core study list. Thus, you may NOT write on: Canada, U.K., Germany, Netherlands,
Switzerland, Japan or Singapore.
What is a critical essay?
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A critical essay provokes and reflects thought. It examines health policy solutions from multiple
perspectives. It thinks through both market and government failure, including how a program is
implemented and how and how often it is evaluated for cost-effectiveness.
One Critical Essay Required
You will be analyzing how effectively the nation’s health system works, the major reforms needed, and
whether you would recommend this system, or parts of it, for the U.S.
Or you may analyze an economically developing or transitional nation (Cuba, Mexico, China). You will
be paying particular attention to how scare resources are utilized, major reforms needed and whether the
nation is heading in the right direction.
Present Both Sides: Look for the Fight
Every nation has at least a major and an opposition party and candidates with very different ideas about
healthcare. In developed, and even in some developing nations, the two sides are usually represented by
policy institutes or think tanks that publish many useful articles.
Presenting Your Analysis
You will be orally summarizing your essay for your classmates. You should use a one page outline of your
key points to hand out to the class. These presentations must be short (3-5) and allow five minutes for
discussion.
Length and Format
The best “op-ed” pieces are often the shortest. Two-four pages double-spaced (your references add a fifth
page) should be adequate to present your argument. Be brief but specific and make your report fact, chart,
data-laden.
Please Use Microsoft Word for your essay. This allows me to easily track my changes and edits to your
work. If this is a hardship, I will paste my corrections into Word but you will have the own the program
open my corrections.
References
You must include two references (books, journal articles) in addition to the texts. Use a consistent and
standard reference protocol.
Common Issues to Consider in Your Country Critical Essays (Check out http://www.procon.org for
other ideas):
1. Is personal medical care a right? Who should pay for your healthcare: employer, government,
yourself?
2. Is consumer choice of services a right?
3. What indicates market failure and supports government intervention?
4. What indicates government failure and the need to establish market forces?
5. Why is U.S. health care said to be in crisis? Are any other nations in crisis with health care?
6. Compare/contrast ObamaCare with mandate systems of other nations such as France.
7. How is the ObamaCare similar to the Massachusetts state plan (RomeyCare)? Has RomneyCare
worked?
8. What actually is success? Is it universal access? Is it lower cost services? Is it better quality
services?
9. Is there access to care or access to a waiting list?
10. Have taxes been raised continually to support health care? Are tax rates growing faster than
national income? Is economic growth slowed as a consequence?
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11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
Market Failures the government is attempting to correct.
Evidence of Government Failure in implementation of public policy.
Interaction of Public Health Services and Personal Medical Care Services in Selected Nations.
Control of Budgets and Revenues Under Different Systems of Government.
How to Control Demand for Health Care.
Consumer Control and Empowerment.
Health Professional Licensure and Certification: does it help or hinder cost effective services?
Changing Stakeholders in Health Services in Different Countries
Is Technology Lifesaving or Cost-Increasing in a particular nation?
Cost Benefit and Cost-Effectiveness Analysis.
Access as a Worldwide Ethical Issue.
Rationing of Health Care in Different Settings
Health Reform and Quality Assurance Trends Affecting Health
Institutional Ownership of the Health Care Industry
War, Civil Disorder and Health Services
DEBATE GUIDELINES
Using http://www.procon.org/ website as our inspiration, we will debate each nation’s health system in a
pro/con format. The class is divided into ten groups of about three students per group. The groups will be
matched against each other with two groups presenting each class. You must be prepared to argue both the
pro and con position. I will flip a coin to determine whether you are pro or con.
QUIZ/EXAM SCHEDULE
Quiz 1
Quiz 2
Quiz 3
Quiz 4
Quiz 5
Final Exam (TH)
Intro to Problems in U.S. Health System
Canada Ideals and Government Failure
Can the U.K. NHS Ever Be Kaiser?
Mandate Nations: Germany, Holland, Japan
Developing Nations: Poverty, Disease, Corruption, Hope
Model Nations (Singapore, Switzerland); PPACA
February 7, 2012
Feb 21
Mar 6
Apr 3
Apr 24
May 8
CRITICAL ESSAY SCHEDULE
Discuss Topic and Reference Sources in Class
Complete Draft, with references for grade (Optional)
Final Critical Essay (with improvement bullets if Draft was graded)
Present Essay in Class
February 14, 2012
Mar 6
Apr 3
Apr 17, 24, May 1
Semester Schedule and Reading Assignments
Week 1:
Jan 24 What Went Wrong on the Way to Universal Health Care?
