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THE U.S. HEALTH CARE SYSTEM
                  PAST, PRESENT AND FUTURE
             OSHER - W20- TUESDAYS – 11:15AM-12:45PM



OVERVIEW and DESCRIPTION:



        This course will study the efforts of all U.S. presidents from FDR to Obama to
reform the U.S. health care system. It will introduce the student to the development and
current functioning of the U.S. health care system regarding costs, coverage, quality and
outcomes. It will cover the organization, delivery and financing of the system and the
current policy debates about reforming this system.
         The course should be especially interesting and relevant because the subject of
health care reform is one of the most important domestic issues facing President Obama,
Congress and the nation in 2010. We will follow the continuing debate over health care
during the term and study and analyze the bills going through Congress (although not all
2,000 pages of them).



COURSE OBJECTICES:



         1. To understand what all presidents from FDR to Barack Obama have done or
            not done to change and reform the U.S. health care system.
         2. To understand the influence of significant political, economic, social and
            historical influences on the shaping of the American health care system and
            the making of health policy.
         3. To know in a general way the evolution of the health care system in the 20th
            century.
         4. To understand how the U.S. political system deals with health policy.
         5. To know the principal issues involved in the current debate about health
            care reform.
         6. To understand the overall organization, delivery and financing of health
            care in the U.S. and how the system works.
         7. To understand the relationships between the providers, payers, consumers
            and regulators in the system.




                                            1
COURSE FORMAT:


         A combination of lectures and class discussion. Chapters from The Heart of
Power, by Blumenthal and Morone, will be assigned each week along with several timely
handouts for class discussion. Students are encouraged to volunteer to lead class
discussions and to bring interesting and timely articles to the class.
         Videos and audios will also be played when appropriate. These and the handouts
will not be included on the syllabus as they should be timely, up-to-date, and often from
current news.
         Students are encouraged to make comments on personal or work experiences that
relates to ideas in the readings or lectures, to share your thoughts about ideas in the
readings or lectures that seem particularly interesting and insightful and to compare and
contrast any of the readings.


TEXTBOOK:

        David Blumental and James A. Morone, The Heart of Power, Health and Politics
in the Oval Office, University of California Press, 2009.


OPTIONAL READINGS:

        Paul Starr, The Social Transformation of Anerican Medicine, Basis Books, 1982.
        Donald A. Barr, Introduction to U.S. Health Policy, The Organization, Financing,
and Delivery of Health Care in America, 2nd. Ed. Johns Hopkins Un. Press, 2007.
        Theda Skocpol, Boomerang, Clinton’s Health Security Effort and the Turn
Against Government in U.S. Politics, W.W. Norton, 1996.
        Haynes Johnson and David S. Broder, The System: The American Way of Politics
at the Breaking Point, Little Brown, 1996.
        Bob LeBow, Health Care Meltdown, Confronting the Myths and Fixing Our
Failing System, JRI Press, 2002.
        Regina Herzlinger, Who Killed Health Care?: America’s $2 Trillion Medical
Problem – and the Consumer-Driven Cure, McGraw-Hill, 2007.
        Thomas Bedenheimer and Kevin Grumbach, Understanding Health Policy, A
Clinical Approach, McGraw-Hill, 2009.
        Ezekiel Emanuel, Healthcare, Guaranteed, A Simple, Secure Solution for
America, Perseus Books Group, 2008.
        Senator Tom Daschle, Critical, What We Can Do About the Health Care Crisis,
St. Martin’s Press, 2008.
        .R. Reid, The Healing of America, A Global Quest for Better, Cheaper, and
Fairer Health Care, The Penguin Press, 2009.
        Howard Dean, Howard Dean’s Prescription for Real Healthcare Reform, Chelsea
Green Publishing Co. 2009.



