Department of Health Administration
HADM J711: HEALTH POLITICS
Course Syllabus, Fall, 1998
Department of Health Administration
HADM J711: HEALTH POLITICS
Course Syllabus, Fall, 1998
Time: Friday 8:00A.M. – 12:00, Saturday 1:00 – 5:00 P.M., Wednesday 5:30 – 8:00 P.M.
(104 HESC)
Instructor: Michael E. Samuels, Dr.P.H.
Office: 116 HESC
Office Hours: Tuesday & Wednesday - 1:00 - 2:00 PM
Telephone: 777-7417 E-mail: msamuels@sph.sc.edu
Course Content: The purpose of this course is to provide the
student of public health a clear understanding of health politics as a
key component of the environment in which the health care administrator
must function. In the historical, social, economic, and political context
that the U.S. health care system evolved are lessons and understandings
that are necessary for this generation of health administrators and health
policy makers to advance health for all. The course will provide an understanding
of the structure of the political process in the health policy making.
The political roles of the legislative, executive and judicial branches
of government in health policy will be examined, as well as political roles
that selected health professionals assume in the community. Major actors
in health care policy development are identified within the context of
the forces and institutions that they react to in shaping health care policy.
The course will provide practical mechanisms to intervene on behalf of
programs or institutions.
Course Objectives:
Upon successful completion of the course the student will:
(1) Understand the structure of the political process in the health policymaking process in the United States at the State and Federal level.
(2) Be familiar with the political roles of the legislative, executive and judicial branches of government relative to health policy.
(3) Be familiar with the political role that selected health professionals assume in the community.
(4) Be able to identify and classify the major and minor forces and institutions that shape health care policy.
(5) Understand the steps in the health policy process and how they as
administrators may intervene on behalf of their program or institution.
TEXTS:
U.S. Senate, How Our Laws Are Made, Document No 12, 102D Congress, First Session.
The Instructor will make the Senate Document available. There will also
be assigned journal articles. The assigned journal articles are available
at Universal Copies at 1120 College Street.
Course Conduct:
The course will be conducted as a seminar with lectures provided by
the instructor. Lectures and discussion will be based on the assigned readings.
When possible, guest participants from the Columbia health professional
community will be invited to provide personal insight into the topic under
discussion (e.g. – Randolph Lee III, President of the South Carolina
Health Association will discuss the politics of Long Term Care in South
Carolina). Student comprehension of the course material will be demonstrated
by student presentations that analyze assigned readings on a particular
health topic, a mid-term examination, and a major paper or annotated bibliography.
The mid-term examination will be in essay form (3-5 questions) covering
lectures and reading assignments. It will be handed out at the end of class
on October 28th and is to be turned in prior to class on November 11th.
The topic for the major paper or annotated bibliography should be approved
as early in the semester as possible. Although not required students may
submit an outline for critique and guidance. The major paper or annotated
bibliography is due on December 9th.
Course Requirements Include:
- Completing all reading assignments
- Class room participation including discussion leadership
- A mid-term examination (take home)
- Student presentation on assigned readings.
- A major research paper or annotated bibliography with a short summary.
There is no page requirement on the research paper or bibliography.
The emphasis will be on quality research of narrow scope drawing on large
numbers of source articles or in an extensive annotated bibliography.
GRADES will be computed as follows:
| Classroom participation and oral presentation | 30% |
| Mid-term examination | 30% |
| Paper or bibliography | 40% |
| 100% |
ASSIGNED READINGS:
CLASS 1 - THE PROCESS OF GOVERNMENT
September 2 (Swearingen Engineering Studio) (Introduction)
Class Objective: Student will understand the functioning of national government relative to health policy.
Assigned Readings:
Stevens, Rosemary, "Can the Government Govern? Lessons from the Formation of the Veterans Administration, Journal of Health, Politics, Policy and Law, Vol. 16, No. 2, Summer 1991, pp. 281-305.
Tierney, John T., "Organized Interests in Health Politics and Policy Making", Medical Care Review, 44:1 (Spring 1987), pp. 89-118.
Derrick, Frederick W., Scott, Charles E., "National Health Insurance:
Lessons from the United States experiment", Health Care Manage Rev,
1995, 20(3), 55-63.
