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Abstract/Syllabus:
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Sapolsky, Harvey, 17.315 Comparative Health Policy, Fall 2004. (Massachusetts Institute of Technology: MIT OpenCourseWare), http://ocw.mit.edu (Accessed 09 Jul, 2010). License: Creative Commons BY-NC-SA
Comparative Health Policy
Fall 2004
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Course Highlights
This course features lecture outlines and exam questions.
Course Description
This course examines in comparative prospective the health care policy problems facing the United States including providing adequate access to medical services for all, the control of rising health care costs, and the assurance that the quality of health care services is high and improving. It explores the market and regulatory policy options being debated politically in the United States to solve these problems and compares possible foreign models for reform including those offered by the Canadian, British, Japanese, and German systems. The course shows how the historical development of the American health care system limits greatly policy options that can be considered and creates pressures that favor a continuing emphasis on technology and structural decentralization. The course also examines important health risks and the political and organizational factors that distort the public's understanding of these risks.
*Some translations represent previous versions of courses.
Syllabus
Course Description
This course examines in comparative prospective the health care policy problems facing the United States including providing adequate access to medical services for all, the control of rising health care costs, and the assurance that the quality of health care services is high and improving. It explores the market and regulatory policy options being debated politically in the United States to solve these problems and compares possible foreign models for reform including those offered by the Canadian, British, Japanese, and German systems. The course shows how the historical development of the American health care system limits greatly policy options that can be considered and creates pressures that favor a continuing emphasis on technology and structural decentralization. The course also examines important health risks and the political and organizational factors that distort the public's understanding of these risks.
Course Requirements
Midterm and final examinations: The midterm examination tests for background information on the U.S. system. The final examination tests the ability to draw policy lessons from comparative sections and integration of all course material. Students' participation in class is important. Students are also required to attend a weekly discussion section lead by the teaching assistants and scheduled at off class hours.
Grading
Grades in 17.315 are based on midterm examination (30%), class participation (20%), and final examination (50%).
Calendar
LEC # |
TOPICS |
1 |
Health Status, Expenditures and Resources |
2-3 |
Paying for Health Care: History and Methods |
4 |
The Quest for National Health Insurance: Clinton Health Care Plan |
5 |
States as an Alternative |
6 |
Markets as an Alternative |
7 |
Comparative Systems: UK |
8 |
Comparative Systems: Germany and Japan |
9 |
Comparative Systems: Canada |
10 |
Comparative Assessment |
11 |
Medical Research |
12 |
Politics of Health Risks I |
13 |
Politics of Health Risks II |
14 |
Can There be Reform? |
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Further Reading:
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Readings
LEC # |
TOPICS |
READINGS |
1 |
Health Status, Expenditures and Resources |
McGinnis, J. Michael, and William H. Foege. "Actual Causes of Death in the United States." Journal of the American Medical Association 270, no. 18 (November 10,1993): 2207-12.
Manning, Willard G., et al. The Costs of Poor Health Habits. Cambridge, MA: Harvard University Press, 1991, pp. 1-25. ISBN: 9780674174856. |
2-3 |
Paying for Health Care: History and Methods |
Reinhardt, Uwe E. "The United States: Breakthroughs and Waste." Journal of Health Politics, Policy and Law (Winter 1992): 637-66.
Stone, Deborah A. "The Struggle for the Soul of Health Insurance." Journal of Health Politics, Policy and Law (Summer 1993): 286-317.
Sapolsky, Harvey M. "Empire and the Business of Health Insurance." Journal of Health Politics, Policy and Law 16, no. 4 (Winter 1991): 747-60.
Bergman, Abraham B., et al. "A Political History of the Indian Health Service." The Milbank Quarterly 77, no. 4 (1999): 571-604. |
4 |
The Quest for National Health Insurance: Clinton Health Care Plan |
Enthoven, Alain. "Managed Competition: An Agenda for Action." Health Affairs 7, no. 3 (Summer 1988): 25-47.
