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PHW200E, Summer 2017 Course Syllabus Robin Flagg, Ph.D.
Paper ................................................................................................................................................... 11
Course mail ......................................................................................................................................... 11
Due Dates ............................................................................................................................................ 12
Late Assignments ................................................................................................................................ 12
Disability Support Services .................................................................................................................. 12
Accommodation of Religious Creed .................................................................................................... 12
PHW200E, Summer 2017 Course Syllabus Robin Flagg, Ph.D.
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Course Description
Welcome to the Health Policy and Management course! We are excited to be teaching this course at
such an interesting moment in history: The Affordable Care Act (ACA) passed in 2010, the U.S. Supreme
Court upheld the key tenets of the ACA in 2012 and 2015, and the federal and state health insurance
marketplaces (exchanges) are operating. However, concerns persist on whether the United States will
be able to afford its healthcare in the future given its historical spending increases and forecasted
pharmaceutical spending. Add to that the uncertainty of the Trump Administration’s policy preferences
and the future of our healthcare system remains unclear. In addition, given that health outcomes in the
United States rank poorly in comparison to most all economically developed countries despite how
much the country spends, there must be a greater focus on improving health by addressing the social
determinants of health. This 6-week course is an introduction to key topics in health policy and
management. Each week will focus on a different aspect of the field incorporating economics,
organizational behavior, political science, and policymaking perspectives.
Week 1: Intro to U.S. Healthcare + Private Insurance Week 2: Public Insurance Programs + The Uninsured Week 3: Quality of Care + Stakeholders Week 4: Health Care Reform Policy + Politics Week 5: Current Topics in Health Care Delivery Week 6 (On-Campus): Current Topics in Health Care Delivery (cont.) and an Introduction to the
School of Public Health
Course Goals
This breadth course is designed to provide MPH students a basic set of competencies in the domains
central to the field. At the end of this course, students will be able to demonstrate the following core
competencies in health policy and management:
Analyze the policymaking process and the respective roles of federal and state government, markets, and stakeholders
Explain the principle functions of health insurance, the structure of public and private health insurance plans, and trends in enrollment and expenditures
Identify and discuss the main components and issues in the organization and payment methods for health care and public health services delivery
Analyze institutional, cultural, economic, and political foundations of the health of populations and communities
Discuss disparities in access to health insurance and health care and the impact of various efforts to reform U.S. healthcare including the Affordable Care Act
Identify the drivers and consequences of innovation in biomedical, pharmaceutical, and health information technologies
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The learning objectives and competencies will be addressed in multiple lectures as indicated in the
matrix below.
Matrix of Competencies
Lecture Policy Process
Insurance Financing
Organization of Care and
Payment Methods
Population Health
Performance Measurement
and Quality Improvement
Disparities in Access
Technology Innovation
1.1 Healthcare in the US
X X X X X X X
1.2 Private Insurance
X X X X
1.3 Econ of Insurance
X X
2.1 Medicare X X X X X 2.2 Medicaid X X X X X 2.3 Uninsured X X X 3.1 Quality X X 3.2 Stakeholders X X X X 4.1 “P” in HPM X 4.2 Healthcare Reform Options
X X X X X X X
4.3 ACA Politics and Policy
X X X X X X
4.4 ACA Passage to Trump
X X X X X X
5.1 Mental Health
X X X
5.2 Hospitals X X X X X X 5.3 Clinics X X X X X 5.4 Healthcare Workforce
X
6.1 Reform Today
X X X X
6.2 Advocacy X X X 6.3 “M” in HPM X X X 6.4 ACOs X X X X X 6.5 PhRMA and Tech
X X X
6.6 21st Century Primary Care
X X X X X X
6.7 “H” in HPM: Health Disparities and Social Determinants of Health
X X X
PHW200E, Summer 2017 Course Syllabus Robin Flagg, Ph.D.
Introduction: Dr. Robin Flagg has over 25 years of experience in health policy development and advocacy. She has worked with numerous organizations including the California Association of Public Hospitals, the Centers for Medicare and Medicaid Services (CMS) in the US Department of Health and Human Services, and Kaiser Permanente. Additionally Dr. Flagg was the Director of Health Policy at the California Medical Association. Dr. Flagg’s research interests include state policymaking, health care politics, and senior health care services. Dr. Flagg serves on the Board of On Lok, Inc (a PACE plan) and as the Chair of the Advisory Board for Piedmont Gardens, a Continuous Care residential community. She received both her PhD in Health Services and Policy Analysis and her MPH in Health Policy and Administration from UC Berkeley. Her BA was in Art History from Williams College. Following her BA, she worked for 3 years with US Peace Corps in Nepal.
