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NEW YORK UNIVERSITY
Robert F. Wagner School of Public Service |
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Mondays 4:30pm to 6:10pm
Institute of French Studies
15 Washington Mews
Basement Classroom
Prof. Victor Rodwin
Phone: 212-998-7459
Office: 4 Washington Square North, Rm. 51
E-mail: Victor.Rodwin@nyu.edu
Assistant: Zuzanna Kobrzynski: 212-998-7435, zk3@nyu.edu |
| COURSE DESCRIPTION |
| Health systems around the world
are grappling with problems of cost, access, equity and quality of health
care, and the tradeoffs between these objectives. Economic and political
reforms designed to promote markets, manage competition, organize systems
for public contracting, improve management, and change financial
incentives in the health sector have been debated in most countries, and
in many cases, implemented. While health system reform has received more
attention than public health, there has also been increasing attention to
what is often termed the "new public health." As reforms to improve
population health have been added to the political agenda, there have
been new efforts to rekindle health reform.
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| In this seminar, we will
apply some perspectives and tools of public policy analysis, and draw on
international comparisons of health systems to analyze efforts at health
system and public health reform. The readings, lectures and class
discussions should make students more knowledgeable about policy options
and policy changes in different countries. The seminar begins with a
discussion of the impact of globalization on public health and health
system reform. Next, we focus on ideas, concepts and theories of health
care reform. We then go on to explore OECD's database on health systems
and examine cases of health care reform in Great Britain, Germany, Japan,
Canada and France. Each case will apply a common, general framework for
analyzing health care reform while emphasizing a different aspect of
reform and a different approach to studying it. Students are encouraged to
select any country of their choice and become "experts" about the goals,
the process, the attempts to implement, and the obstacles encountered, in
their own examination of health system and public health reform. |
| Prerequisites |
| The seminar assumes that students will be familiar with policy analysis and with our current system of health care organization and financing in the United States. Courses such as P11.1022, P11.1830, P11.1834 or their equivalent, would provide good preparation.
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| Course requirements |
| Students must do all of the required reading before each class. They must also write several short briefs (2-page position papers) based on the readings. In addition, students must prepare a short paper (10-15 pages, double spaced) on some aspect of health system reform in a country of their choice. Alternatively, students may choose to compare system and public health reforms in two countries.
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| Teaching Method and Grading |
| Classes will consist of short lectures and questions aimed to provoke discussion about the readings and the issues they raise. There will also be many short student presentations and debates.
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| The position papers will count for 30 percent of the grade. The final paper will count for 70 percent of the grade. The grade may be raised or lowered by up to one half a letter based on class contributions.
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Required Books
- Francis Powell and Albert Wessen, eds. Health Care Systems in Transition: An International Perspective. Thousand Oaks, CA: Sage, 1999.
- International Health Reform. Special Issue of Health Affairs (18) 3, May/June 1999.
- Lynn Payer, Medicine and Culture. New York, Henry Holt, 1988.
- Marshall Raffel, Health Reform in Industrialized Nations. Pennsylvania: Pennsylvania State U. Press, 1997.
- Joseph White, Competing Solutions: American Health Care Proposals and International Experience. Washington, DC: Brookings Institute, 1995.
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| OUTLINE OF COURSE TOPICS AND READINGS |
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| INTRODUCTION |
- Introduction to Seminar
January 28
Baker, E. et. al., "Health Reform and the Health of the Public," JAMA (272)16, 1994.
(Article available on Blackboard.)
Coyne, J. and Hilsenrath, P, "The World Health Report 2000: Can Health Care Systems Be Compared Using a Single Measure of Performance?" American Journal of
Public Health (92)1, 2002. (Article available on Blackboard.)
Fielding, J. and Halton, N., "Where is the Health in Health System Reform?" JAMA (272)16,1994. (Article available on Blackboard.)
Navarro, Vincente, "The World Health Report 2000: Can Health Care Systems Be Compared Using a Single Measure of Performance?" American Journal of
Public Health (92)1, 2002. (Article available on Blackboard.)
The World Health Organization, The World Health Report 2000. http://www.who.int/whr/2000/en/report.htm
IDEAS, CONCEPTS AND THEORIES OF HEALTH CARE REFORM
- Globalization, Public Health and Health System Reform
February 4
Payer, Forward, Introduction and pp. 13-34
Powell and Wessen, Pt. I, especially Chapters 1 and 2
White, Chapters 1 and 6
Health Affairs, Karen Davis, pp. 135-143
Gill, W. "Globalisation of International Health," The Lancet (351) 9100, 1998. (Article available on Blackboard)
Zacher, M. "Global Epidemiological Surveillance: International Cooperation to Monitor Infectious Diseases," and Chen, L. Evans, T. and Cash, R. "Health as a Global Public Good," (both are in Kaul, Grunberg and Stern, eds. Global Public Goods)
- Managed Competition, Public Competition and Managed Care
February 11
Enthoven, A. "The History and Principles of Managed Competition," Health Affairs (12), Supplement, 1993.
