Understanding ealth Insurance: Public/Private Options

Joan Bantz, MPA, RHU

LAB I, 3011            360-867-5095

e-mail: bantzj@evergreen.edu

NOTE:   This course is accepting graduate and undergraduate junior/senior levels to gain a balanced learning community.  Students seeking to enter the health field will mix with those already working in a variety of areas of health care.  Students already within a health care environment will be challenged to revisit old constructs with fresh insight.  Undergraduate enrollment is limited, so please sign up early.
 

Syllabus

Room:  Lab I, Room 1040        4 Credit Hours

Class Sessions: Wednesdays, 6pm to 10pm

Course Description:  This elective will prepare students to understand the current three tiered health care delivery and payment model: public, private, uninsured (and underinsured).  Particular emphasis will be given to service delivery, managed care, types of insuring options and state/federally funded options for coverage.

Students will examine current health care issues such as prevention, quality, access, aging of population,  innovations, genetics, alternative care, demographic trends and culture, bio-terrorism, public health services and lifestyle or health behaviors.  Payment mechanisms, regulations, laws, consumer rights, contracts, quality and other issues will be explored to better understand the inter-woven complexities of insurance.

In order to understand the current marketplace, insurance and future scenarios we will review how conflicting policy and regulations impact health care; e.g., the Clinton Administration nearly implement a national managed care plan in 1994 and then tried to regulate managed care out of existence in 1999. Policy has been focused on incremental reform or is a byproduct of unintended consequences.We will review attempted solutions to the health crisis, such as: vertical integrated systems as the wave of the future, disease management companies, hospital owned HMOs or a managed competition model of vertically integrating systems like Group Health to compete head to head for patients. Another wishful solution is for the consumer using the Internet, being "engaged" with their care working hand in hand to solve the health care crisis.  Even with all of these "solutions" health care premiums are rising 9 to 11 percent, more patients are concerned about quality of care, wanting "caring versus cure", the number of uninsured is increasing, Medicaid increases are breaking states budgets, etc.

We are in a place where we have run out of workable ideas and the times are ripe for trying ill-conceived solutions in desperation. Policies at the state and federal levels are hung up on provider fraud and abuse and managed care regulation, both but a patch on a "non-system" at best.  This lack of a coherent direction is further adding to provider losses and reluctance to serve Medicaid or Medicare enrollees. And as we look around things appear to be getting worse for consumers, providers, insurers and government. In an era of unprecedented technological medical solutions we still suffer from the same old problems of cost, quality, access and security of health benefits that we have concerned ourselves with for the past forty years.

Experts from the insurance industry, state and federal agencies, providers and others will help students explore this complex arrangement of employer, payer, regulator and consumers.

Text

 Weissert, Carol & William     Governing Health: The Politics of Health Policy
Paperback: Publisher: Johns Hopkins Univ Pr; ISBN: 0801852668; 1st edition
Reagan, Michael D.  The Accidental System: Health Care Policy in America
 Paperback: Publisher: Westview Press; ISBN: 0813399963; (October 1999)
Morrison, Ian      Health Care in the new Millennium: Vision, Values, and Leadership
 Paperback: Publisher: Jossey-Bass; ISBN: 0787962228; 1st edition (April 2002)
Institute for the Future,  Health and Health Care 2010: The Forecast, the Challenge, 2nd
    Edition
 Paperback: Publisher: Jossey-Bass; ISBN: 0787953482; (March 2000)

Several articles, case studies and on line resources will be used as well
 

NOTE: This is one of two newly delevoped POLICY CONCENTRATIONS offered under the revised MPA program at Evergreen.  There are three concentrations: Tribal Governance, Public and Non-Profit Administration and Policy/Health Policy.  This course can be taken as an elective as well as within the Policy concentration.  Please see the MPA homepage for more programatic information. MPA Homepage   Or I  would be happy to explore options with you, please contact me at bantzj@evergreen.edu.