U.S. HEALTH CARE: NEED and GREED

U.S. HEALTH CARE: NEED and GREED

FIRST YEAR SEMINAR

Professor Catherine Lynde Economics G112

Department of Economics Spring 2009

Email: Office: Wheatley-5-029

Office Hours: Tuesday, Thursday 12:30-1:30 & by appt. Telephone: 617-287-6959

Class Mentor: Ms. Heather Boersma

Office Hours: Thursday 11:15 – 12:15 & by appt. Wheatley-5-088

FIRST YEAR SEMINARS:

This course is a First Year Seminar (FYS). FYS’s welcome new students (with fewer than 30 transfer credits) to UMass Boston with small-sized courses designed to prepare them for a successful college experience. Students may choose from a variety of FYS courses, reflecting a wide range of topics and disciplines. A major goal of a FYS is to practice the following habits of mind essential to university-level educational success: careful reading, clear writing, critical thinking, information literacy and technology, working in teams, oral presentation and academic self-assessment.

All FYS courses meet 4 hours per week and carry 4 credits. An academic advisor and a “library buddy” are attached to each seminar. The academic advisor will visit the class during the semester, and can be helpful in choosing courses and a major, finding out about financial aid, tracking your degree progress and aiming you toward any university services that would increase your success here at UMB. The “library buddy” will meet us in the library and help you learn to navigate the library, including the books, the journals, and the electronic databases available, as well as give you ideas about how best to find information on any particular subject.

UMass Boston is a wonderfully diverse community. We hope that you will take advantage of the opportunity to learn about the rich array of opinions and experiences that will inevitably be present in this class. (There is nothing like discussions about health and medical care policy to bring out strong opinions in people! It is expected that we will not completely agree. I will grade you on your understanding of the material and both sides of the debates, rather than what you personally believe.)

If you entered UMB with 30 or more transferable credits, you shouldn’t be enrolled in this course; in fact, you won’t get credit for it. If you entered UMB with fewer than 30 credits, but you now have more than 30 credits, you still need a course such as this. (Also, DCCDE credits do not count as transfer credits.) If you have taken another G100-level course in any department or program at UMB, you cannot receive credit for this one.

STUDENT REFERRAL PROGRAM:

If it appears to me that you might not pass this FYS, and if I cannot figure out how to support your success in the course, I will inform the director of the student referral. The staff in this program will attempt to help you address the difficulties that are interfering with your success in the class. If you do not want me to contact the student referral program on your behalf, please let me know.

ASSESSMENT OF FYS’S:

In addition to a student self-assessment form to be completed at the end of each FYS, an assessment committee will look at randomly chosen student writing from various FYS’s. Therefore, please save all your writing in this course so that , if you are randomly chosen, you will have your work available. (You may remove your name from your papers if you choose to submit them anonymously.) The purpose of this is to improve the FYS program and to improve particular FYS courses, where necessary. I will let you know later in the semester if your portfolio has been selected.

A NOTE ON ETIQUETTE:

To avoid disruption in the class and to show respect to the rest of us: cell phones and pagers must be turned off during class and no headphones are allowed. Individual conversations between students is disruptive to others and should not occur.

COMPUTER LABS:

There are a number of “general use” computer labs available for your use in the Upper Level of Healey Library, and on the 3rd floor. In addition, there are several “pay for print” stations in the library. Each students is allotted 200 free pages of print at the beginning of each semester. These stations require the use of your student identification number. (After that you may buy a “print card” and pay a charge of 10 cents per page.)

The Economics Department Computer Lab is in Wheatley-5-088. This lab is available for students in economics courses and I think you will find it a useful place to do some of your work in this course. The Economics Dept. charges 10 cents a page for paper for the printer.

COURSE OBJECTIVES:

The purpose of this course is to provide an introduction and overview of how health care is delivered, with primary reference to the U.S. health care system, and with a particular focus on the role economics can play in understanding and evaluating the health care system. We will:

·  recognize the relevance of economic analysis to health and medical care issues.

·  analyze public policy in health and medical care from an economic perspective.

·  understand the mechanisms of the health care delivery system within its broad social, political and economic context.

·  explore the changing nature of health and medical care and the implications for medical practice, medical education and research, and health policy.

·  compare the U.S. system to those found in other countries.

·  examine the high-priority health and medical policy problems facing the U.S. today.

·  understand a few crucial economic principles necessary to understanding the economic role of healthcare in the economy.

No prior knowledge of the health care system is assumed. No basic knowledge of economics is necessary either. You will learn what you need along the way.

