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MPPA Program (11-Week On Campus)

PA 582-01 Healthcare Policy Winter Term 2017

COURSE TYPE:

The majority of professor-led contact hours take place in a traditional classroom. The overall nature of the course is “traditional”, although required Blackboard components have also been included.

INSTRUCTOR INFORMATION:

Name: Marilyn Gesch, Ph.D. Phone Numbers: 805-493-3794 (MPPA Office) Office Location: n/a Office Hours: By email or appointment Email: [email protected]

TIME / PLACE:

x Term Dates: November 21, 2016 – February 16, 2017, first meeting is Wednesday, Nov. 23, 2016. x Weekly Class Meeting: Wednesday, 7:00 – 9:50 PM x Classroom: Humanities, 107 x Last Day to Add: Monday, December 5, 2016 x Last Day to Drop (without a “w” or financial penalty): Monday, December 5, 2016 x Last Day to Withdraw (without academic penalty): Tuesday, January 17, 2017

READINGS:

Readings will be available on the course website or through the Pearson Library’s online databases. Refer to the Course Calendar.

COURSE DESCRIPTION:

This course provides an overview of medical sociology and its contribution to understanding health policy, focusing on the American health care system. We will study health care policy from a sociological perspective, which means we will explore the social contexts in which medicine, health, illness, and health care delivery are situated. Major topics include health inequalities, medical cultures, and the economic markets and politics that affect our health care system. In the first weeks of the course we will look at the social conditions underlying the experience of health and illness. In the remainder of the course, we will look at the variety of players in policy making – including but not limited to the patients themselves, medical professionals, medical industries, insurers, government agencies, and politicians.

mailto:[email protected]

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TECHNOLOGY REQUIREMENTS: CLU utilizes Blackboard to enhance course learning and achieve the designated student learning outcomes. Technology requirements for the Blackboard system can be found at the following website:

http://www.callutheran.edu/ctl/Blackboard.php

OUTLINE OF STUDENT LEARNING OBJECTIVES:

Students will obtain skills and knowledge in the following areas: 1. understanding and applying sociological concepts and approaches to medicine and health care policy, 2. developing analytical skills in relation to contemporary health care debates, 3. collaborating with the instructor and other members of the class in a critical assessment of course readings

and materials, and, 4. practicing and improving both oral presentation and written communication skills.

Because we will be engaging with contemporary and often controversial issues within the field of healthcare policymaking, you are expected to think critically about the subject matter which means reading assigned books and articles and considering authors’ arguments in light of each week’s topic area.

LEARNING OUTCOMES:

The MPPA Program at California Lutheran University’s School of Management has been designed to achieve a total of nine learning outcomes. While each course alone, including this present one, teaches only towards a subset of those nine outcomes, all of them will be accomplished by students upon successful completion of their program. 1. FUNDAMENTALS: Graduates of the School of Management are equipped with knowledge of the essential concepts and tools

in their professional field, as well as the ability to relate and apply theoretical concepts into practical situations both within their discipline and across disciplines.

2. PLANNING AND ORGANIZATION: Graduates of the School of Management have the ability to plan, organize, direct and

control effectively in contemporary organizations. 3. INDIVIDUAL COMPETENCIES: Graduates of the School of Management have individual competencies related to critical and

creative thinking, integrity and ethical judgment, and the ability to function in a complex and demanding professional environment. 4. INTERPERSONAL COMPETENCIES: Graduates of the School of Management have interpersonal competencies related to

effective and appropriate communication and collaboration that support and enhance their individual and organizational effectiveness.

5. GLOBAL ENVIRONMENT: Graduates of the School of Management have a sound understanding of the global environment

and its importance to organizational effectiveness, as well as the ability to successfully operate in an international context. 6. LEADERSHIP AND CHANGE: Graduates of the School of Management are able to demonstrate effective and principled

leadership including the ability to influence organizations in complex and changing environments. 7. PUBLIC MANAGEMENT SKILLS: Graduates of the Master of Public Policy and Administration have knowledge of project

management, evaluation of policy alternatives, collaboration, communication and team building, which allow them to effectively work with communities, policy makers and other stakeholders on a wide range of policy issues.