Focus Question Week 1: Did Obama Fix Market Failures? Is Everyone Covered?
A.
Why this class is important to you, the nation and your world
B.
What went wrong on the way to universal care?
C.
Three way of organizing a health system. Market, Mandate, and Single-Payer.
D.
What are the goals of ObamaCare (PPACA)?
E.
Review of reading assignments
F.
Review of written assignments (See: Critical Essays)
G.
Participation in class discussions, debates
H.
Attendance, expectation of performance
I.
Testing and grading policies
7
Reading Assignment:
“How American Healthcare Killed My Father”
http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/
Tanner (“Green,” pages 1-7)
Tanner (“Bad,” see: “Executive Summary” and “Introduction” and Page 63, Timetable)
PowerPoint: “Ten Characteristics of U.S. Health System”
Note: students that are taking HCA 422I without a foundation course (HCA 202 or 402) must read the entry
on “Health Care” http://en.wikipedia.org/wiki/Health_care
Background in health systems around the world: http://en.wikipedia.org/wiki/Health_care_system
http://en.wikipedia.org/wiki/Universal_health_care
White. E.B. 1979 (third edition); Chapter II, “Elementary Principles of Composition.”
Video presentation: John Stossel, six part series: “Sick in America
http://www.youtube.com/watch?v=kf3MtjMBWx4
Week 2:
Jan 31. Learning the Three Components of Market Failure.
Focus Question Week 2: Is Health Care in the U.S. So Uniquely Unaffordable Because the Market
has Failed?
Reading Assignment: STONEBRAKER: JOY OF ECONOMICS (SEE BEACHBOARD)
MILTON FRIEDMAN; HOW TO CURE HEALTH CARE (SEE BEACHBOARD)
Critical Thinking Discussion Topics
1. What are moral hazard, adverse selection and information asymmetry?
2. What are the common elements of all health systems?
3. How do we evaluate health systems?
4. Is it possible to have both equity and efficiency?
5. What is the role of the state?
6. What parts of the health system are public goods and which are private goods?
7. What kinds of regulatory mechanisms do governments use?
8. How do we evaluate public and private financing options?
9. How are providers paid?
10. How are services provided?
11. What kinds of reform should we look for in each nation?
a. Regulation reform
b. Financing reform
c. Resource allocation reform
d. Provision of services reform
Key Terms:
Universal entitlement
Enforcement of legal rights
Moral ideals
Market failure and government intervention
Week 3:
Feb 7
QUIZ 1: 20 QUESTIONS on government failure featuring Friedman and market failure featuring
Stonebraker.
Focus Question Week 3: If the Answer to Market Failure Is Government Intervention with New
Programs, What Happens When Government Fails?
Short Movie: IOUSA http://www.youtube.com/watch?v=O_TjBNjc9Bo
Government Growth and Government Failure Background Reading
Weimer and Vining. 2005, Policy Analysis (Prentice Hall, 4th Edition, “Chapter 9, Government Failure” in
e-reserves.
Economist: “Survey: the Future of the State”
8
 Page 8: Government Spending as Percentage of GDP over 100 years in selected nations.
 Page 18 – The Hidden Cost of Taxes.
Instructor PowerPoint: Government Failure
Bureaucracy: http://en.wikipedia.org/wiki/Bureaucracy
Public Choice Theory: http://en.wikipedia.org/wiki/Public_choice_theory
Government Failure; http://en.wikipedia.org/wiki/Government_failure .
Freidman, Milton. “How to Cure Healthcare”. The Public Interest, Winter, 2001. (Word copy on
BeachBoard).
CLASS ASSIGNMENT: John Stossel’s STUPID IN AMERICA
http://abcnews.go.com/2020/stossel/story?id=1500338 will be shown in class.
See: review here: http://blogcritics.org/archives/2006/01/16/052113.php.
Steps to fire a bad teacher are here: http://cgood.org/i/burden/question-6.gif
Critical Thinking Discussion Topics
1. Why do government programs to help the poor so often fail in practice? Why did the old welfare
system lead to government dependency?
2. How does Milton Friedman reason that bad tax policy led to the crisis in U.S. healthcare?
3. How does tax policy encourage over-consumption and waste and systematically reward the
wealthy at the expense of the poor?
