COMPARATIVE HEALTH CARE SYLLABUS
|Joan Bantz, Member of the Faculty|
|Dates: April 21, May 12, and June 2|
|Location: Sem II, D3107
|TIME: 9 am – 5 pm (plus moodle – distance learning)|
CRN: 30204 (Grad), 30205 (UG)
|Moodle site: http://www2.evergreen.edu/moodle/
format (Saturdays and online course) facilitates an analysis of major
health service delivery and administrative within a theoretical context
by looking at linkages and interconnections, the nature of health
system boundaries, external influences, and metacultural frames
exploration - to promote a broader understanding of how health
care systems operate in industrial countries, third world countries and
tribal programs in the United States.
This course focuses on reform efforts from an international perspective.
Internationnal health care policies have been informed by countries studying one another's efforts. In the US we tend to be ethnocentric in our views of health care organization and policy. A look abroad however, can provide insights about problems at home. For example, we are faced with many of the same aging of our population that Japan has already had to address, and we have then a model to review.
US Health Care, "Why the US Does not have a Universal System"
In order to more fully enable a comparative study this course first examines the historical development of the United States health care (non)system that continues to shape and limit policy options from consideration, and creates pressures that favor a continuing emphasis on technology and structural decentralization. Health and illness are familiar concepts to all of us, but we are used to thinking of them as biological phenomena. This course will develop a critical approach to health and illness by looking at them also as socio-cultural phenomena. Important differences rooted in culture, ethnicity, social, economic and political factors will be examined to encourage innovative "framing" of U.S. health public health policies. This course also examines important health risks and the political and organizational factors that distort the public’s understanding of these risks.
Teach to Learn Format
Each small team will be responsible for facilitating an understanding of a self-selected country, or tribal government and compare with the US system, in a “teach to learn” format.
Different countries have developed various approaches to their health care issues, from national health schemes to a greater reliance on the private sector to provide health care. The aim of this course is to analyze the advantages and disadvantages of these approaches without having preconceived ideas about what approach provides the best outcomes. Our study will not neglect the opportunity to learn from other countries, especially those middle and lower income countries implementing interesting and innovative reforms.
In spite of differences in the
organization and financing of their health care systems, most countries
share a number of common problems with the United States. First, is the
question of deciding - or not explicitly deciding - what proportion of
GNP should be devoted to health and welfare. Second, is the problem of
agreeing on appropriate criteria to allocate health and social service
expenditures. Third, is the problem of how to implement established policies: through
regulation, promotion of competition, budgeting, or reimbursement
incentives directed at health care providers. Underlying these are
important metacultural, political economy and globalism determinates.
II. Learning Objectives
By the end of the quarter students will have achieved these broad objectives:
- Appreciate historical factors and how they
have shaped the institutional arrangements of the current health care
- Ability to ground analysis of each country's
health care system within its broader political, cultural and social
- Understand what sets health care apart from ordinary goods and services traded in the free markets.
- Explored the principal factors that constitute and frame health care systems and how they are influenced by changes in the environment external to the health system.
- Become familiar with the principal organizations, institutions and services involved in the provision of health care in health systems throughout the world.
- Gained an awareness of the demographic
factors and how they shape the health care responses of the system in
addressing the needs and demands for health services from populations
according to age, race, gender and class as well as epidemiological data.
- Understand country-level debates on such issues as health care funding mechanisms; physician payments; hospital and technology use; privatization and decentralization of health services and rationing the reorganization of hospital and community services, evaluation of outcomes, the ethics of resource allocation, quality management, changes in hospital management and payment methods, marketing, and a greater emphasis on evidence-based medical practice.
- Understand the financial factors and how these have influenced the sources and types of funding for health services.
- Examined the human resource factors and their
influence on issues such as professionals and professionalism, power
and the characteristics of regulation and training in the health
workforce, and the issues of work definition and delineation.