Introduction: Erika Brown is an epidemiology doctoral student at the School of Public Health. She completed her MPH in epidemiology/biostatistics with a certificate in Public Health Nutrition at UC Berkeley in 2016 and her BA in Community Health and American Studies at Tufts University in 2012. While volunteering as a social service advocate throughout college, she grew interested in improving the accessibility and efficacy of health-oriented policies and programs. After graduating, Erika spent two years working as a research associate and patient navigator at Brigham and Women’s Hospital. She decided to pursue an MPH, and subsequently, a PhD, with the goal of understanding how to quantify the impact of social safety net program use on immediate and long-term health outcomes. Since arriving in the Bay Area, she has partnered with various researchers at local NGOs, SFDPH, UC Berkeley, UCSF, and the Nutritional Policy Institute to optimize hunger safety net programming among Single Room Occupancy residents living in San Francisco and University of California students, respectively. She looks forward to taking a broader approach to health policy and management this summer as a GSI for the OOMPH program. When she’s not attached to her laptop, Erika enjoys running, painting, and being outdoors.
Introduction: Keerti just graduated from the MPH in Health Policy and Management program at UC Berkeley this May (woo!). She also holds a BA in Psychology from the University of Chicago. Prior to graduate school Keerti was a Policy Analyst at the National Academy for State Health Policy (NASHP) in Washington DC, where she worked on projects related to health care reform implementation, children’s coverage in CHIP and Medicaid, behavioral health, and oral health. Prior to NASHP, she worked at the Teen Screen National Center for Mental Health Checkups at Columbia University helping to implement recommendations and guidelines that support access to mental health screening and follow-up services for teens. Keerti’s work focuses on strategies to reduce health disparities by better address social determinants of health such as housing, employment, and access to care. She is passionate about mental health and addressing structural barriers to health. Keerti has GSI-ed for Dr. Flagg’s undergraduate course for five semesters and helped develop the content for this online course. She is looking forward to getting to know you and hearing your feedback on the course.
Introduction: Welcome 200E students! As an OOMPH graduate, Jung looks forward to GSI’ing his third OOMPH course and sharing his perspectives as both an OOMPH student of the past and working student. Jung is currently a PhD student at UC Berkeley’s Health Policy program and Center for Healthcare Organizational Innovation Research (CHOIR), with a concentration in Organizations and Management. He is a passionate supporter of public health and hold a Masters in Public Health from the OOMPH program, a Bachelor of Science in Public Health and Korean Studies from the University of Washington, and is board-certified in Public Health (CPH). He also works as an Executive Curriculum lead for the Kaiser Permanente School of Medicine and a Clinical Teaching Associate at the University of Washington School of Medicine. Jung’s professional interests in public health are to link primary care medical education outcomes research to health services and design health systems-based curriculum across the medical education continuum. He is excited to get to you know you all!
Introduction: Jessica Watterson is in her second year of the Health Policy PhD program at UC Berkeley. She also has an undergraduate degree in Biochemistry from New York University and her MPH in Health Policy and Management from UC Berkeley. Jessica was first introduced to health policy as a pre-med undergraduate student and immediately was drawn to the field by the emphasis on prevention and population health over treating individuals. She has put her passion for health policy to use while working at the San Francisco Department of Public Health on children’s oral health, while working to build the health workforce with the World Health Organization in Samoa, and as a Fulbright-Clinton Public Policy Fellow, strengthening Samoa’s health policies and legislation for compliance with international conventions. More recently, her research has focused on evaluating innovations in health care delivery, both domestically and abroad, to generate evidence for better policy-making. She is really looking forward to working with you all throughout the course, and to learning from your ideas and experiences!
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Course Format
Students will watch up to 4 hours of lecture and complete 1-2 assignments per week. The course incorporates a mix of group assignments and individual work. We encourage students to tie in current events and lessons from their own ongoing work at all stages. Student competencies will be assessed through weekly assignments and activities, a midterm, one 5-page paper, a group debate, and a group final project.