8. ETHICS: Graduates of the Master of Public Policy and Administration are able to evaluate and apply ethical values to policy practice.

9. RESEARCH AND POLICY ANALYSIS: Graduates of the Master of Public Policy and Administration are able to conduct research and apply relevant analysis to public administration and policy.

Information on which learning outcomes are addressed in this course can be found in the section on “Assessments and

Learning Outcomes” below.

http://www.callutheran.edu/ctl/Blackboard.php

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DIDACTIC APPROACH:

This course rests on several components – self-study, lectures, interaction, as well as practice and application: x Self-Study

o Preparation in self-study by students before lecture to become familiar with new material and to stimulate thinking, generate ideas and questions.

x Lecture o Presentation of topics in class by instructor using PowerPoint slides.

x Student-Instructor Interaction o Discussion of selected questions, finding examples, and answering questions in the weekly forum. o Direct interaction between student and instructor.

x Practice and Application o Preparation of weekly assignments by students. o Participation in discussion boards. o Deepening of concepts in discussion. o Policy project / presentation on a selected topic.

ASSESSMENT:

Assessment in this course is based on multiple elements. Each form of assessment addresses different (sometimes multiple) learning outcomes and each form of assessment requires a different set of knowledge, skills and abilities:

Attendance and Participation: Attendance at all sessions, including weekly online forums, is critical toward the fulfillment of course requirements. Students should come to class each week prepared to discuss the readings for that day as well as any assignments associated with them. A 10% reduction in a student’s final grade will be assessed for each unexcused absence from class or the online forum.

SUMMARY TABLE OF ASSIGNMENT DEADLINES AND DUE DATES:

Assessment

Due Date

Weekly on-site & online attendance & participation

Weekly, through the term (refer to course calendar)

Weekly readings and writing assignments including Blackboard postings

Weekly through the term

Case study class discussion (brief write-up due on class date)

Selected by student

Term Project (Policy Analysis Assignment) Annotated Bibliography & “Five Questions” Essays

Jan. 4, 2017

Term Project (Policy Analysis Assignment) PowerPoint presentation of project

Feb. 8, 2017

Term Project (Policy Analysis Assignment) Final paper

Feb. 15, 2017

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ASSESSMENTS AND LEARNING OUTCOMES: The following table provides information on how various forms of assessment contribute to the student learning outcomes as outlined earlier in this syllabus, based on the following criteria:

Form of Assessment Student Learning Outcomes 1 2 3 4 5 6 7 8 9

Class participation (on-site & online) x x x x x

Writing assignments (reading write-ups, case study write-up, policy project writings)

x x x x x x x

Oral presentations (case study; policy project) x x x x x x x x

Integration of course concepts (from lectures, readings, library research) into written and oral work including class participation

x x x x x x

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SCHEDULE OF TOPICS AND ACTIVITIES

2016 Week 1, Nov. 23: Introduction; Sociological Perspective on Health and Illness

The course syllabus, readings and other materials will be available on our Blackboard web page.

1. Review of course materials and requirements; sign up for (1) policy project topic, and, (2) date/topic for case study discussion.

2. Overview of sociological concepts important to understanding a sociological perspective on health and illness and the debates on health care reform.

Assignment: Prepare a one-page summary of the reading and turn in print copy to instructor.

Week 2, Nov. 30: Political Context of Health Care Reform Required Readings: Morone, James A., “Morality, politics, and health care,” in Policy Challenges in Modern Health Care, Mechanic et al., eds., ©2006 [Bb]; and, Barr, Donald A., Chapter 1, in Introduction to U.S. Health Policy (Johns Hopkins Univ. Press, 3rd edition, ©2011) [Bb]

Assignment: Who are some of the players in health care reform, according to this week’s authors, and what kinds of pressures and ideologies do they bring to the debates? Post to your journal page a 300-500 word summary that draws on the required readings to answer the questions above.

Discussion Board: Post a response to the weekly discussion question; respond to others’ postings and questions.