- Explored the technological factors and how
these influence decisions about the type and nature of technology used
in the health services, issues about efficacy, evaluation of outcomes
and benefits, the development of new technology, the social impacts and
- Developed a critical approach to the way things work in the US health care system and thereby develop ideas on how things could be done better.
III. Course Texts (in
order of use in class)
Students are encouraged to read as many text as possible during the time before our first class
1. Payer, Lynn. Medicine and Culture:
Revised Edition (we will seminar on this text the first class)
· Publisher: Owl Books; Reprint edition (1996)
· ISBN-10: 0805048030
· ISBN-13: 978-0805048032
2. Bodenheimer, Thomas S., Kevin Grumbach.
Understanding Health Policy
· Publisher: McGraw-Hill Medical; 4th edition (2004)
· ISBN-10: 0071423117
· ISBN-13: 978-0071423113
3. Stevens, Rosemary A. (Editor), Charles E.
Rosenberg (Editor), Lawton R. Burns (Editor) History And Health
Policy in the United States: Putting the Past Back in (Critical
Issues in Health and Medicine)
· Publisher: Rutgers University Press (2006)
· ISBN-10: 0813538386
· ISBN-13: 978-0813538389
4. Law, Jacky. Big
Pharma: Exposing the Global Healthcare Agenda
· Publisher: Carroll & Graf (2006)
· ISBN-10: 0786717831
· ISBN-13: 978-0786717835
Meredith, Mary Anne Mercer and Oscar Gish (Editors). Sickness
and Wealth: The Corporate Assault on Global Health
· Publisher: South End Press (2004)
· ISBN-10: 0896087166
· ISBN-13: 9780896087163
IV. Expectations and Assignments
Expectations and Evaluations:
The program is designed as an active/experiential learning community. Much of our "making of meaning/knowledge" in this course will be woven from your past experiences, peer perspectives, our discursive process, the readings and peer's teach to learn integrative studies. Therefore, attendance and engagement are required. Credit for the program and a positive evaluation are contingent upon the following:
If something prevents you meeting these expectations, you must inform faculty immediately. Credit denial decisions are by faculty. Plagiarism (i.e., using other peoples’ work as your own), failing to complete one or more assignments, completing one or more assignments late (without having made arrangements before the due date), or multiple absences may constitute denial of total credit.
In turn, students can expect faculty to be prepared for classes and seminars, to be available for office hours as posted and for scheduled meetings outside of office hours, to respond to telephone or email messages in a timely manner, and to provide timely feedback on assignments.
All students will receive a written evaluation of their academic performance by faculty. Each student is expected to participate in the end of quarter evaluation conference with faculty. For the end of quarter conference, each student is expected to complete and bring to the conference a written self-evaluation – no conference will be conducted without the self-evaluation. Students are also expected to provide a written evaluation of faculty. These two evaluations are part of the requirements of the course, are central to the reflection process of your intellectual journey and must be completed to obtain full credit.
In furtherance of our learning community, we expect students and faculty to:
· Act in accordance with the Evergreen Contract and Student Conduct code.
· Promote a cooperative, supportive atmosphere within the community; give everyone an opportunity for self-reflection and expression.
· Use high standards in reading the text and preparing our papers, lectures, and comments in seminar.
· Handle all disputes in a spirit of goodwill.
Team Posting Timelines (one paper per team for each of the 5 postings):
All team papers will be posted on Moodle in the designated areas, under the due dates as attachments. These well-researched academic papers should provide a brief synthesis of your findings. The reference sections must be in APA format and are not counted as part of the 2-3-page requirement. This is an iterative paper and the final paper is the last part of the paper, not a rewritten one. However, it should contain at least one paragraph of your overall reflection upon your comparative effort. PEER RESPONSES ARE ENCOURAGED.
|TEAM PRESENTATIONS ON PART I AND II
|FINAL TEAM PRESENTATIONS ON PART III, IV and V (6/2)|