4. Can government discriminate in providing services?
5. When, if ever, are taxes just too high? What is the relationship between taxation and economic
growth and opportunity?
6. When government gets into the subsidy business, what socio-economic groups tend to benefit?
7. In what ways is King-Drew Medical Center (so-called “Killer King”) an example of government
failure? Was too little money the problem?
8. Are American “public schools” really public? Why are performance levels of American students
relatively low internationally? Is money the problem?
Key terms:
Theory of government failure
Rent seeking
Relationship of high taxes to economic growth
Government growth over 100 years
Capitalism and Socialism
Week 4:
Feb 14
Focus Question Week 4: What Are the Idealist Goals and Values of Canadian Health Care?
The Canadian Health Care System
A.
The development of the Canadian System
B.
The early years of Canadian medicine
C.
Principles of Canada NHI
D.
Comparing provinces
E.
Is Canada a lesson for the U.S.?
F.
Do Canadians hate their health system?
Critical Thinking Discussion Topics:
1.
What does a single payer of health care mean?
2.
Can uniformity be enforced in health and social welfare?
3.
What is the real market for health care? Providers? Insurers?
4.
Why is Canada different from the U.S.?
Reading Assignment:
TANNER PAGES 31-33
Feldstein, Paul J. 2007. Health Policy Issues: An Economic Perspective, Chapter 32, “The Canadian Health
Care System.” (posted on BeachBoard)
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Medicare in Canada (Medicare is term for government universal healthcare)
http://en.wikipedia.org/wiki/Medicare_%28Canada%29
Look for supplemental articles on BeachBoard concerning recent attempts to reform Canadian healthcare in
light of recent court decisions
Key Terms
Monopsony http://en.wikipedia.org/wiki/Monopsony
Canadian style socialism
Week 5: Feb 21
Focus Question Week 5: What Are the Recent Challenges and Crises in Canadian Style Socialism?
A
Supreme Court Decisions: the crisis and its aftermath
B
What about the private sector in Canada?
Reading Assignment: Steinbrook, Robert. 2006. “Private Health Care in Canada” New England Journal of
Medicine
Gratzer: Chapter Nine: “The Hip That Changed History” in The Cure. See e-reserves.
QUIZ 2: 20 questions on Canada
Week 6: Feb 28
Focus Question Week 6 and 7: Can the U.K.’s National Health Service Really Become Like Kaiser?
The British National Health Service (NHS)
A.
The British government and constitution
B.
History of Britain since the industrial revolution
C.
Workers health insurance 1911-1945
D.
The birth and growth of the NHS 1945-present
E.
Structure and function
F.
Reforms in the NHS 1954, 1976, 1993
G.
The private sector in the UK
Critical Thinking Discussion Topics:
1.
What is the impact of nationalizing hospitals?
2.
What were incentives built into the payment of GPs?
3.
Why is the NHS less costly than other national programs?
4.
What is the future of private sector alternatives?
5.
Human resources management in a nationalized system
Reading Assignment:
http://en.wikipedia.org/wiki/British_National_Health_Service
Herzlinger, Regina E. 2005. Harvard Case Study: “Hospital for Special Surgery” (9-305-076). Harvard
Business School. Note especially reading starting page 12, “The United Kingdom.”
Review the NHS redesigned website based on consumer choice:
http://www.nhs.uk/Aboutnhs/howthenhsworks/Pages/HowtheNHSworks.aspx
Key Terms:
Primary Care Trusts
Hospital Trusts
Double jeopardy
Waiting lists
Super bugs
Privatization
Week 7: Mar 6; U.K. Continued
QUIZ 3: 20 Questions on Great Britain
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Week 8: Mar 13 Germany and Netherlands
Focus Question(s) Week 8: What Does ObamaCare and the German system have a common? How
have the Dutch taken the German system and reformed it?
Germany: Bismark’s Great Experiment and the Current Crisis
A.
Bismarck and social reform
B.
The role of sickness funds in Germany
C.
Labor and management relations in Germany
D.
Functioning and problems of the system
E.
Lack of product differentiation; cream-skimming; lack of real competition
Critical Thinking Discussion Topics:
1.
How did Bismark co-opt the workers’ revolutionary movement?
2.
Is Germany today a public or a private system?
3.
Describe the crisis Germany faces today.
4.
How has German healthcare contributed to high unemployment and slow economic growth?
5.
How does the necessity for increased payroll taxation decrease future international
competitiveness?