Week 3, Dec. 7: Social Conditions of Disease

Required Readings: Phelan, Link & Tehranifar, “Social conditions as fundamental causes of health inequalities” in Mechanic, Policy Challenges… ©2006 [Bb]; and, McKinlay, “A case for refocusing upstream,” in The Sociology of Health and Illness: Critical Perspectives, Peter Conrad, ed. ©2001 [Bb]

Assignment: Post on your journal page a 300-500 word assessment of either the Link and Phelan or the McKinlay article. (Note: You prepare for class by reading both required readings, but write up this assignment using only one of the articles.) This should include a summary of the author’s argument(s) and any supporting evidence provided. In conclusion, make note of your questions and critique of the work.

Discussion Board: Post a response to the weekly discussion question; respond to others’ postings and questions. Case Study Question: Go to Handouts on the course Blackboard page for information about case study questions.

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Week 4, Dec. 14: Health Inequalities (Poverty, Race/Ethnicity, Gender)

Required Readings: Williams, David R., and Michelle Sternthal. “Understanding racial-ethnic disparities in health.” Journal of Health and Social Behavior (JHSB) ©2010 [Bb]; Riecker, Patricia P. and Chloe E. Bird. “Rethinking Gender Differences in Health.” The Journal of Gerontology, vol. 60B, 40-47. ©2005 [Bb]

Assignment: “Media Moment”: Post a minimum 300-word analysis of a news article or story (with source) on the Blackboard forum for this date. Address the issues identified in the required readings regarding some aspect of the issue of health disparities in the U.S. healthcare system.

Discussion Board Question: Post on this week’s discussion board; respond to others’ postings and questions.

Case Study Question: Go to Handouts on the course Blackboard page for information about case study questions.

* * Holiday Break, Dec. 16, 2016, to Jan. 2, 2017 * * Prepare Annotated Bibliography & “Five Questions” Essay To Turn In January 4

2017

Week 5, Jan. 4: Patient Experience of Illness

Discussion Board Question: Provide your analysis of the patient experience of illness, according to the Charmaz article. What are her images of the patient, and how do these perspectives impact healthcare policy? Post your response, and respond to others’ postings and questions.

Class Discussion of Policy Project Essays for All Students: Come to class prepared to talk about what you have learned about your policy topic thus far, what concepts from readings and lectures seem to fit your topic best, and what questions you think still need to be answered.

Week 6, Jan. 11: Norms of Medical Culture

Required Readings: Freidson, Eliot, “Dilemmas in the Doctor-Patient Relationship,” in Kornblum & Smith, eds., The Healing Experience ©1994 [Bb]; Stevens, Rosemary, “Medical Specialization as American Health Policy,” in History & Health Policy in the U.S., Stevens et al. ©2006 [Bb] Discussion Board Question: Drawing on the required readings, post a brief essay identifying and describing some of the customs that define how medical professionals operate every day (i.e., interactions with patients, other professionals, and medical suppliers and industries).

Case Study Question: Go to Handouts on the course Blackboard page for information about case study questions.

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Week 7, Jan. 18: The Changing Health Care Environment: Medical Institutions

Required Readings: Budrys, Grace. “Hospitals and Other Health Care Organizations.” From Our Unsystematic Health Care System, 2d ed., pp. 39-55, ©2005. [Bb]; Hoffman, Beatrix, “Emergency Rooms: The Reluctant Safety Net,” History & Health Policy in the U.S., Stevens et al. ©2006 [Bb]

Discussion Board Assignment: “Media Moment”: Post a minimum 300-word analysis of a news article or story (with source) on the weekly forum. Discuss how hospitals are being affected by the 2010 PPACA. Draw on the required readings to put these changes in context of what these authors observe (for ex., will the roles of ERs change, or the relationships between hospitals and medical professionals?). As with other discussion boards, read and respond to others’ postings and questions.

Case Study Question: Go to Handouts on the course Blackboard page for information about case study questions.

Assignment: Turn in a 300-500 word essay drawing on ideas from the Conrad et al. article on how medical industries shape what we think of as illness and what we do about it.

Discussion Board Question: Post a response to the weekly discussion question; respond to others’ postings and questions. Case Study Question: Go to Handouts on the course Blackboard page for information about case study questions.