White, Chapters 7 and 8
Saltman, R. and von Otter, "Public Competition versus Mixed Markets: An Analytical comparison,"
Health Policy, 11, 1991.
Glaser, W. "The Competition Vogue and Its Outcomes," The Lancet (341), 1993.
- OECD Health Data: Special Session in Computer Laboratory
February 18
Spend some time in the lab and select country for paper topic.
Work on first exercise.
Health Affairs, 178-192
Opitional Class: Prof. Donald Light on British Health Care Reform - February 21
CASE STUDIES OF HEALTH CARE REFORM
- Britain: Evolution of Reform
February 25
Light, D. "Policy Lessons From the British Health Care System," Ch. 13 in Powell and Wessen.
Raffel, pp. 227-262
Payer, 101-123
Enthoven, A. "In Pursuit of an Improving National Health Service," Health Affairs (19)3, 2000 (Article available on Blackboard.).
- Britain: Implementation of Recent Reforms
March 4
Health Affairs, pp. 40-46
Powell and Wessen, Chapters 14 and 15
Klein, R. "Big Bang Health Reform: Does It Work? The Case of Britain's 1991 NHS Reforms," Milbank Quarterly (73)3, 1995
Klein, R. "What's Happening to Britain's National Health Service?" New England Journal of Medicine (345)4, 2001. (Article available on blackboad.)
Spring Break
- Germany: "Manacled Competition?"
March 18
Payer, pp. 74-100
Raffel, pp. 77-104
Powell and Wessen, Chapters 4-6
Health Affairs, pp. 76-94
Optional Class: Prof. Christa Altenstetter on the German Health System Reform - March 21
- Japan: Low Costs, Good Health and Problems, Nevertheless
March 25
Raffel, pp. 105-134
Health Affairs, pp. 56-75
Ikegami, N. and Campbell, J. "Medical Care in Japan," New England Journal of Medicine (333) 1995:1295-1299. (Article available on Blackboard.)
Ikegami, "Public Long-Term Care Insurance in Japan," JAMA (278)16, October 1997. (Article available on Blackboard.)
- No Class; No Joke: Group Discussions on Presentation of Cases
April 1
- Canada: Evolution of Reform Efforts
April 8
White, Chapter 4
Powell and Wessen, Chapters 7 and 8
Raffel, pp. 1-28
- Canada: Recent Experience
April 15
Health Affairs, David Naylor, pp. 9-26
Powell and Wessen, Chapter 9
Optional Class: Prof. Raissa Deber on Canadian Health Reform - April 19
- France: Evolution of Reform Efforts
April 22
Payer, pp. 35-73
Raffel, pp.
White, Chapter 5
Rodwin and Sandier, "Health Care Under French NHI," Health Affairs, Fall 1993.
Lancry, P.J. and Sandier S. "Recent Changes in the Financing and Provision of Medical Services in France," Eurohealth. 43(3), (1998): 37-39
- France: Contemporary Debates
April 29
Rodwin, V. "The Rise of Managed Care in the United States: Lessons for French Health Policy," In C. Altenstetter and J. Bjorkman, eds., Health Policy Reform, National Variations and Globalization. New York: St. Martin's Press, 1997.
Durand-Zaleski, I., Colin, C. and Blum-Boisgard, C. "Preliminary Evaluation of an Attempt to Merge Mandatory Practice Guidelines and Cost Containment in France," British Medical Journal (315) 1997, pp. 9-20. (Article available on Blackboard.)
Sorum, P.C. "Striking Against Managed Care: The Last Gasp of la Medicine Liberale?" JAMA 280, no. 7 (1998): 659-664. (Article available on Blackboard.)
Sorum, P.C. "Two Tiers of Physicians in France: General Pediatrics Declines, General Practice Rises." JAMA 280, no. 12 (1998): 1099-1101. (Article available on Blackboard
COMPARATIVE EVALUATION OF HEALTH CARE REFORM
- Comparative Analysis: Case Presentations
May 6
Powell and Wessen, Chapters 14 and 15
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Short Bibliography on Health Care Reform
- C. Altenstetter and J. Bjorkman, eds., Health Policy Reform, National Variations and Globalization. New York: St. Martin's Press, 1997.
- O. Anderson, The Health Services Continum in Democratic States. Ann Arbor, MI: Health Administration Press, 1989.
- P. Basch, Textbook of International Health. Oxford: Oxford University Press, 1999.
- A. Bennett, and O. Adams, Looking North: What Can We Learn from Canada's Health Care System? San Francisco: Jossey-Bass, 1993.
- J. Campbell and N. Ikegami, The Art of Balance in Health Policy: Maintaining Japan's Low-Cost Egalitarian System. New York: Cambridge University Press, 1998.
