SOC POL 351- Topics in Social Policy: Social Policy and the US ...

SOC POL 351- Topics in Social Policy: Social Policy and the US Health Care
System
Winter Quarter, 2004
Mondays and Wednesdays, 4:00 p.m. to 5:30 p.m.
Location: Annenberg 345
Adjunct Faculty: Heidi Romans Nelson
Daytime Phone: 773-751-4107
Evening Phone: 847-424-0171
E-mail: hnelson@heartlandalliance.org
Office hours by appointment
Course Description: This course will introduce the student to the health care delivery
system in the United States through a review of US health policy issues. A construct for
review of major health policy issues will be introduced and current health policy issues
will be examined through this lens. Special attention will be paid to health disparities for
low-income and minority populations; and how policy decisions exacerbate or relieve
these issues. Interactive lecture, focused discussions and class activities relevant to
assigned readings and special topic areas will be the format for the course.
Requirements:
Readings:
Students must have completed SOC POL 201, Introduction to Social Policy, or
SESP 202, Introduction to Community Development.
Students are expected to attend and participate in class sessions. Bring assigned
readings to class and be prepared to discuss them.
One paper and two presentations will be assigned. One short paper will be
assigned on topics related to health disparities, and teams of students writing on
the same issue will be scheduled to make group presentations. One group
presentation will be assigned related to the health policy platforms of the US
presidential candidates.
Additionally, there will be an essay exam for the mid-term and a final paper
analyzing a national or state health policy issue.
Required:
A packet of copied readings will be available in Annenberg 123, Student Affairs
Office. A copying fee will be charged for this packet.

Some of the required readings are available on the internet; instructions for
accessing these documents are included in this syllabus. Internet readings are
marked with an asterisk (*).
Optional:
It is recommended that students read a daily newspaper for articles related to
health policy. National Public Radio is also a good resource for information on
health policy issues.
Theda Skocpol,Boomerang: Clinton’s Health Security Effort and the Turn against
Government in US Politics. New York, W.W. Norton & Company, 1996.
Paul Starr, The Social Transformation of American Medicine. New York, Basic
Books, 1984.
Course Grading:
Class Participation 10%
Health Disparities Paper and
Presentation 20%
Presidential Platform Presentation 10%
Mid-term 20%
Final Paper 40%
Attendance is expected. Students are responsible for all material and assignments
presented in class, as well as in required readings. Lectures may supplement,
highlight or bring something completely different from what is in the required
readings.
All work assigned is due at 4:00 p.m. on the specified due date. Assignments are
submitted by delivering a hard copy to the instructor, and sending an electronic
copy via electronic mail. In the event of a documented emergency, assignments
will be accepted. Any student with a legitimate excuse for missing class or
submitting a late assignment must contact the instructor prior to class time.
Unexcused late assignments will be downgraded, and participation grade will be
downgraded for unexcused absences.
Accommodations for Students with Disabilities
In compliance with Section 504 of the 1973 Rehabilitation Act and the Americans with
Disabilities Act, Northwestern University is committed to providing equal access to all
programming. Students with disabilities seeking accommodations are encouraged to
contact the office of Services for Students with Disabilities (SSD) at 467-5530 or

ssd@northwestern.edu. SSD is located in the basement of Scott Hall. SSD also has an
excellent website which is viewable at: http://www.stuaff.northwestern.edu/ssd/
Academic Integrity
Northwestern University students are expected to comply with policies found in the
booklet Academic Integrity at Northwestern. A copy of this booklet is found in section
four of the SESP handbook or on-line at http://www.northwestern.edu/uacc/. Infractions
may result in a grade of ‘F’ and/or probation or dismissal from the university.
Plagiarism
All papers submitted for credit for this course must be sent as electronic mail attachments
as well as delivered in printed form. Your written work may be electronically tested for
plagiarized content.
Course Calendar and Assignments Winter, 2004
January 5 Session 1
Review Syllabus and Assignments
January 7 Session 2
Overview of the US Health Care System
Readings
Strunk, B. and Ginsburg, P. (2003). “Tracking Health Care Costs: Trends
Stabilize But Remain High in 2002,” Health Affairs, 11 June, 2003:W3-266-W3-
274.
Anderson, G., Reinhardt, U. Hussey, P. and Petrosyan, V. (2003). “It’s the Prices,
Stupid: Why The United States Is So Different From Other Countries.” Health
Affairs, Vol. 22(3):89-105.
January 12 Session 3
Health Disparities
Readings
Keppel, RG, Pearch, JN, Wagener, DK (2002). ‘Trends in Racial and Ethnic-
Specific Rates for the Health Status Indicators: United States, 1990-1998,’
National Center for Health Statistics, Number 23:1-16.
Collins, KS, Hughes, DL, Doty, MM, Ives, BL, Edwards, JN, Tenney, K.
‘Diverse Communities, Common Concerns: Assessing Health Care Quality for
Minority Americans,’ The Commonwealth Fund, March, 2002.

