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 |
Introduction to health policy Course outline |
Costs are lumpy; present insurance market poorly structured;
state role 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. e. CHANGE IN CLASS ROOM JUST THIS FRIDAY f. CHANGE IN SCHEDULE |
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 e. OSH 214 f. choice of data page postponed from 1/12 to 1/17 |
| Jan 12 Fri | a. Multiple goals b. Multiple forms of rationality c. Divisions of power d. "Muddling Through" e. Special note: Inform Huefner if you have a serious problem with shifting class to M,W (no F) beginning at 7:00 (not 7:30) |
a. Liberty, equality, welfare b. Efficiency, value, solidarity, assurance, action c. Federalism; separation of powers d. Lindblom e. If this change is adopted, we will begin Mon., Jan 22 |
| Jan 17 Wed | a. Four divisions of power b. Access/Measures (a/m) |
a. Privacy concerns and
information technology b. Language barriers |
| Jan 19 Fri | a. Quality/Measures
(q/m) b. Course schedule changes (details by email) |
a. Lalonde
categories, Accreditation standards, Socioeconomic status Practice patterns, patient safety b. Meet M & W 7:00-8:20 Data page draft postponed |
| Jan 22 Mon | a. Course Schedule changes b. Cost/Measures (c/m) |
a. Fridays omitted; Adjustments for Data Page and Research
Results b. Slower growth |
| Jan 24 Wed |
a. AHRQ
Research Activities, monthly reports b. Cost/Measures (c/m) c. Review of Rolfs' visit d. Regulation: Power & Politics |
a. Policy oriented; only research supported by AHRQ b. hospital & physician costs; projections; administration; per capita; long-term care c. Epidemiology; incidence; prevalence c. Medicare data--Bill Roper--Outcomes research c. Epidemiology as sleuthing d. NYTimes: tobacco regulation |
| Jan 29 Mon | a. Sources: "Research Activities" b. Regulation: adjudication; rule making c. Cost/Issues (c/i) Who will pay the price of change? d. Insurance and insurance regulation e. Access/Issues (a/i) f. disease prevention and health promotion |
a. Pub
Med classes at Eccles b. Cigarettes; air quality; control of infectious disease, etc. c. Providers, government, patients, insurers? d. Community rating; experience rating; ERISA e. Multiple tiers? f. How much regulation? Creating moral burdens? |
| Jan 31 Wed | a. U.S. health spending compared with other post-industrial
nations b. Conciseness is a primary concern of media assignments c. Quality/Issues (q/i) |
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. e.g. Eat food, not too much, mostly from plants (NYTimes) c. Quality: drives costs? or savings? e.g. genetic screening |
| Feb 5 Mon | a. Quality increases costs b. Quality saves expenditures c.Conciseness in communications |
a. Technology, as in drugs, scanners, & procedures b. Reduction of "adverse events"; IOM reports c. Seek few words and yet substance and specifics |
| Feb 7 Wed | a. Multiple actors (Gaus) b. Multiple processes (Jones) c. Ethics: responsibility; honesty |
a. Adminstrators: DofVet.Affrs.; Surgeon General b. Budgeting c. Life style (blame?); placebo |
| Feb 12 Mon | a. Present your research b. Midterm c. Hypotheses |
a. Utah
Health Services Research Conference, April 6 b. A past exam c. (h/a) equality, or market? (h/c) incentivies: right or wrong? (h/q) habits: individual, provider |
| Feb 14 Wed | a. Multiple processes and actors determine quality of care b. Insurance plans shaped by market structure to avoid costs c. Expenditures depend upon market structure: bargaining power |
a. Good quality: staff level? Poor quality: high level policies? Other way around, or both ways? b. Eligibility, terms, & rates can avoid expensive care c. Discounted payments for proceedures and drugs |
| Feb 21 Wed |
MIDTERM REVIEW |
|
| Feb 26 Mon | MIDTERM EXAM |
|
| Feb 28 Wed | a. More on the
Jones
Outline |
|
| Mar 5 Mon |
a. Getting problems to govt./Jones b. Access: who pays? a/d c. Relative power; influence |
a. Walter Reed; election campaigns b. 3rd party; state v. federal; etc. c. Agenda setting (again) |
| Mar 7 Wed | a. Guest: Kim Wirthlin | |
| Mar 12 Mon |
a. Access politics a/p b. Cost politics c/p c. Quality politics q/p |
a-c. Wilson's
typology |
| Mar 14 Wed | a. Allocation of scarce resources |
a. More than money |
| Mar 26 Mon | a. Measuring access b. Health care studies: more than any individaul can track c. Biomedical ethics, as in the "principleS" approach |
a. More than the # of uninsured b. Respect for uncertainty, patient/practitioner interaction, etc. c. 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 |
| Apr 2 Mon | a. Influencing policy b. Economic analysis a/tq c. Statistics and epidemiology q/tq |
a. Garbage
Can; Confidence
(i.e. trust) b. Benefit/Cost analysis c. Expected value; decision trees |
| Apr 4 Wed |
a. Financial analysis c/tq b. Influence: money or voters? c. Quality improvement d. Public policy development often begins outside of government, for ratification and implementation by government |
a. Financial statements b. Lobbying and campaign expenditures c. Uncertainty of measures; certanty of room for improvement d. Utah Health Data agency |
| Apr 9 Mon | a. FYI "Yield
Curve" b. Administrative tools a/ti |
a. FYI: interest rates, risks, supply of
capital, deficits, etc. b. Range of govt/private mix; Communication |
| Apr 11 Wed | a. Negotiation c/ti b. Dr. Sundwall: purposes and challenges of public health FYI: Utah Dept. of Health |
a. Getting to Yes; e.g. BATNA can improve
balance in negotiations b. Are liberal Democrats essential? Join Public Health with Medicaid? Education: how expensive? q/ti |
| Apr 16 Mon | a. Habits: challenges to change b. Politics, Processes, and Skills |
a. Practitioners (IOM); life style b. Compare Smoking & Politics to Civil Action, Great Influenza, Complications, and Medicine and Culture |
| Apr 18 Wed |
a. Final exam: 5 of 6 questions |
a. 2006 exam |
| Apr 23 Mon |
a. Last link, not yet covered in
class: Burns re leadership,
in which he finds that leaders change, as well as those led. |
a. E.g. contrast Wilson re
League of Nations and FDR re the Depression How will health care reform evolve? |
| Apr 25 Wed |
||
| Apr 27 Fri |
FINAL EXAM: 8-10 |