Course Schedule
Week 1: US Healthcare and Private Insurance
Topic Activities Assignment
Introduction
Introduction to Article
Introduction video Assignment 1: Key concepts chart (group) Assignment 2: Case study (individual)
HealthCare in the US
Private Access to Health Care/Insurance Coverage
The Economics of Insurance
Week 2: Public Insurance and the Uninsured
Topic Activities Assignment
Public Programs: Medicare
Article Presentations
Assignment 3: Key concepts chart (group) Assignment 4: Case study (individual)
Article Presentations Paper due (individual) Hospitals
Clinics
Health Care Workforce
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Week 6: Current Topics in Health Care Delivery (cont.) and Intro to School of Public Health
(On-Campus)
Topic Activities Assignment
Health Care Reform: What’s Happening Now
Debates (group) Final Project (group)
Advocacy
Putting the “M” in HPM
ACOs in Action
PhRMA and Tech Policy
Issues in 21st Century Primary Care
Putting the “H” in HPM: The role of social determinants and health disparities in health
Course Grading
Grading is based on the following:
Midterm 20%
Paper 20%
Policy/Org Proposal Final Project 20%
Debate 10%
Article Presentation 10%
Assignments 15%
o Assignment 1: Key Concepts Chart (Private)
o Assignment 2: Case Study
o Assignment 3: Key Concepts Chart (Public)
o Assignment 4: Case Study
o Assignment 5: Policy worksheet
Participation 5%
o Introduction video
o Assignment group participation
o Debate group participation
o Final project group participation
o On-site attendance
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Course Requirements
Required Course Materials
1. Microphone/headset for your computer
2. Required book: Barr, Donald. 2011. Introduction to U.S. Health Policy, The Organization, Financing and Delivery of Health Care in America. The Johns Hopkins University Press.
Note: Both the 3rd or 4th editions of Barr are fine. The appropriate chapter for each edition is designated within the reading list. Barr is a great source and will be a big help for you in understanding/clarifying material. However, the textbook is not set up as Professor Flagg runs the class. The textbook is used pre-midterm, which will not include any material on the ACA (we start covering the ACA in week 4). When reading Barr, please skip any part that discusses the ACA. Note that sometimes the chapter summary is before the ACA section and sometimes it is after the ACA section. While you will find the chapter summary helpful, you are not responsible for knowing the ACA material until after the midterm. In fact, it is recommended that you not read the ACA material unless you have a STRONG understanding of all the material covered at the time.
Videos and other resources are found on weekly course pages. A weekly course reader in pdf format
which includes video transcripts and course readings will also be available on the course site for you to
download.
During this course, you will be provided with links to PDF files of articles and other materials from the
UC Berkeley Library Collection. Please make sure you understand and follow the University of California
Library Conditions of Use.
Completion of Course Modules
Students are expected to complete all modules, including viewing all lectures; completing all required
readings and individual activities; and fully participating in class activities.
Participation in Group Activities
This course uses group work as a way for students to learn from each other’s real-world experiences
and expertise. As such, active group participation is critical to the course. Students will have an
opportunity to provide feedback on group member’s contribution, which will be incorporated into a
final participation grade.
Debates
This assignment will ask you to draw upon what you have learned about the US health care system, as
well as hone your advocacy skills. During the on-campus week you will be divided into debate teams
and will be assigned a topic. Debate teams will present their arguments in a clear and concise manner
incorporating supporting facts and evidence. You will also be asked to assess your classmate’s
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Before posting to a discussion board, you should read prior messages to get a sense of the flow
and language of the discussion. Keep your questions and comments relevant to the topic of the
discussion.
Don’t be afraid to ask questions within the course discussion group, or to share what you know.
If you post a different viewpoint, first acknowledge what someone else has said. If you disagree
with someone, it is better to start a message by briefly restating what the other person has said
in your own words. This lets the other person know that you are trying to understand him/her.
Support the points you make with examples or evidence from lecture, readings and/or from
your own professional experience.
Email messages should be considered private and not shared with others or quoted without
permission. However, whatever you post to a newsgroup or discussion board is public. You
never know who might read what you posted.
Consider that a post may be the first – and lasting - impression you make on someone: Make
sure your postings contain correct information. Check your spelling.
Do not use ALL CAPS. It gives the impression that you are shouting.
Do not send “Me Too!” or “Thank You” etc. messages to the entire group. Send those directly to
the original poster.
Cite all quotes, references and sources and respect copyright and license agreements.
Expectations of Student Conduct
As members of the academic community, students are responsible for upholding the standards of
academic integrity. The basic rules of academic study and inquiry call for honesty in the preparation of
papers and assignments, acknowledging sources of ideas, and taking examinations on the foundation of
one’s own knowledge.
The Berkeley Campus Regulations Implementing University Policies, which address standards of student
conduct, were amended in 1992 and are now published separately as “The Code of Student Conduct.”
The complete document is available here: http://students.berkeley.edu/uga/conduct.pdf.
An excerpt from the introductory statement of principles is presented below:
The University of California at Berkeley is committed to providing its students the very best education
that is possible within our resources. Thus, we try to attract the finest faculty members, we endeavor
to maintain excellent classroom and laboratory facilities, and we support literally hundreds of co-
curricular activities that enhance the quality of the Berkeley student’s experience. Yet, for the campus
to function as a university community, it is not enough for the faculty and administration to carry out
their respective obligations. It is equally important that every student assume his or her individual
responsibilities.