In addition to learning about the substance of the health care system in the U.S., you will also learn some skills that will prove helpful in the class and in later university work. In particular, you’ll learn

·  the basics of Excel spreadsheets and graphing

·  downloading data from various websites into Excel for manipulation and analyses

·  basic quantitative data table construction and evaluation

·  a few basic economic graphing techniques and graphical interpretation.

COURSE STRUCTURE, COURSE REQUIREMENTS AND GRADING:

This is a lecture, reading and discussion-based course. Students are expected to have read the assigned material before class. Each student will complete short in-class essays, based upon the assigned readings. There will be 3 longer assignments, also based on the readings, but incorporating data using Excel. These can be revised one time. There will also be a research paper (5 pages minimum), on a topic to be decided upon. You will submit an outline and a draft (for corrections and suggestions) prior to submitting the final paper. Finally, each student will be graded on attendance and the quality of their participation in class – which will include an oral presentation during the semester.

Your grade will be calculated as follows:

In-class essays (4 – weighted equally & occurring randomly) ……………….... 10%

Assignments (3 – weighted equally)….…………………………………….….. 35%

Research Paper:

Outline ……………...... …………...... 5%

Draft …………………………………………………………………..15%

Paper ………………………………………………………….……… 25%

Class Participation (attendance & participation weighted equally)………...... 10%

(Late assignments will be given 50% of their grade, and will only be accepted until the graded assignments are returned to the class – usually 1 week. Any evidence of plagiarism will result in appropriate penalties, as defined by university policy – see below.)

BLACKBOARD and EMAIL:

I will be posting copies of the syllabus, many of the readings, useful web sites, and other course materials on UMB’s Blackboard system. You access it by going to http://boston.umassonline.net. . If you need more information about how to do this, go to http://www.umb.edu/it/help/videos.html for more help.

I will communicate with you via email frequently, and I assume you will do so with me – and with the other students in the class. The easiest way for me to do this is through your UMB email account. I know most of you use another email account, therefore, I need you to go to your UMB account and forward it to your customary email. (Details as to how are found at: http://www.umb.edu/it/help/videos.html.)

REQUIRED READINGS:

Angell, Marcia. The truth about the drug companies: How they deceive us and what to do about it. NY: Random House, 2004.

Cutler, David M. Your money or your life: strong medicine for America’s health care system. NY: Oxford University Press. 2004.

There are other required readings; these will be available either:

(1) on Blackboard Vista (http://www.boston.umassonline.net/index.cfm), as Word or PDF files or

(2) as url addresses to access the articles directly from the web (with address on course outline).

(You will need Adobe Acrobat Reader for some of the articles. If you don’t already have it, go to http://www.adobe.com/products/acrobat/readstep2 and follow the instructions.)

DISABILITY ACCOMODATION POLICY:

Section 504 of the Americans with Disabilities Act of 1990 offers guidelines for curriculum modifications and adaptations for students with documented disabilities. If applicable, students may obtain adaptation recommendations from the Ross Center for Disability Services, M-1-401, (617-287-7430). The student must present these recommendations and discuss them with each professor within a reasonable period, preferably by the end of the Add/Drop period.

STUDENT CONDUCT:

Students are required to adhere to the University Policy on Academic Standards and Cheating, to the University Statement on Plagiarism and the Documentation of Written Work, and to the Code of Student Conduct as delineated in the University Catalog and Student Handbook. The Code is available online at: http://www.umb.edu/student_services/student_rights/code_conduct.html

COURSE OUTLINE

Jan. 27 -29:

Introduction

Feb. 3 - 5:

Introduction to the course: the movie, “Sicko,” and an exploration of your own health insurance situation.

Feb. 5: 1st assignment available

Feb. 10 - 12:

Health Care Outcomes: demography and economics - who is healthy, who is not.

Cutler, Ch. 1

Reuss, A., “Cause of death: inequality,” Dollars & Sense, The Economics of Health, May/June 2001, No. 234, pp. 10-12. (Blackboard)

Abraham, L. K., “The rigors of kidney dialysis for Robert Banes,” Ch. 2 in Mama might be better off dead: the failure of health care in urban america. Chi: Univ. of Chicago Press, 1993. (Blackboard)

Abraham, L. K., “The inner-city emergency room,” Ch. 6 in Mama might be better off dead: the failure of health care in urban america. Chi: Univ. of Chicago Press, 1993. (Blackboard)

Feb. 10: 1st assignment due:

Feb. 17 - 26:

Health Insurance in the U.S.: who has it, who doesn’t, why do we buy it?