Eckholm, Erik. "Introduction." In The President's Health Security Plan. New York, NY: Three Rivers Press, 1993, vii-xvi. ISBN: 9780812923865.
Skocpol, Theda. "The Rise and Demise of the Clinton Health Plan." Health Affairs 14, no. 1 (Spring 1995): 66-85.
Heclo, Hugh. "The Clinton Health Plan: Historical Perspective." Health Affairs 14, no. 1 (Spring 1995): 86-98.
Peterson, Mark A. "The Politics of Health Care Policy: Overreaching in an Age of Polarization." In The Social Divide. Edited by Margaret Weir. Washington, DC: The Brookings Institution Press, 1998, pp. 181-229. |
5 |
States as an Alternative |
Leichter, Howard M. "Oregon's Bold Experiment: Whatever Happened to Rationing." Journal of Health Politics, Policy and Law 24, no. 1, (February 1999): 147-159.
Jacobs, Lawrence, Theodore Marmor and Jonathan Oberlander. "The Oregon Plan and the Political Paradox of Rationing." Journal of Health Politics, Policy and Law 24, no. 1 (February 1999): 161-180.
Swartz, Katherine and Deborah Garnick. "Lessons from New Jersey." Journal of Health Politics, Policy and Law 25, no. 1 (February, 2000): 44-70.
Brown, Lawrence D., and Michael Spencer. "Window Shopping: State Health Reform Politics in the 1990s." Health Affairs 20, no. 1 (January/February 2001): 50-67.
Grob, Gerald N. "Deinstutionalization: The Illusion of Policy." Journal of Policy History 9, no. 1 (1997): 48-73. |
6 |
Markets as an Alternative |
Wilkerson, John D. Chapter 1 in Competitive Managed Care. Edited by Kelly Devers and Ruth Given. San Francisco: Jossey-Bass, 1997, pp 1-29. ISBN: 9780787903091.
Gold, Marsha. "The Changing US Health Care System: Challenges for Responsible Public Policy." The Milbank Quarterly 77, no. 1 (1999): 3-37.
Robinson, James C. "Theory and Practice in the Design of Physician Payment Incentives." The Milbank Quarterly 79, no. 2 (2001): 149-78.
Mechanic, David. "The Managed Care Backlash.'' The Milbank Quarterly 79, no. 1 (2001): 35-54. |
7 |
Comparative Systems: UK |
Morone, James A., and Janice M. Goggin. "Health Policies in Europe: Welfare States in a Market Era." Journal of Health Politics, Policy and Law 20, no. 3 (Fall 1995): 557-69.
Klein, Rudolf. "Learning from Others: Shall the Fast be First." Journal of Health Politics, Policy and Law 22, no. 5 (October 1997): 1267-78.
Giaimo, Susan, and Philip Manow. "Adapting the Welfare State - The Case of Health Care Reform in Britain, Germany and the United States." Comparative Political Studies 32, no. 8 (December 1999). Read the British Case and Conclusion (From Reading Packet A).
Klein, Rudolf. "Why Britain Is Reorganizing Its National Health Service -- Yet Again." Health Affairs 17, no. 4 (July/August 1998): 111-25.
Enthoven, Alain C. "In Pursuit of an Improving National Health Care Service." Health Affairs 19, no. 3 (May/June 2000): 102-19.
Prottas, Jeffrey. "Rationing Human Organs for Transplant." In Transparency in Public Policy. Edited by Neal D. Finkelstein. NY: St.Martin's Press, 2000, pp. 71-92. |
8 |
Comparative Systems: Germany and Japan |
Ikegami, Naoki, and Yoshinori Hiroi. "Factors in Health Care Spending: An Eight-Nation Comparison with OECD Data." In Containing Health Care Costs in Japan. Edited by Naoki Ikegami and John Creighton Campbell. Ann Arbor: Michigan University Press, 1996, pp 33-44.
Campbell, John Creighton, and Naoki Ikegami. "Long-term Care Insurance comes to Japan." Health Affairs 19, no. 3 (May/June 2000): 26-39.