Foremost among these, of course, is the student’s responsibility to perform academically to the full
extent of his or her ability. In so doing, it is assumed that each student will observe the basic tenets of
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academic honesty. Therefore, any act of cheating or misrepresenting one’s own or someone else’s
academic work will be considered a very serious offense. Intellectual products – including papers,
exams, laboratory reports, articles, and books – are the heart and soul of any university’s academic
life. We cannot permit them to be willfully compromised or expropriated.
Beyond our expectations of academic honesty – and of equal importance – is the assumption that the
Berkeley student will accept his or her civil and civic responsibilities. What are these responsibilities?
Simply put, they are the courtesies, considerations, and gestures of respect towards other members of
the campus community that allow us all to express our personal freedoms without trampling on those
of others.
The University is a fragile organism, requiring for its vitality consensus among its members concerning
acceptable standards of conduct. These standards must both underlie and promote a degree of
tolerance far greater than that which is exhibited in society at large. For it is not coercive law which
restrains our actions, but a common purpose.
That purpose is understood as guaranteeing the right of every Berkeley student to pursue his or her
personal path to an education, to ask his or her very own questions, and to express his or her private
reflections – in short, to evolve as an individual without undue interference. Any infringement of this
right, whether in the classroom or elsewhere on campus, will be regarded as an offense against the
entire campus community.
UCB Code of Student Conduct, 1992, pp. 1 and 2
Academic honesty
The School of Public Health and the University of California, Berkeley place a high value on academic
honesty, which prohibits cheating and plagiarism. What is meant by “cheating is usually quite clear cut,
but not so for “plagiarism”. The following memo, prepared by Professor William Bicknell at the Boston
University School of Public Health for orientation of students, defines plagiarism quite well. Please read
this carefully and discuss with your faculty adviser or with Associate Dean of Student Affairs if you have
any questions.
“Plagiarism” a memo by Dr. William J. Bicknell: The purpose of this memo is to make clear:
What plagiarism is, how to avoid plagiarism and the consequences of plagiarism
Misunderstanding is widespread about what plagiarism is and whether or not it is a serious offense. It is
a serious offense, and should be painstakingly avoided. Acceptable practice on citing sources of
information differs as one moves from an academic environment to the world of work. There are also
differences in custom between countries and cultures. This memo outlines practices appropriate to a
U.S. academic environment.
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What is plagiarism? Plagiarism is using someone else’s work, words, or ideas without giving them
proper credit. An example of plagiarism, and an example of one acceptable way to avoid it, is shown
below under the heading of Attachment 1.
How to avoid Plagiarism. Here are some simple guidelines for avoiding plagiarism:
1. If you use a phrase, sentence or more from any source, you must put them in quotation marks and cite the source in footnote.
2. If you recount someone else’s ideas in your own words (paraphrasing), you must provide a footnote at the end of the passage citing the source of the ideas.
3. if you draw on someone else’s ideas, even though you neither quote nor paraphrase them precisely, one of the following is called for:
A footnote crediting the source of the ideas.
A direct reference to the source within the text (for example, “Seligman has repeatedly made the point that.”, with facts of publication (title, etc.) provided in a footnote or bibliography.
Footnotes should be complete enough to enable the reader to accurately identify your sources. In
addition to articles and books, sources may be personal communication, unpublished data, working
memos and internal documents. A footnote should cite the author (if no author is named, the
organization), as well as the title, date and page number(s). a bibliography, listing your sources but not
linking them to specific points in your text, may well be desirable but is not a substitute for footnotes.
The Consequences of Plagiarism
The consequences of plagiarism are serious. Students can be expelled and lose all chance of completing
their studies. Even if 99 percent of a student’s work has been above reproach, proven plagiarism could
easily result in a degree not being granted.
Summary
A good paper typically demonstrates grasp of concepts, originality and appropriate attention to detail.
The person who reads your paper assumes that the words and ideas originate with you unless you
explicitly attribute them to others. Whenever you draw on someone else’s work, it is your obligation to
say so. If you do not, you are operating under false pretenses. That is plagiarism.
Original Source
“Tribal pressures affect Kenyans’ behavior more than pronouncements arriving from the national seat
of government but what ultimately counts is what an individual perceives as in his or her own best
interest. For more than 80 percent of Kenya’s people who live and work on the land, children are seen
as essential to survival and status. This is particularly true for women. Children and young adults
provide an extra labor needed during peak planting and harvest times when everyone in the household
must work long hours every day. For women, children are essential to lessen their heavy workload
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throughout the year: in a study of the Akamba tribe, three-quarters of the respondents gave this reason
for having children.”
Frank L. Mott and Susan H. Mott, “Kenya’s Record Population Growth: A Dilemna of Development,