These are links to summary outlines of frameworks, concepts,
perspectives and facts.
Outlines were presented and critiqued as part of the discussion on the
dates indicated and, usually, again on the following session.
Abbreviations: HPF: Health
Policy
Framework; GPF: General
Policy Frameworks Web: Links to key web sites; Glossary: Glossary
provided by AcademyHealth
Accountability: Exams may concern material covered in these notes
(except those noted as FYI) and in the links provided here
(except
the portions of the links under the heading For further information).
The exams will cover links on the HPF and GPF only when
the same links are made in the notes below.
| Date | Notes on Topics Covered | Illustrations |
| Jan 8 Mon |
a. Introduction to health policy b. Course outline |
a. Costs are lumpy; present insurance market poorly
structured;
state role b. Form study team (2 members) |
| Jan 10 Wed | a. Review of Books to be read b. Policy and Administration have multiple and conflicting purposes c. Amer. govt is concerned with who and how to balance these purposes d. Links are provided in these notes to materials to be studied for this course. Students are responsible for the material on the links, but not for the material on secondary links, that are FYI. |
b.Purpose of government (e.g. why do we have federalism and
why do we limit it): Liberty,
Equality, Welfare (Ylivasaker) Professional perspectives as conflicts and complements: Efficiency, Value, Solidarity, Assurance, & Action (Diesing) c. Levels of Government: 10th Federalist Paper. Separation of Powers: 51st Federalist Paper |
| Jan 12 Fri | a. Multiple goals b. Multiple forms of rationality c. Divisions of power d. Muddling through |
a. Liberty, equality, welfare b. Efficiency, value, solidarity, assurance, action c. Federalism; separation of powers d. Lindblom |
| Jan 17 Wed | a. Four divisions of power b. Access/Measures (a/m) |
a. Privacy concerns and
information technology b. Access to what care? |
| Jan 19 Fri | a. Quality/Measures
(q/m) |
a. Lalonde
categories, Accreditation standards, Socioeconomic status Practice patterns, patient safety |
| Jan 22 Mon | a. Syllabus update b. Cost/Measures (c/m) |
a. Slight changes in the
"Research Results" assignment b. Slower growth |
| Jan 24 Wed |
a. AHRQ
Research Activities, monthly reports b. Review of Rolfs' visit |
a. Policy oriented; only research supported by AHRQ b. Epidemiology; incidence; prevalence b. Medicare data--Bill Roper--Outcomes research b. Epidemiology as sleuthing |
| Jan 26 Fri | a. Cost/Measures (c/m) b. Insurance c. Political power changes |
a. hospital & physician costs;
projections; administration; per capita; long-term care
b. Necessary for "lumpiness" b. Works poorly because of lumpiness c. From physicians to insurers and pharma |
| Jan 29 Mon | a. Sources: "Research Activities" b. Insurance and insurance regulation c. Access/Issues (a/i) |
a. Pub
Med classes at Eccles b. Community rating; experience rating; ERISA c. Multiple tiers? |
| Jan 31 Wed | a. U.S. health spending compared with other post-industrial
nations b. Media reviews might consider changes in general conditions c. Access/Issues |
a. U.S. @ 16% of GDP: more than 50% higher
than most; twice G.B. U.S. @ $6k/person: more than twice others; three times G.B. b. General changes in regulatory purposes affect health policy c. Health care: a commodity? |
| Feb 2 Fri |
a. Cost/Issues
(c/i) b. Conciseness in communications |
a. Who will pay the price for the costs of health care? b. Seek few words and yet substance and specifics |
| Feb 5 Mon | a. Quality/Issues
(q/i) |
a. Quality increases costs. Can it save expenditures? IOM reports re adverse
events |
| Feb 7 Wed | a. Incentives: functional or disfunctional b. Budgeting |
a. P4P? (c/h)
Health insurance market? (a/h) b. Spending for drug testing |
| Feb 9 Fri | a. Multiple processes
(Jones) b. Budgeting: incrementalism c. Costs: market incentives? (c/h) d. Access: Relative values (a/h) |
a. Agenda setting: autism b. Complexity (muddling again) c. Asymmetric info.; tax preferences; tort law d. Equality v. market; multiple public purposes |
| Feb 12 Mon | a. Rhetoric for
Public Policy b. Present your research c. Quality: Habits (q/h) d. Midterm |
a. Respect, clarity, specifics b. Utah Health Services Research Conference, April 6 c. Individuals; providers d. A past exam |
| Feb 14 Wed | a. Multiple actors
(Gaus) and processes determine quality of care b. Ethics: changing and conflicting criteria |
a. Good quality: staff level? Poor quality: high level policies? Other way around, or both ways? b. Over time and among such criteria as autonomy and justice |
| Feb 16 Fri | |
|
| Feb 21 Wed |
MIDTERM REVIEW | |
| Feb 23 Fri | NO CLASS |
|
| Feb 26 Mon | MIDTERM EXAM |
|
| Feb 28 Wed | a. Designs: It does matter who pays for care.