Assignment: Drawing on the Cockerham material, turn in a 300-500 word essay arguing for those aspects of health care reform that you believe provide the best evidence for addressing sociological issues of equal access, patient needs, accountability, role of profit, etc.

Case Study Question: Go to Handouts on the course Blackboard page for information about case study questions.

Week 10 (Feb. 8) reserved for Student Presentations

* FINAL PAPERS ARE DUE Feb. 15 and E-MAILED TO INSTRUCTOR.*

DISCLAIMER: This information sheet may change prior to or during the term to accommodate changing circumstances. Every effort will be made to alert students in a timely manner to any

alterations that occur.

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DESCRIPTION OF ASSIGNMENTS WEEKLY WRITING ASSIGNMENTS AND ONLINE DISCUSSIONS: In addition to the readings, each week you will prepare short assignments that you will post online on your journal page, accessible only by the instructor.

You will also be responsible for participating in a weekly online forum with your classmates. Two of these forums will focus on discussions of media stories researched and submitted by students; topics for the remaining forums will be assigned by the instructor. The earlier you place your initial post, the more time you will have to check in and interact with additional posts.

Writing assignments are subject to the general requirements for written work as stated above, and assessed on how well your essay covers the conditions in the assignment description. Blackboard postings must be made no later than the date and time specified for each one on the Course Calendar. For example, article summaries must appear on your journal page no later than midnight Mondays.

The article summaries are based on the required readings for the week. The focus of each week’s summary is provided in the Course Calendar; look for the weekly “Assignment.” Your essay is graded on how well you respond to the question posed and summarize key arguments and evidence used in the readings that address the point. Due midnight on Saturdays prior to the class meeting. Follow up posts required.

A Media Moment posting is your summary and analysis of a contemporary news story that meets the topic requirement (read “Assignment” description for that week). Your news source must be a major news service, and in your posting you must provide a working link to the full story or scan and upload a print version. Briefly describe the issue raised by the story and make a connection to our course readings and discussion, highlighting social factors that are present or absent from the account. Due midnight on Saturdays prior to the class meeting. Follow up posts required.

CASE STUDY DISCUSSION and WRITE-UP Each student will select a case study (see Course Calendar, weekly “Case Study”) and prepare to lead discussion for the last hour of class that includes an overview of the substantive topic for that date and embeds it in that week’s key ideas. Your case study work will be graded on how well you integrate conceptual material from the required readings, critique the readings that address the case study issues, and generate discussion with the class on your topic.

What to do:

(1) Start with the week’s required readings. Focus on those pieces of evidence and/or arguments that are important for understanding how to formulate or evaluate health policy in your case study area.

(2) The second step is to investigate current regulations in place, both at the state and federal levels. Most agencies have published this information on their websites.

(3) Then, using library databases, such as JSTOR, Lexis-Nexis and Medical Sciences (ProQuest), find at least one relevant research article on that issue and at least one relevant news story that take issue with, illustrate or extend the issues and arguments provided in the reading. Keep track of the citations and provide that list to the instructor.

(4) Develop a presentation to the class explaining key concepts and major issues in that subject

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area based on your readings. Summarize main arguments, being careful to identify key policymakers on this issue as well as their claims as to the major problems and solutions.

9 Organize your presentation in such a way that your summary of the key issues in your case study link to ideas from the required readings for that week.

9 Approach your presentation by asking “What are the issues in this case study?” and “what social factors affect these conditions?”

9 Be succinct in your report: Don’t spend a lot of time and space recapping readings page by page. Your presentation to the class (at least 12 to15 minutes) should focus on telling us what is important in order to understand the issue and summarize those points for your readers.

9 Use of PowerPoint is not required.

(5) Follow up your overview with a series of discussion questions (about 4-5) for the class to consider in terms of potential public policy issues. Discussion should be a minimum of 20 minutes.