CLASS 2 - THE PROCESS OF GOVERNMENT
September 11 (104 HESC)
Class Objective: Student will understand the functioning of national government relative to health policy.
Assigned Readings:
How Our Laws Are Made, pp. 1-50.
Peterson, Mark A., "Political Influence in the 1990s: From Iron Triangles to Policy Networks", Journal of Health, Politics, Policy and Law, Vol. 18, No. 2, Summer 1993, pp. 395-437
Rothman, David J., "A Century of Failure: Health Care Reform in America", Journal of Health, Politics, Policy and Law, Vol. 18, No. 2, Summer 1993, pp. 271-286.
Steinmo, Sven, Watts, Jon, "It's the Institutions, Stupid! Why Comprehensive
National Health Insurance Always Fails in America", Journal of Health,
Politics, Policy and Law, Vol. 20, No. 2, Summer 1995, pp. 329-372
CLASS 3 - AMERICAN VALUES
September 12 (104 HESC)
Class Objective: Student will understand the relationship of "American" values to health policy and politics.
Assigned Readings:
Draper, Elaine, "Genetic Secrets: Social Issues of Medical Screening in a Genetic Age", Hastings Center Report, Special Supplement, July-August, 1992, pp. 15-18.
Mechanic, David, Health & illness in technological societies", Hastings Center Studies, pp. 7-18.
Morone, James A., "Enemies of the People", Journal of Health, Politics, Policy and Law, Vol. 22, No. 4, August, 1997, pp. 992-1020.
Veatch, Robert M., "The medical model: its nature & problems, Hastings
Center Studies, pp. 60-76.
CLASS 4 - THE FEDERAL LEGISLATIVE BRANCH
October 2 (104 HESC)
Class Objective: Student will understand how the U.S. Congress functions in making national health policies.
Assigned Readings:
Hacker, Jacob S., Skocpol, Theda, "The New Politics in U.S. Health Policy", Journal of Health, Politics, Policy and Law, Vol. 22, No. 2, April, 1997, pp. 315-338.
Navarro, Vicente, "Why Congress Did Not Enact Health Care Reform", Journal
of Health, Politics, Policy and Law, Vol. 20, No. 2, Summer 1995, pp.
455-462.
CLASS 5 - HEALTH CARE INSTITUTIONS - HOSPITALS
October 3 (104 HESC)
Class Objective: Student will understand the role of hospitals in developing national health policy.
Assigned Readings:
Thorpe, Kenneth E., "The Health Care System in Transition: Care, Cost,
and Coverage", Journal of Health, Politics, Policy and Law, Vol.
22, No. 2, April, 1997, pp. 339-361.
CLASS 6 - THE FEDERAL EXECUTIVE BRANCH: INTERFACING POLITICIAN AND BUREAUCRAT
October 8 (Swearingen Engineering Studio)
Class Objective: Student will understand the role of the Executive Branch in making national health policies.
Assigned Readings:
Fox, Daniel, "Health Policy and the Politics of Research in the United States", Journal of Health, Politics, Policy and Law, Vol. 15, No. 3, Fall 1990, pp.- 481-499.
West, Darell M., Heith, Diane, Goodwin, Chris, "Harry and Louise Go to Washington: Political Advertising and Health Care Reform", Journal of Health, Politics, Policy and Law, Vol. 21, No. 1, Spring, 1996, pp. 35-68.
Waitzkin, Howard and Hubbell, F. Allen, "Truth's Search for Power in
Health Policy: Critical Applications to Community-Oriented Care and Small
Area Analysis", Medical Care Review, Vol. 49, No. 2, Summer, 1992,
pp. 161-189.
CLASS 7 - COMPARATIVE HEALTH CARE SYSTEMS
October 28 (Swearingen Engineering Studio) (Mid-Term Examination Passed Out)
Class Objective: Student will understand the relevance of studying comparative health care systems with the objective of improving the U.S. health care system.
Assigned Readings:
Jacobs, Alan, "Seeing Difference: Market Health Reform in Europe", Journal of Health, Politics, Policy and Law, Vol. 23, No. 1, February 1998, pp.1-33.