                                           2
DATE              ASSIGNMENT



March 30   Introduction
           Conclusion
           Chapter 1 – Franklin Delano Roosevelt
                         The Enigmatic Angler

April 6    Chapter 2 – Harry S. Truman
                         We’ll Take the Starch Out of Them-Eventually
           Chapter 3 – Dwight D. Eisenhower
                         Compassionate Conservative

April 13   Chapter 4 – John F. Kennedy
                         The Charismatic with a Stricken Father
           Chapter 5 – Lyndon B. Johnson
                         The Secret History of Medicare

April 20   Chapter 6 – Richard Nixon
                          The Flower That Bloomed Only in the Dark
           Chapter 7 – Jimmy Carter
                          The Righteous Engineer

April 27   Chapter 8 – Ronald Reagan
                         Socialized Medicine and the Working Stiff
           Chapter 9 – George H.W.Bush
                         Stick to the Running Game

May 4      Chapter 10 – Bill Clinton
                         Kicking the Can Down the Road

May 11     Chapter 11 – George W. Bush
                         Bring it On – Reforming Medicare
           Chapter ?? – Barack Obama
                         ???????????????????

May 18     Term Paper Due
           Final Exam




                                3
NEWSPAPTERS, JOURNALS, ORGANIZATIONS


The New York Times – www.nytimes.com/edhealth2009.com
The Wall St. Journal – www.wsj.com
The Washington Post – www.washingtonpost.com



Health Affairs – www.healthaffairs.org
The Journal of the American Medical Association – www.ama-assn.org
The New England Journal of Medicine – http://www.nejm.org




Campaign for America’s Future – http://home.ourfuture.org/healthforall/

Cato Institute – http://www.cato.org/healthcare/index.html

Center for American Progress –
http://www.americanprogress.org/projects/healthprogress/

Center for Economic and Policy Research – http://www.cepr.net

Center for Studying Health System Change – http://www.hschange.com/

Families USA – http://www.familiesusa.org

Heritage Foundation – http://www.heritage.org/research/healthcare/

Kaiser Family Foundation – http://www.kff.org

Progressive Policy Institute – http://ppionline.org

The Nelson Rockefeller Institute of Government– http://www.rockinst.org

The Robert Wood Johnson Foundation – http://www.healthreform.org



                                       4

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Osher Health Care Syllabus S10