The Insurance Mkt |
a. Market
incentives, competition for funds, etc (a/d). |
| Mar 2 Fri |
a. Readings for next Monday, March 5: (1) & (2) b. Relative Power, i.e. Influence |
a. Information technology b. Changes in relative power of AMA, Pharma, Insurers, etc. |
| Mar 5 Mon |
||
| Mar 7 Wed | a. Guest: Kim Wirthlin |
|
| Mar 19 Fri | ||
| Mar 12 Mon |
a. Access politics a/p b. Cost politics c/p c. Quality politics q/p |
a-c. Wilson's
typology More than money |
| Mar 14 Wed | a. political capacity as a scarce resource |
a. reform of health care |
| Mar 16 Fri | a. professional and program perspectives of
administrators will shape policy b. benefit-cost analysis: what to measure and other problems |
a. Air pollution control, highway and public
transportation, public or private insurance b. automobiles v. public transit; railways v. trucks |
| Mar 26 Mon | a. Health care studies: more than any individaul
can track b. Biomedical ethics, as in the "principleS" approach |
a. Respect for uncertainty, patient/practitioner
interaction, etc. b. Accountability to patient, or community? (Multiple values!) |
| Mar 28 Wed |
a. Medicare (Title
XVIII) b. Medicaid (Title XIX) c. FYI: Proposals d. Reform designs re cost c/d e. Reform designs re quality q/d |
a-b "Primers" by Kaiser Family Foundation c. The Commonwealth Fund d. Balance of public & private? e. Education: providers & patients |
| Mar 30 Fri | a. Economic analysis a/tq; q/tq b. Benefit/cost analysis c. Decision trees |
a. Screening for cancer? b. Value of life, of health? c. Costs of false positives |
| Apr 2 Mon | a. Expected value b. Benefit/cost analysis c. Expected value; risk aversion |
a-b. Comparisons of alternative public health
programs c. Insurance |
| Apr 4 Wed |
a. Influence: money or voters? b. Quality improvement c. Benefit/cost problems |
a. Lobbying and campaign expenditures b. Uncertainty of measures; certanty of room for improvement c. Use to sharpen judgement, not to replace it |
| Apr 6 Fri. | a. Financial analysis c/tq using financial statements b. beneift-cost & cost-effectiveness analysis c. "Garbage Can" -- chance & opportunity |
a. Is net worth real, or is infrastructure
neglected? b. Financial measures; utility (utils); relative costs of years of life saved; or of quality adjusted life years (QUALYs) c. Huntsman's million $s |
| Apr 9 Mon | a. Administrative tools a/ti b. Negotiating tools c/ti |
a. Range of
govt/private mix; Communication b. Building future relationships |
| Apr 11 Wed | a. Present interactions shape future
relationships b. Two way communication; two way change c. Changing habits |
a. Public education; negotiations; etc. b. Burns on leadership: transactional & transformational c. Difficult, but involve |
| 13 Fri | a. Quality: SES? Personal connections?
Facilities? Habits? b. Significance of culture |
a. Personal experiences: OB, appendix, voice,
cataracts, etc. b. Political cultures |
| Apr 16 Mon | a. Culture and environment or framing of
decision making b. Friday April 20 class c. Tort v. regulation |
a. Cuban Missile
Crisis b. important links c. Complications; Civil Action, Smoking & Politics |
| Apr 18 Wed |
a. Final exam: 5 of 6 questions | a. 2006 exam |
| Apr 20 Fri |
a. The Jones outline |
a. SB 132 |
| Apr 23 Mon |
a. Last links, not yet coverd in
class: Habits as tools re quality: (q/ti);
Conflicts within primary purposes as well as between them: Stone. |
a. Habits re either providers or
life style. Conflicts re whose liberty and for what acts. |
| Apr 25 Wed |
||
| May 1 Tue |
FINAL EXAM: 8-10 |