(6) Turn in your list of references to instructor the night of the case study. TERM PROJECT: Policy Analysis Assignments There are three graded components to your term project, a policy analysis paper:

(1) Annotated Bibliography & “Five Questions” Essay (writing assignment) (2) Class presentation (PowerPoint) (3) Final paper (writing assignment)

The first assignment gets you started on researching and analyzing information for your final paper, first, engaging you with library research on academic sources for your topic, and second, engaging you with key concepts from the early weeks of the course (both lectures and required readings) as they relate to your topic.

This assignment should follow proper formatting (double-spaced, one-inch margins, 12pt font), spell-checks and grammar- checks available in your word processing program, and follow the specific instructions of the assignment.

Annotated Bibliography and Topic History 9 You will research your topic in library databases and report on what you have found. 9 An annotated bibliography means that the structure of this paper will be a list of the sources

you have found (correctly formatted) with one- to two- paragraph descriptions of each. 9 Each description will include a brief summary of the research findings and arguments presented

by the authors, plus a statement from you on why you find this article relevant to your topic. 9 A minimum of eight (8) scholarly works from peer-reviewed journals are required; additional

bibliographic material should include relevant readings from our course materials. You may also find media sources helpful to your study, but you will have to defend their credibility in order to use them.

9 This assignment concludes with a 350-500 word summary of this topic’s history as a policy issue (see the description of the final paper).

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“Five Questions”: 9 You will write responses to five (5) questions provided by the instructor, each response

approximately 350-500 words long. 9 These questions will help you identify and evaluate:

� the role of the governing body that you are targeting with your proposal; � the two opposing policy positions and their claimsmakers (i.e. those who are supporting

each position and their investment in that stance); and, � your integration of conceptual material from weekly readings and class discussions

through midterm, including: x types of moral perspectives; x political alliances and relative political power of policy proposals; x impact of social factors/social conditions on issue and proposed solutions; x current and projected disparities in healthcare use and outcomes.

It is expected that you will be building on these writings as you proceed through the term.

PRESENTATION OF POLICY PAPER: Papers will be presented in class at our final meeting. Presentations should be five (5) minutes in length, using a PowerPoint format. They should be concise and convincing. Following the presentation, time will be allowed for class members to ask questions and discuss the pros and cons of each policy issue.

Your final product will be a typewritten paper, 12-15 pages in length, presenting your analysis of a key health policy area being considered by state, local or federal government entities.

In general, your analysis should provide background and description of the topic area, and an explication and sociological analysis of multiple perspectives that are part of the contemporary debates. Your sources must include both class readings and research from scholarly journals. You will make use of and build on information and analyses provided in your first two assignments to complete the tasks listed below.

In addition to general requirements for written work, your paper must include: (1) The historical background of the issue, particularly prior programs or approaches used by

industries or governments. You will identify how current policies developed, what they were designed to do, and identify gaps or problems as well as successes. Stick to relevant aspects of the history that are shaping today’s debates.

(2) Comparison of two key positions on this question and the health models or solutions each propose. Describe key elements of each proposal and discuss how each proposal is likely to solve the problems or gaps in current policies. Identify each proposal’s advocates, or claimsmakers (i.e., who has vested interests in the approach?), and summarize the evidence these groups provide to support their arguments. Finally, identify the “winners” and “losers” of each proposal in contrast to the status quo, or current policy. Provide your reasoned assessment of the political prospects each approach might have for adoption.

(3) Important to your analysis is your evaluation of these proposals from a sociological

perspective, specifically addressing relevant research and concepts that look at: (a) a patient’s or consumer’s perspective, (b) the operation of medical norms in this context, (c) the changing role of health care provision, and (d) the impact of a policy change on health financial markets, integrating relevant course readings into your analysis. It is critical to your analysis that you include discussion of the aspects of the new healthcare law that affect your issue.

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Sources must include course readings as well as research from peer-reviewed academic journals.

Final write-up of the paper is due at 7 p.m. on Wednesday of Finals Week and

emailed to the instructor.

Choose one of the following for your policy analysis paper.

1. Public Health and Rights to Privacy: Should medical providers be bound by Public Health policies? Recently, a nurse who was exposed to the Ebola virus refused quarantine rules imposed by the legislature and health department of New Jersey. What were the arguments on both sides? What roles did science, cultural values and norms, and political posturing play in policymaking? What other factors were involved? What are implications for other issues in which private and public health sectors must collaborate?