- J. De Kervasdoue, J. Kimberly, and V. Rodwin, eds., The End of an Illusion: The Future of Health Policy in Western Industrialized Nations. Berkeley: University of California Press, 1984.
- A. Ellenweig, Analyzing Health Systems: A Modular Approach. New York: Oxford University Press, 1992.
- M. Field, ed., Success and Crisis in National Health Systems. New York: Routledge, 1989.
- D. Fox, Health Policies, Health Politics. Princeton, NJ: Princeton University Press, 1986.
- R. Freeman, The Politics of Health in Europe. Manchester and New York: Manchester University Press
- W. Glaser, Health Insurance in Practice: International Variations in Financing, Benefits, and Problems. San Francisco: Jossey-Bass, 1991.
- L. Graig, Health of Nations: An International Perspective on U.S. Health Care Reform. Washington, DC: CQ Press, 1999.
- Health Affairs, Pursuit of Health Systems Reform (Special Issue), 10, Fall 1991.
- J. Hurst, The Reform of Health Care: A Comparative Analysis of Seven OECD Countries. Paris: OECD, 1992.
- E. Immergut, Health Politics: Interests and Institutions in Western Europe. New York: Cambridge University Press, 1992.
- Investing in Health: World Bank Development Report. Washington, DC: World Bank, 1993.
- M. Jerome-Forget, J. White, and J. Weiner, eds., Health Care Reform through Internal Markets: Experience and Proposals. Washington, DC: Brookings Institute for Research on Public Policy, 1995.
- Journal of Health Policy, Politics and Law, "Comparative Health Policy" Special Issue, 17, Winter 1992.
- R. Klein, The New Politics of NHS, third edition. London: Longman, 1995.
- M. Lassey, W. Lassey, and M. Jinks, Health Care Systems Around the World. Upper Saddle River, NJ: Prentice Hall, 1997.
- H.M. Leichter, A Comparative Approach to Policy Analysis: Health Care Policy in Four Nations. Cambridge: Cambridge University Press, 1979.
- J. Merril, The Road to Health Care Reform. New York: Plenum, 1994.
- OECD, The Reform of Health Care: A Comparative Analysis of Seven OECD Countries (Paris: OECD, 1992).
- OECD, Health: Quality and Choice. Paris: Author, 1994.
- OECD, New Directions in Health Policy. Paris: Author, 1995.
- OECD, Health Care Reform: The Will to Change. Paris: Author 1996.
- OECD, Internal Markets in the Making: Health Systems in Canada, Iceland and the United Kingdom. Paris: Author, 1995.
- L. Payer, Medicine and Culture: Varieties of Treatment in the United States, England, West Germany and France. New York: Henry Holt, Owl Book Edition, 1996.
- M. Raffel, ed., Health Care Reform in Industrial Countries. University Park, PA: Pennsylvania State University Press, 1997.
- V. Rodwin, The Health Planning Predicament: France, Quebec, England and the United States. Berkeley: University of California Press, 1984.
- M. Roemer, National Health Systems of the Worlds (Vols. 1 and 2). New York: Oxford, 1991.
- R. Saltman, and C. Von Otter, Planned Markets and Public Competition: Strategic Reform in Northern Europe Health Systems. Philadelphia: Open University Press, 1992.
- R. Saltman, and C. Von Otter, Implementing Health Care Reform. Bristol. PA: Open University Press, 1995.
- R. Saltman and J. Figueras, European Health Care Reform. Copenhagen: World Health Organization, 1997.
- A. Wall, ed., Health Care Systems in Liberal Democracies. London: Routledge, 1996.
- J. White, Competing Solutions: American Health Care Proposals and International Experience. Washington, DC: Brookings Institution, 1995.
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Websites
- OECD/Education, Employment, Labour and Social Policy Directorate: Click Here
OECD in Figures: Click Here
OECD Free On-Line Documents: Click Here
- International Clearinghouse of Health System Reform Initiatives (ICHSRI): Click Here
- European Clearing House on Health Systems Reform: Click Here
- Clearinghouse on Health Sector Reform in Latin America and the Caribbean: Click Here
- Publications of the International Health Systems Group (IHSG): Click Here
- Centers for Disease Control and Prevention: Click Here
- UNAIDS - The Joint UN Programme on HIV/AIDS: Click Here
- United Nations Children's Fund (UNICEF) works for children worldwide: Click Here
- United Nations Development Programme: Click Here
- United Nations Population Fund - UNFPA: Click Here
- UN International Drug Control Programme: Click Here
- UNESCO home page - United Nations Educational, Scientific and Cultural Organization: Click Here
- United Nations' InfoNation: Click Here
- WHO/OMS: World Health Organization: Click Here
WHO Statistical Information System (WHOSIS): Click Here
WHO Europe: Click Here
- The World Bank Group: Click Here
Development Data: Click Here
Health Reform Online: Click Here
- International Longevity Center - USA, Ltd.: Click Here
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