Katz, Steven J., Charles, Cathy, Lomas, Jonathan, Welch, H. Gilbert,
"Physician Relations in Canada: Shooting Inward as the Circle Closes",
Journal of Health, Politics, Policy and Law, Vol. 22, No. 6, December,
1997, pp.1413-1431.
CLASS 8 - LOBBYING
November 4 (Swearingen Engineering Studio)
Class Objective: Student will understand the techniques of lobbying
Assigned Readings:
Kronebusch, Karl, "Medicaid and the Politics of Groups: Recipients, Providers, and Policy Making", Journal of Health, Politics, Policy and Law, Vol. 22, No. 3, June, 1997, pp. 839-878.
Podhorzer, Michael, "Unhealthy Money: Health Reform and the 1994 Elections",
International Journal of Health Services, Volume 25, Number 3, pp.
393-401, 1995.
CLASS 9- STATE AND LOCAL GOVERNMENT
November 11 (Swearingen Engineering Studio)
Class Objective: Student will understand the role of state and local government in health policy and politics.
Assigned Readings:
Paul-Shaheen, Pamela A., "The States and Health Care Reform: The Road
Traveled and Lessons Learned from Seven That Took the Lead", Journal
of Health, Politics, Policy and Law, Vol. 23, No. 2, August, 1998,
pp. 319-361.
CLASS 10 - THE POLITICS OF THE BUDGETARY PROCESS
November 13 (104 HESC) (Mid-Term Examination Due)
Class Objective: Student will understand Student will understand the national and state budgetary process.
Assigned Readings:
Anton, Thomas J., "New Federalism and Intergovernmental Fiscal Relationships", Journal of Health, Politics, Policy and Law, Vol. 22, No. 3, June, 1997, pp. 691-720.
Sparer, Michael S. "Laboratories and Health Care Marketplace: The Limits
of State Workforce Policy", Journal of Health, Politics, Policy and
Law, Vol. 22, No. 3, June, 1997, pp. 789-838.
CLASS 11 - HEALTH CARE INSTITUTIONS - INSURANCE, PROFESSIONAL ORGANIZATIONS
November 14 (104 HESC)
Class Objective: Student will understand the relationship of
the health insurance and health
professions organizations in influencing national health policies.
Assigned Readings:
Evens, Robert G., "Going for the Gold: The Redistributive Agenda behind Market-based Health Care Reform", Journal of Health, Politics, Policy and Law, Vol. 22, No. 2, April, 1997, pp. 427-465.
Ginsberg, Paul B., "The Dynamics of Market-Level Change", Journal of Health, Politics, Policy and Law, Vol. 22, No. 2, April, 1997, pp. 363-382.
Rice, Thomas , "Can Markets Give Us the Health System We Want ?", Journal
of Health, Politics, Policy and Law, Vol. 22, No. 2, April, 1997, pp.
383-426.
CLASS 12 MENTAL HEALTH and CARING FOR THE UNINSURED AND UNDERINSURED
December 4 (104 HESC)
Class Objectives: Student will understand the major substance abuse issues. Student will understand the issues surrounding health services for the poor and working poor.
Assigned Readings:
Jacobsen, Karen, McGuire, Thomas G., "Federal Block Grants and State Spending: The Alcohol, Drug Abuse, and Mental Health Block Grant and State Agency Behavior", Journal of Health, Politics, Policy and Law, Vol. 21, No. 4, Winter, 1996, pp. 753-770.
Bachman, Sara S. "Why Do States Privatize Mental Health Services ? Six State Experiences", Journal of Health, Politics, Policy and Law, Vol. 21, No. 4, Winter, 1996, pp. 807-824.
Long, Stephen H., Marquis, M. Suzan, "Federalism and Health System Reform:
Prospects for State Action", JAMA, August 13, 1997 -Vol 278, No.6,
pp. 514-517.
December 9 - Major research paper or annotated bibliography due.
University of South Carolina
School of Public Health
Department of Health Administration
HADM 711: HEALTH POLITICS
Fall, 1998
Michael E. Samuels, Dr.P.H.
Office: 116 HESC Telephone: 777-7417
Outside Readings