2. Is unregulated economic growth good for our health? Scientists argue that diminishing

biodiversity in our ecosystems world-wide, much of it due to unrestricted development and other human activity, will affect our health in the future. Are there ways we can grow an economy and maintain diversity in the environment?

3. Health care digitization and other new technologies in your doctor’s office: Physicians

and their staffs are facing increased pressures to digitize medical records, and recruit and maintain a remote client base through telemedicine practices, i.e., incorporate new technologies into their practices. Are these new practices changing the doctor-patient relationship? What do both doctors and patients think about the changes? And, what roles are medical industries, healthcare corporations, and governments playing in effecting certain changes?

4. Making the rules regarding women’s contraceptive choices: One of most

controversial (and litigated) provision of the PPACA is the obligation of employer plans to cover contraceptive services under prevention. Businesses that oppose coverage have challenged the law and won concessions. What are the origins of this debate, both in the construction of the law and in the history of women’s contraceptive choices in America? What implications does this have for women’s health care and for future policymaking? Should private businesses be able to block access to health care for women?

5. What should government do in response to the problem of access to health care?: The

Obama administration developed a health care policy that addressed the tens of millions of Americans who in 2010 were uninsured (and millions more who were underinsured). What provisions of the PPACA attempt to create a more inclusive system? What are the values and politics behind them? What are the arguments opposed? Did the PPACA go far enough, as others contend the U.S. should transition to a federally-funded "Medicare for Everybody” universal health insurance system?

6. What role should medical professionals have in military anti-terrorism practices?:

Since the exposure of abuse of detainees at Abu Gharib in Iraq in 2003, critics have questioned the role of psychiatrists in the justification of torture practices by military interrogators. Should physicians and psychiatrists provide information that helps determine how much and what kind of mistreatment could be delivered to detainees of the military during interrogations? Is there a point where a doctor’s obligation to “do no harm” is suspended during times of war?

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7. Immigrants and health care laws: In 1994 Californians passed an initiative, subsequently ruled unconstitutional, that included a provision requiring medical personnel to refuse care to undocumented immigrants. More recently, the Obama administration has ruled that while young undocumented immigrants may be allowed to be “lawfully present” in the U.S. (for schooling or work), they would not be eligible for health benefits under the new health care law. What are the obligations of a society to those within its borders? Is health care different from other kinds of “benefits”? How have other countries addressed this issue?

8. Are there limits to the uses of medical technology?: Should genetic screening be used in

hiring and contracting by employers, insurers, and governments? Is genetic enhancement an acceptable use of technology? These and other questions can be explored in determining at what point the costs of technologies (in terms of harm to persons or communities) outweigh the benefits.

9. Technology and doctor/patient interaction: How are new medical technologies changing

the doctor- patient encounter, as well as doctors’ approaches to clinical care? Is the use (or overuse of testing) improving diagnostic accuracy, or is this more myth than fact? What evidence speaks to what the balance should be between subjective observation and laboratory data in a doctor’s deliberations? Does the new health care law have something to say about the use of technologies in patient care?

10. Off-label marketing of drugs: A common practice by physicians, and heavily

promoted by drug companies, off-label use of drugs was given a boost by an appeals court decision in New York supporting marketing of drugs for uses not approved by the FDA. What are the pros and cons of this decision for doctors and patients? What should be the responsibilities of drug manufacturers, and what would be an appropriate governmental policy on this issue?

11. Should medical providers be allowed to deny medications on grounds of

conscience?: First pharmacists, and then, with the new provisions in the 2010 health care law, hospitals are exercising moral or religious grounds to gain exception to the mandate to provide birth control medications. Should exceptions be allowed? How should religious claims be weighed against individual rights?

12. Should state legislatures or U.S. Congress regulate fracking? We are immersed in a new

era of oil booms in North Dakota, Pennsylvania, and, more recently, Central California. Water infused with “various chemicals” (unidentified, to date) is blasted deep underground – below farms, close to water tables, handled by workers. Are these chemicals and processes harming workers or the environment? What responsibility do these companies have, not only to the environment which they are changing, but to workers and residents who may be affected by their practices?