  • 1. THE U.S. HEALTH CARE SYSTEM PAST, PRESENT AND FUTURE OSHER - W20- TUESDAYS – 11:15AM-12:45PM OVERVIEW and DESCRIPTION: This course will study the efforts of all U.S. presidents from FDR to Obama to reform the U.S. health care system. It will introduce the student to the development and current functioning of the U.S. health care system regarding costs, coverage, quality and outcomes. It will cover the organization, delivery and financing of the system and the current policy debates about reforming this system. The course should be especially interesting and relevant because the subject of health care reform is one of the most important domestic issues facing President Obama, Congress and the nation in 2010. We will follow the continuing debate over health care during the term and study and analyze the bills going through Congress (although not all 2,000 pages of them). COURSE OBJECTICES: 1. To understand what all presidents from FDR to Barack Obama have done or not done to change and reform the U.S. health care system. 2. To understand the influence of significant political, economic, social and historical influences on the shaping of the American health care system and the making of health policy. 3. To know in a general way the evolution of the health care system in the 20th century. 4. To understand how the U.S. political system deals with health policy. 5. To know the principal issues involved in the current debate about health care reform. 6. To understand the overall organization, delivery and financing of health care in the U.S. and how the system works. 7. To understand the relationships between the providers, payers, consumers and regulators in the system. 1
  • 2. COURSE FORMAT: A combination of lectures and class discussion. Chapters from The Heart of Power, by Blumenthal and Morone, will be assigned each week along with several timely handouts for class discussion. Students are encouraged to volunteer to lead class discussions and to bring interesting and timely articles to the class. Videos and audios will also be played when appropriate. These and the handouts will not be included on the syllabus as they should be timely, up-to-date, and often from current news. Students are encouraged to make comments on personal or work experiences that relates to ideas in the readings or lectures, to share your thoughts about ideas in the readings or lectures that seem particularly interesting and insightful and to compare and contrast any of the readings. TEXTBOOK: David Blumental and James A. Morone, The Heart of Power, Health and Politics in the Oval Office, University of California Press, 2009. OPTIONAL READINGS: Paul Starr, The Social Transformation of Anerican Medicine, Basis Books, 1982. Donald A. Barr, Introduction to U.S. Health Policy, The Organization, Financing, and Delivery of Health Care in America, 2nd. Ed. Johns Hopkins Un. Press, 2007. Theda Skocpol, Boomerang, Clinton’s Health Security Effort and the Turn Against Government in U.S. Politics, W.W. Norton, 1996. Haynes Johnson and David S. Broder, The System: The American Way of Politics at the Breaking Point, Little Brown, 1996. Bob LeBow, Health Care Meltdown, Confronting the Myths and Fixing Our Failing System, JRI Press, 2002. Regina Herzlinger, Who Killed Health Care?: America’s $2 Trillion Medical Problem – and the Consumer-Driven Cure, McGraw-Hill, 2007. Thomas Bedenheimer and Kevin Grumbach, Understanding Health Policy, A Clinical Approach, McGraw-Hill, 2009. Ezekiel Emanuel, Healthcare, Guaranteed, A Simple, Secure Solution for America, Perseus Books Group, 2008. Senator Tom Daschle, Critical, What We Can Do About the Health Care Crisis, St. Martin’s Press, 2008. .R. Reid, The Healing of America, A Global Quest for Better, Cheaper, and Fairer Health Care, The Penguin Press, 2009. Howard Dean, Howard Dean’s Prescription for Real Healthcare Reform, Chelsea Green Publishing Co. 2009. 2
  • 3. DATE ASSIGNMENT March 30 Introduction Conclusion Chapter 1 – Franklin Delano Roosevelt The Enigmatic Angler April 6 Chapter 2 – Harry S. Truman We’ll Take the Starch Out of Them-Eventually Chapter 3 – Dwight D. Eisenhower Compassionate Conservative April 13 Chapter 4 – John F. Kennedy The Charismatic with a Stricken Father Chapter 5 – Lyndon B. Johnson The Secret History of Medicare April 20 Chapter 6 – Richard Nixon The Flower That Bloomed Only in the Dark Chapter 7 – Jimmy Carter The Righteous Engineer April 27 Chapter 8 – Ronald Reagan Socialized Medicine and the Working Stiff Chapter 9 – George H.W.Bush Stick to the Running Game May 4 Chapter 10 – Bill Clinton Kicking the Can Down the Road May 11 Chapter 11 – George W. Bush Bring it On – Reforming Medicare Chapter ?? – Barack Obama ??????????????????? May 18 Term Paper Due Final Exam 3
  • 4. NEWSPAPTERS, JOURNALS, ORGANIZATIONS The New York Times – www.nytimes.com/edhealth2009.com The Wall St. Journal – www.wsj.com The Washington Post – www.washingtonpost.com Health Affairs – www.healthaffairs.org The Journal of the American Medical Association – www.ama-assn.org The New England Journal of Medicine – http://www.nejm.org Campaign for America’s Future – http://home.ourfuture.org/healthforall/ Cato Institute – http://www.cato.org/healthcare/index.html Center for American Progress – http://www.americanprogress.org/projects/healthprogress/ Center for Economic and Policy Research – http://www.cepr.net Center for Studying Health System Change – http://www.hschange.com/ Families USA – http://www.familiesusa.org Heritage Foundation – http://www.heritage.org/research/healthcare/ Kaiser Family Foundation – http://www.kff.org Progressive Policy Institute – http://ppionline.org The Nelson Rockefeller Institute of Government– http://www.rockinst.org The Robert Wood Johnson Foundation – http://www.healthreform.org 4