Cutler, Ch. 9

Crook, C.,“Poison pill,” The Atlantic Monthly, April 2006. (Blackboard)

Kotlikoff, L. J., “We are all uninsured now,” Boston Globe, Aug. 8, 207.

(www.boston.com/news/globe/editorial_opinion/oped/articles/2007/08/28/we_are_all_uninsure d_now?mode=PF)

: Feb. 26th: 2nd assignment available

Mar. 3 – 12:

Healthcare as a commodity: is it different than a haircut or a car? How to value it.

Cutler, Chs. 2, 3

Krugman, P., “Health economics 101,” New York Times. Nov. 14, 2005. (Blackboard)

Harris, G. “British Balance Benefit vs. Cost of Latest Drugs,” New York Times, Dec. 3, 2008. (Blackboard)

Brownlee, S. “The Overtreated American,” The Atlantic Monthly. Jan./Feb. 2003. (Blackboard)

Peck, D. “Putting a value on health,” The Atlantic Monthly, Jan./Feb. 2004, 142- 144.(Blackboard)

Mar. 5th: 2nd assignment due

Mar. 10 - 12:

Valuing health care: what’s worth paying for, what not?

Cutler, Chs. 4, 5, 6

Mintz, M. “Single-payer: good for business,” The Nation, Nov. 15, 2004..

“The federalist prescription,” The Economist, Jan. 13, 2007.(Blackboard)

Mar. 24 - 26:

History of U.S. Healthcare: how did we get to this point?

Cutler, Chs. 7, 8

Woolman, J., “Job-Based Health Insurance: Sick and Getting Sicker,” Dollars & Sense, May/June 2004. (Blackboard)

Mar. 31 - Apr. 2:

National Health Care Policy and the Massachusetts Compact

Cutler, Chs. 9, 10

Fuchs, V. “Health and social choice,” in Who shall live? Health, Economics, and Social Choice. NJ: World Scientific, pp. 143-151. (Blackboard)

Hakim, D.and Abelson, R., “Big Insurer To Update Its Fee Data.”The New York Times, Jan 13, 2009.(Blackboard)

Baker, D. “The Origins of the Doughnut Hole: Excess Profits on Prescription Drugs,” CEPR Issue Brief, August 2006. (Blackboard)

Selection of newspaper articles on Mass. Compact. (Blackboard)

Apr 2nd: 3rd assignment available

Apr. 7 - 16

How do they do it in other countries?

Relman, A., “Canada's romance with market medicine: for-profit health care has failed in the U.S. so now its sponsors hope to export it north,“ The American Prospect,. October 21, 2002. (Blackboard)

Baxandall, P. “Spending #1, performance #37: How U.S. Healthcare stacks up internationally,” Dollars & Sense, May/June 2001. (Blackboard)

The Economist. “The price of popping pills,” May 15, 2004. (Blackboard)

Powerpoint slides comparing several countries. (Blackboard)

Apr. 9th: 3rd assignment due

Apr. 14 – 23:

“Big PhARMA,” the pharmaceutical industry: who should own new drugs and procedures, does R&D explain high drug prices, what about advertising, should we get our drugs from Canada?

Angell. The truth about the drug companies.

Conaway, C., “The pros and cons of pharmaceutical patents,” in Fed. Res. Bank of Boston Regional Review, 13, 1st quarter, 2003, pp. 10-18. (Blackboard)

Apr. 21st: paper outline due

Apr. 28 - 30:

Markets in organs & buying babies

Zarembo, A., “Allocation of kidneys debated,” Boston Globe, Nov. 12, 2006. (Blackboard)

Stein, R., “In push for transplant organs, critics see room for abuses.” Washington Post, Sept. 16, 20007.

Peck, D. “Putting a value on health,” The Atlantic Monthly, Jan./Feb. 2004, 142- 144.(Blackboard)

Dolnick, S. “Pregnancy becomes latest job outsouorced to Inida,” USA Today, Dec. 30, 2007. (www.usatoday.com/news/health/2007-12-30-surrogacy_N.htm?csp=34)

(www.boston.com/yourlife/health/diseases/articles/2007/09/16/in_push_for_transplant_or gans_critics_see_room_for_abuse/)

Stein, R., “State legislatures revising organ-donation law to ease shortages,” Washington Post, April 8, 2007. /www.boston.com/news/nation/articles/2007/04/08/state_legislatures_revising_organ_donation