13. What’s the future for employer-based health care coverage?: At one time, employers

willingly offered health care benefits as they competed with each other for workers. With outsourcing in the global labor market, high health care costs in the U.S., and a troubled economy, employers have implemented strategies for reducing their costs. What are some pre-2010 business strategies and current trends, and how does the ACA address them?

14. Drug shortages, high-priced generics, and American health: Drug shortages have

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Assessment Points Weekly attendance in class and online participation (postings in forum, discussion boards)

Weekly writing assignments (journal) 15 Case study class discussion (with brief write-up) 15 Policy Project: Annotated bibliography & “Five Questions” Essays; class discussion Jan. 4

Policy Project: PowerPoint presentation in class 10 Policy Project: Final Paper 20

increased dramatically in the last decade, nearly tripling. In especially short supply is a generic version of an important cancer drug. What is the threat to public health? What’s wrong with the drug production and distribution system? What have Congress and the FDA done in response? How can private enterprise and government agencies address this problem?

15. Health Care and the poor: Community health providers who treat the poor find they cycle

in and out of care due to periods of homelessness, jail time, and other barriers, disrupting medical regimens. What are implications for individual health and public health? What provisions of the ACA can help address these issues?

Proposing an Alternative Topic If you prefer to work on a topic not listed above, you must submit a proposal (typewritten, single-spaced, due no later than our first class meeting) addressing each of these points and arguing why your topic is relevant to health care policymaking as well as recent health care reforms:

(1) state your key policy question (examples provided above); (2) state what level of governance is involved at which a policy decision should be made

(local, state, federal; specific agency), and provide the rationale for why that governmental entity is critical for this issue;

(3) identify 2 key positions on this issue, including how each identifies the problem and what each proposes for a solution; for example, using a topic above, DTC advertising of pharmaceuticals is argued by some as improving patient choice and by others as inventing demand – what is each side identifying as a problem, and what do they suggest be done about it?

(4) outline sources of evidence each position puts forth in its claims; and, (5) finally, looking at the topic areas for each week of this course, consider which you expect to

be most relevant for your topic and why; for example, DTC advertising of prescription drugs is relevant to the study of the patient empowerment movement as well as the study of medical industries and the role of profit-making in health-related fields.

GRADING:

Grading in this class will be based on the following elements and the grading scale provided below:

Percentage Grade >94% A

90% to 93% A- 87% to 89% B+ 84% to 86% B

80% to 83% B- 77% to 79% C+ 74% to 76% C 70% to 73% C- 67% to 69% D+ 64% to 66% D 60% to 63% D-

<60% F

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GRADING STANDARDS

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STUDENT WORKLOAD FOR THIS COURSE:

This is an 11-week, three credit unit course that consists of a minimum of 45 hours of instructor-led components and a minimum of 90 hours of non-instructor led, independent activities. A detailed breakdown of times (1 hour = 50 minutes) and activities can be found from the following table:

Activity Instructor-Led Independent

Remarks Weekly Course Weekly Course

Lecture/class discussion 3 33 Instructor-led lecture & discussion Readings 3 33 Assigned by instructor Blackboard postings 1.5 12 Assigned by instructor (8 wks) Case study 2 10 Assigned by instructor Policy paper preparation 30 Policy paper presentation 1 4 Policy paper written report 20

TOTALS 48 103

COURSE POLICIES:

1. There are aspects of health care policymaking that are quite controversial. I ask that we maintain a civil

dialogue on all subjects, being open to ideas that may be new to us, and respecting others’ opinions if different from our own.

2. It is also important to be “unitaskers” in the classroom when it comes to our use of electronic devices. To encourage keeping our attention on the topic at hand, I ask that use of personal electronic devices be limited to breaks and before and after class.

3. There are a variety of assignments in this course. It is recommended that you develop habits to keep track of upcoming deadlines and contact the instructor when conflicts or problems arise. Materials submitted past the given deadlines (including online posts) are subject to penalties of 10 percentage points per day.