Hiroi, Yoshinori, and Taichi Ono. Building a Model for International Cooperation in the Area of Social Security: the Global Aging Trend and Japan's Experience. Tokyo: Institute for Health Economics and Policy, 1997, Part 2, Evaluation of the Experiences in Japan, 65-102. |
9 |
Comparative Systems: Canada |
Evans, Robert G. "Canada: The Real Issues." Journal of Health Politics, Policy and Law, Winter 1992, 739-62.
Charles, Cathy, Johathan Lomas, Mita Giacomini, et.al. "Medical Necessity in Canadian Health Policy: Four Meanings and . . . A Funeral?" The Milbank Quarterly 75, no. 3 (1997): 365-94. |
10 |
Comparative Assessment |
Stone, Deborah A. The Limits of Professional Power. Chicago: The University of Chicago Press 1980, chapters 1, 2, 6 and 7.
Henke, Klaus-Kirk, et.al. "The German Health Care System: Structure and Changes." Journal of Clinical Anesthesiology, May/June 1994, 252-62.
Jost, Timothy. "German Health Care Reform: The Next Steps." Journal of Health Politics, Policy and Law 23, no. 4 (August 1998): 697-712.
Giaimo, Susan, and Philip Manow. "Adapting the Welfare State - The Case of Health Care Reform in Britain, Germany and the United States." Comparative Political Studies 32, no. 8 (December 1999). Read the German case. |
11 |
Medical Research |
Blumenthal, David, and Nigel Edwards. "A Tale of Two Systems: The Changing Academic Health Center." Health Affairs 19, no. 3 (May/June 2000): 86-101.
Fein, Rashi. "The Academic Health Center: Some Policy Reflections." JAMA 283, no. 18 (May 10, 2000): 2436-37.
Dresser, Rebecca. "Public Advocacy and Allocation of Federal Funds for Biomedical Research." The Milbank Quarterly 77, no.2 (1999): 257-74.
Groopman, Jerome. "The Thirty Years' War: Have we been fighting Cancer the wrong way?" The New Yorker, June 4, 2001, 52-63.
Harvey, Sapolsky. "The Truly Endless Frontier." Technology Review, November/December 1995. |
12 |
Politics of Health Risks I |
Marks, Harry M. The Progress of Experiment: Science and Therapeudic Reform in the United States, 1900-1990. NY: Cambridge University Press, 1997, pp 229-52.
Marcia, Angell. Science on Trial: the Clash of Medical Evidence and the Law in the Breast Implant Case. NY: W.W. Norton Co., 1996.
Satel, Sally L. "There is no women's health crisis." The Public Interest, no. 130 (Winter 1998): 21-33.
Bix, Amy Sue. "Diseases Chasing Money and Power: Breast Cancer and Aids Activism Challenging Authority." Journal of Policy History 9, no. 1 (1997): 33-47. |
13 |
Politics of Health Risks II |
Sapolsky, Harvey M. "The Politics of Risk." Daedalus (Fall 1990): 83-96.
Marcus, Alan I. "Sweets for the Sweet: Saccharin, Knowledge, and the Contemporary Regulatory Nexus." Journal of Policy History 9, no. 1 (1997): 5-32.
Jacobson, Peter D., and Kenneth E. Warner. "Litigation and Public Health Policy Making: The Case of Tobacco Control." Journal of Health Politics, Policy and Law 24, no. 4 (August 1999): 769-804.
Melnick, R. Shep. "Tobacco Litigation: Good for the Body but Not the Body Politic." Journal of Health Politics, Policy and Law 24, no. 4 (August 1999): 806-814.
Taubes, Gary. "The (Political) Science of Salt." Science 281, August 14, 1998, 898-907. |
14 |
Can There be Reform? |
Wildavsky, Aaron. "Doing Better and Feeling Worse: The Political Pathology of Health Policy." Daedalus 96 (1967): 105-23.
Wyke, Alexandra. "The Year 2050." Chapter 10 in 21st Century Miracle Medicine. New York, NY: Plenum Trade, 1997, pp. 211-238. ISBN: 9780306455650. |
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