6.
Are physicians as a corporatist cartel the key obstacle to reform?
7.
What did the Dutch do to improve on Germany’s system?
Reading Assignments: German Health Care and Dutch Reforms
Getzen, Thomas E. 2007. Health Economics and Financing. John Wiley & Sons. Chapter 17: “International
Comparisons of Health and Health Expenditures”, pp 396-423. Excellent summary of recent problems in
German health system at pages 415-418.
Dutch reform article will be posted on BeachBoard
Key Terms
Sickness Funds
Automatic increases in payroll taxation
Demographic unsustainability
Dutch no claim bonus
Week 9: March 20 Japan
Focus Question: Are Japan-style Price Controls the Answer to Soaring Medical Costs?
The Japanese Health System
A.
Japan’s contact with the West
B.
Development of social security
C.
World War II and the occupation
D.
The roles of Japanese business
E.
Why is Japanese health care so inexpensive or is it?
F.
Health care and health status in Japan
Critical Thinking Discussion Topics:
1.
Why are the Japanese so healthy?
2.
Why Japan had grown so prosperous? Does this include health care providers?
3.
What happened to the Japanese economic miracle?
4.
Is the Japanese price control system applicable to the U.S.?
Reading Assignment:
Yoshikawa and Bhattacharya: Japan in class text, pp 249-266.
Ikegami, et al. 2004. “Japan’s Health Care System: Containing Costs and Attempting Reform.” Health
Affairs, May/June 2004.
Getzen, Thomas E. 2007. Health Economics and Financing. John Wiley & Sons. Chapter 17: “International
Comparisons of Health and Health Expenditures”, pp 396-423. See section discussing Japanese healthcare.
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Key terms:
Society managed health insurance
GMHI
CHI
Standardized reimbursement
LTCI
Aging society
Week 10:
Mar 27 SPRING BREAK
Week 11:
Quiz 4 Germany, Holland, Japan
Apr 3 ** FINAL CRITICAL ESSAY DUE**
Week 12:
Apr 10 Focus question week 14: Why is Sub-Saharan Africa So Poor? Will It Ever
Develop Given the public Health Challenges It Faces?
Poverty and Health: A Global Perspective
A.
Rich nations and poor nations-- an overview
B.
Income and class differences within countries
C.
Rural and urban poverty
D.
Multi-class health care
E.
Models of How Economies Grow
Critical Thinking Discussion Topics:
1.
How is the U.S. similar to or different from developing countries in health care?
2.
Is a two-class health care system inevitable?
3.
Does industrialization lead to an unhealthy civilization? Is economic growth dangerous to health?
Focus Question Week 12: Why Are Most Medical Payments in the Developing World Made Out of
Pocket? Where are Government and Private Insurance in the Picture?
Non-European Models
A.
Differences between less developed and industrialized countries
B.
Economic structure of rich and poor nations http://en.wikipedia.org/wiki/Economic_inequality
C.
Health status differences and social insurance
D.
Role of World Health Organization http://en.wikipedia.org/wiki/World_Health_Organisation .
Critical Thinking Discussion Topics:
1.
Why does an economy dependent on agriculture and raw materials lead to a poorer, less healthy
country?
2.
Does lower GNP per capita mean poverty, disease and illiteracy? Why or Why not?
3.
How does colonialism determine health organization?
Reading Assignment:
http://www.ted.com/index.php/talks/view/id/92 TED Conference, Monterey, CA.
Chapter 17, Getzen in e-reserves, and PowerPoint “International Comparisons”.
Economist; “For 80 Cents More”. August 17, 2002 U.S. Edition. Note: the PowerPoint with this article
explores when developing nations make bad policy decisions because of lack of data on causes of death.
Week 13:
Apr 17 The Model Nations: Switzerland, Taiwan, Singapore
Reading Assignment:
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Focus Question: What Can We Learn from the Model Nations?
Reading Assignment:
“Consumer-Driven Health Care: Lessons from Switzerland” Regina E. Herzlinger, DBA; Ramin ParsaParsi, MD, MPH. Downloaded from www.jama.com at on February 20, 2006.
The Singapore Model. http://www.american.com/archive/2008/may-june-magazine-contents/the-singaporemodel/article_print; Rowan Callick Tuesday, May 27, 2008.
Critical Thinking Discussion Questions:
1.
2.
3.
4.
What is consumer-driven health care?