COURSE EVALUATIONS:

All course evaluations are conducted online. Your feedback is important to us. You will receive an email message reminding you when the website is open for your feedback. The link is: http://courseval.callutheran.edu

ACADEMIC INTEGRITY:

The educational programs of California Lutheran University are designed and dedicated to achieve academic excellence, honesty and integrity at every level of student life. Part of CLU’s dedication to academic excellence is our commitment to academic honesty. Students, faculty, staff and administration share the responsibility for maintaining high levels of scholarship on campus. Any behavior or act which might be defined as “deceitful” or “dishonest” will meet with appropriate disciplinary sanctions, including dismissal from the University, suspension, grade F in a course or various forms of academic probation. Policies and procedures regarding academic honesty are contained in the faculty and student handbooks.

Plagiarism, cheating, unethical computer use and facilitation of academic dishonest are examples of behavior that will result in disciplinary sanctions. Plagiarism includes, but is not limited to:

x Word for word copying without using quotation marks or presenting the work as yours x Using the ideas or work of others without acknowledgement x Not citing quoted material. Students must cite sources for any information that is not either the result

of original research or common knowledge.

http://courseval.callutheran.edu/

MPPA 582-01, Healthcare Policy, Winter 2017_rev 30Dec2016 mg Page 16

PEARSON LIBRARY: At CLU we won't tell you what to think — we'll teach you how to think. You'll learn how to gather information, analyze and synthesize. Don't worry about the "gathering"... that's the easy part. We have technicians, information specialists, and trainers to help you find the information you need. Pearson Library provides access to scholarly books, journals, ebooks, and databases of full text articles from scholarly journals. To begin using these materials, visit the library web page http://www.callutheran.edu/iss/research/. Librarians are available to assist you at the Thousand Oaks campus or via Meebo chat on the Library’s home page or emailing [email protected]. You may contact the library at (805) 493-3250. If you attend classes at one of CLU’s satellite locations, see http://www.callutheran.edu/iss/research/satellite.php for the full range of services provided.

CLU WRITING CENTER: Experienced Writing Center tutors help CLU's undergraduate and graduate students with their writing projects: reading free writes to find the best ideas; refining thesis statements; showing students how to structure paragraphs; and using specific exercises to improve sentence syntax. They work with whole classes as well as with individual students on the style guidelines required for papers in the various disciplines. All enrolled CLU students are invited to make use of the Writing Center’s services. For additional information, please visit http://www.callutheran.edu/writing_center/, call 805- 493-3257, or email [email protected] in order to schedule an appointment or contact.

DISABILITY STATEMENT: California Lutheran University is committed to providing reasonable accommodations in compliance with ADA of 1990 and Section 504 of the Rehabilitation Act of 1973 to students with documented disabilities. If you are a student requesting accommodations for this course, please contact your professor at the beginning of the semester and register with the Accessibility Resource Coordinator for the facilitation and verification of need. The Accessibility Resource Coordinator is located in the Center for Academic and Accessibility Resources (CAAR) Office, and can be contacted by calling 805.493.3878 or by completing the online form at http://www.callutheran.edu/car/contact/.

INSTRUCTOR BIO: Dr. Gesch earned her doctorate in Sociology at The University of California-Santa Barbara. She completed a two- year Post-doctoral Fellowship at The University of California-Los Angeles in the HIV/AIDS research training program, with an emphasis on public health systems. She has worked with the Ventura County Public Health Department in investigating local HIV prevention practices. Her approach to the study of health policymaking comes from this perspective as a sociologist, looking at the field of medicine and health care delivery not only in terms of their structures but of those who populate them – the professionals and corporate CEOs, as well as those whom they serve. Her approach to policymaking spans the micro and macro – from the patient perspective and ways in which patients influence policy, to the broader context of the influence of social institutions and cultural beliefs and practices.

DISCLAIMER:

This syllabus may change from time to time to accommodate changing circumstances. Every effort will be made to alert students to changes that occur in a timely manner.

http://www.callutheran.edu/iss/research/

mailto:[email protected]

http://www.callutheran.edu/iss/research/satellite.php

http://www.callutheran.edu/writing_center/

mailto:[email protected]

http://www.callutheran.edu/car/contact/