How do the Swiss level the playing field with risk selection?
Why does the Democrat party hate Health Savings Accounts when they are so successful in
Singapore?
How does Singapore deal with those that cannot afford to contribute to their health savings
account?
QUIZ 5 20 QUESTIONS ON DEVELOPING WORLD
Week 14:
Apr 24 student presentations
Week 15:
May 1 student presentations
Video presentation, Harvard historian, Niall Ferguson
http://www.thedailybeast.com/newsweek/2011/10/23/yes-wall-street-helps-the-poor.html
Review for Final Exam.
Week 16
May 8 (Last Class) Final Examination
Information Resources
Selected Health Administration & Policy Journals:
American Journal of Managed Care
American Journal of Medical Quality
American Journal of Public Health
Business and Health
The Economist
Harvard Business Review
Cambridge Quarterly of Healthcare Ethics
Health Affairs
Health Care Financing Review
Health Policy
Health Services Research
Health Technology Trends
Inquiry
Journal of the American Medical Assn.
J of Health Services Research & Policy
Journal of Health, Politics, Policy and Law Medical Care
Medicine and Health
Milbank Memorial Fund Quarterly
New England Journal of Medicine
J of HC for the Poor & Underserved
Public Health Reports
Journal of Public Health Policy
Journal of Ambulatory Care Management Social Science and Medicine
Journal of Law, Medicine & Ethics
Medical Care Research and Review
Policy Studies Journal
Modern Healthcare2
Web sites:
Topic
2
Web Sites
Free student subscription available at: http://www.aupha.org/i4a/forms/form.cfm?id=51&pageid=3829&showTitle=1
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Topic
Health policy
Health policy (California)
Information resources
Health policy formation, agenda setting
Policy implementation & modification
Financing health services
Managed care, insurance & benefits
Ambulatory health services
Hospitals & health systems
Long Term Care; Politics of Aging &
Web Sites
Health Affairs http://www.healthaffairs.org/
Department of Health and Human Services: www.hhs.gov/
Healthcare.gov: www.healthcare.gov/index.html
Medicare: www.medicare.gov
Office of Consumer Information and Insurance Oversight:
www.hhs.gov/ociio/index.html
Kaiser Family Foundation: www.kff.org
Center for Health Improvement: www.healthpolicyguide.org
Academy for Health Services Research & Health Policy: www.academyhealth.org/
Health Hippo: hippo.findlaw.com/hippohome.html
Center for Global Development http://www.cgdev.org
Milbank Memorial Fund Quarterly http://www.milbank.org/quarterly.html
New England Journal of Medicine http://www.nejm.org/
Journal of Health Policy, Politics and Law http://jhppl.dukejournals.org/
The Economist http://www.economist.com/
Center for Budget and Policy Priorities http://www.cbpp.org/ (Liberal/left)
CATO Institute http://www.cato.org/ (Libertarian/right)
California HealthCare Foundation: www.chcf.org
Insure The Uninsured Project: www.itup.org
Health Access: health-access.org/
Public Policy Institute of CA: www.ppic.org
National Library of Medicine: www.nlm.nih.gov
Virtual reference style manuals: www.csulb.edu/library/eref/vref/style.html
APA electronic citations: www.apastyle.org/apa-style-help.aspx.
Robert Wood Johnson Foundation: www.rwjf.org
The Urban Institute: www.urban.org; Families USA: www.familiesusa.org
Center for Health Care Strategies: www.chcs.org
Center for Studying Health System Change: www.hschange.com
National Academy for State Health Policy: www.nashp.org
UCLA Center for Health Policy Research: www.healthpolicy.ucla.edu
California HealthCare Foundation: www.chcf.org
Kaiser Family Foundation: www.kff.org; Rand Corporation: www.rand.org
Mathematica Policy Research: www.mathematica-mpr.com/
The Commonwealth Fund: www.commonwealthfund.org/Health-Reform.aspx
Center for Medicare & Medicaid Services: www.cms.gov
Center on Budget & Policy Priorities: www.cbpp.org
Kaiser Family Foundation: www.kff.org
CA Legislative Analyst's Office: www.lao.ca.gov
Healthcare Financial Management Assn: www.hfma.org
Employee Benefits Research Institute: www.ebri.org
America’s Health Insurance Plans: www.ahip.org
CA Assn. Of Health Plans: www.calhealthplans.com
CA Dept. of Managed Health Care: www.dmhc.ca.gov
CA Office of the Patient Advocate: www.opa.ca.gov/index.aspx
National Governors Association: www.nga.org/
National Association of Insurance Commissioners: www.naic.org/
American Academy of Urgent Care Medicine: www.aaumc.com
National Association for Ambulatory Care: http://www.urgentcare.org/
Medical Group Management Association: www.mgma.com
American Hospital Assn.: www.aha.org
Blue Cross/Blue Shield Assn.: www.bluecares.com
Kaiser Permanente: www.kaiserpermanente.org/
American Association of Retired Persons: www.aarp.org
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Topic
Disability
Mental health
Pharmaceuticals
Public health
Health professionals
Quality of care
Ethical issues
Web Sites
Disability Rights Education & Defense Fund: www.dredf.org
National Institute of Mental Health: www.nimh.nih.gov
Bazelon Center for MH Law: www.bazelon.org
Medline Plus: www.nlm.nih.gov/medlineplus/mentalhealth.html
Pharmaceutical Research & Manufacturers of America: www.phrma.org
American Society of Health-System Pharmacists: www.ashp.org/
Centers for Disease Control & Prevention: www.cdc.gov
American Public Health Association: www.apha.org
Am. Medical Assn.: www.ama-assn.org; Am. Nurses Assn. www.ana.org
Am. Academy of Physician Assistants: www.aapa.org
Am. Pharmaceutical Assn.: www.pharmacist.com
Institute of Medicine: www.iom.edu
National Committee for Quality Assurance: www.ncqa.org
Joint Commission (accreditation): www.jointcommission.org
California Healthcare Foundation Quality Initiative: www.chcf.org
Alliance for Health Reform: www.allhealth.org
Hastings Center: www.thehastingscenter.org
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Bibliography
Bruce Fried and Laura Gaydos, World Health Systems: Challenges and Perspectives. Chicago: Health
Administration Press, 2002. (available from CSULB Bookstore and on reserve)
Graig, L. The Health of Nations (1999). Congressional Quarterly Press, Washington, DC., 3 nd ed.
M Merson, R Black, A Mills, International Public Health, Gaithersburg: Aspen Publishers, Inc. 2001.
D Crystal, The Cambridge Encyclopedia of Language. Cambridge: Cambridge University Press, 1997.
G. Anderson, P Hussey, Frogner, H. Waters, “Health Spending in the U.S. and the Rest of the
Industrialized World.” Health Affairs, July/August 2005/Volume 24, Number 4
P Colman, Corpses, Coffins, and Crypts. New York: Henry Holt and Co., 1997.
Global Report 05/06. Published by McGaw Hill, 2005.
Health Affairs Special Issue. “Global Challenges in Health.” May/June 2004.
J Hinnells, A New Handbook of Living Religions. London: Penguin, 1998.
D. Skal, Death Makes a Holiday: A Cultural History of Halloween. New York: Bloomsbury, 2002.
The Economist. Journal with typically one article per issue pertinent to global or international health.
M Toro-Morn and M. Alicea (Eds), Migration and Immigration: A Global View. Westport, CN:
Greenwood Press, 2004
T Tuleja, Curious Customs. New York: The Stonesong Press, Inc., 1987.
World Health Organization. World Health Reports. Annually 1995-2005. Geneva: WHO.
M Merson, R Black, A Mills, International Public Health, Gaithersburg: Aspen Publishers, Inc. 2001.
Health Affairs. May-June, 2002; May-June, 2003; May-June, 2004; May-June 2005; May-June 2006. This
edition is always devoted to international health or health care systems in a foreign nation.
The Reform of Health Care, Health Policy Studies No. 2, Paris: OECD 1992.
Goodman, Musgrave and Herrick. 2005. Lives at Risk: Single-Payer National Health Insurance Around the
World. New York: Rowman & Littlefield.
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STUDENT INFORMATION SHEET
Spring, 2012
(TURN IN TO INSTRUCTOR)
Name___________________________________________________________
Name you prefer to use____________________________________________
Address_________________________________________________________
________________________________________________________________
Phone(s):________________________________________________________
Best time/place to reach you:_______________________________________
Fax:_________________________________________________________
E-mail address:__________________________________________________
Please describe briefly:
a.
Your educational background and work experience:
b.
Future educational and career plans:
c.
Your reasons for taking this course, what you hope to learn from it:
d.
Other HCA classes you are taking or have completed:
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