(*)(skim) US Department of Health and Human Services, Office of Minority
Health, (2002). ‘Eliminating Racial and Ethnic Disparities in Health: The
National Leadership Summit on Eliminating Racial & Ethnic Disparities in
Health.’ Access www.summit.omhrc.gov/summitoolkit.pdf .
(Optional) View the video ‘You Can’t Tell by Looking.’ Access
www.amafoundation.org. Click on ‘Health Literacy.’
Assignment
Divide into groups to write individual papers and do group presentations on health
disparities. Identify issue to instructor by January 14. Group presentations are
February 2 and 4, individual papers are due February 4.
Diabetes/Latinos
Asthma in Urban Populations
Infant Mortality/Low-income and minority
Heart Disease/African-Americans
AIDS in Africa
Breast Cancer/Caucasian Women and African-American Women
(other topics may be chosen if sufficient interest exists)
January 14 Session 4
Health Disparities
Arrange groups for health disparities presentations and papers
Readings
Epstein, AM, Zyanian, JZ. (2001). ‘Racial Disparities in Medical Care,’ The New
England Journal of Medicine, Vol. 344(19): 1471-1473.
Katz, JN. (2001). ‘Patient Preferences and Health Disparities,’ JAMA, Vol.
286(12): 1506-1509.
Ashton, CM, et al. (2003). ‘Racial and Ethnic Disparities in the Use of Health
Services,’ Journal of General Internal Medicine, 18: 146-152.
January 19 Session 5 (Martin Luther King Day)
Discussion regarding NCHS tables 30, 32, 45, 46, 47 and 63.
Readings
(*) Health, United States, 2002, National Center for Health Statistics. Access
www.cdc.gov/nchs/ From home page, click on ‘Health, United States,’ under

‘Information Showcase.’ Click on ‘2002 Trend Tables.’ Review in particular
tables 30, 32, 45, 46, 47 and 63 for class discussion.
January 21 Session 6
Construct for review of social policies/health policies
January 26 Session 7
Construct for review of social policies/health policies
January 28 Session 8
Discussion
Assignment
Mid Term Essay Exam assigned due February 9
Koplan, JP, and Fleming, DW. (2000). Current and Future Public Health
Challenges. JAMA, Vol. 284(13): 1696-1698.
February 2 Session 9
Health Disparities Presentations
February 4 Session 10
Health Disparities Presentations
INDIVIDUAL PAPERS ON HEALTH DISPARITIES DUE
February 9 Session 11
Federal Health Policy-Making
MIDTERM EXAM DUE
February 11 Session 12
Federal Health Policy-Making
Researching Federal Health Policy
Assignment
Research health policy issue at federal level. Identify issue to instructor by
February 18. Research plan due February 25. Problem definition due March 8.
Final paper due March 17.
February 16 Session 13
Health Insurance: Basic Concepts and History
Readings

(*) Access www.uscensus.gov. Locate ‘Health Insurance Coverage: 2001.’
Thorpe, KE, and Knickman, JR (2002). ‘Financing for Health Care.’ In Health
Care Delivery in the United States, Eds. Kovner, AK, and Jonas, S. Springer
Publishing Co.: New York, 2002, pp. 44-67.
Gabel, J. et al. ‘Health Benefits in 2003: Premiums Reach Thirteen-Year High As
Employers Adopt New Forms of Cost Sharing,’ Health Affairs, Vol. 22(5): 117-
125.
Edwards, JN, Doty, MM, and Schoen, C. ‘The Erosion of Employer-Based Health
Coverage and the Threat to Workers’ Health Care,’ The Commonwealth Fund,
August, 2002.
Reinhart, UE. (1999). ‘Employer-Based Health Insurance: A Balance Sheet,’
Health Affairs, Vol. 18(6): 124-132.
Assignment
Volunteers divide into groups to research different solutions for the uninsured
National Health Insurance
Employer Tax Credits
Individual Tax Credits
Expansion of Medicare and Medicaid
February 18 Session 14
Health Insurance: Medicare and Medicaid
Readings
Moon, M. (2000). ‘Medicare Matters: Building on a Record of
Accomplishments,’ Health Care Financing Review, Vol. 22(1):9-22.
Rowland, D., and Garfield, R. (2000). ‘Health Care for the Poor: Medicaid at 35,’
Health Care Financing Review, Vol. 22(1):23-34.
Assignment
Divide into groups to research US Presidential candidates’ platforms on health
care. Presentations on March 1.
FINAL PAPER TOPIC DUE
February 23 Session 15

Managed Care
Readings
Friedman, E. (1996). ‘Capitation, Integration, and Managed Care,’ JAMA, Vol.
275: 957-962.
February 25 Session 16
Discussion: Solutions to the Uninsured
Readings
(*) Rosenberg, D., and Rankin, K. ‘Illinois’ Uninsured: Who They Are, Where
They Live.’ Access www.gileadcenter.org. Access paper from home page.
Committee on the Consequences of Uninsurance (2003). A Shared Destiny:
Effects of Uninsurance on Individuals, Families and Communities. Institute of
Medicine. Washington, DC: National Academy Press, pp. 1-7.
The Physicians’ Working Group for Single-Payer National Health Insurance
(2003). ‘Proposal of the Physicians’ Working Group for Single-Payer National
Health Insurance,’ JAMA, Vol. 290: 798-805.
Reinhardt, U. ‘Is There Hope for the Uninsured?’ Health Affairs Web Exclusives,
27 August, 2003.
FINAL PAPER RESEARCH PLAN DUE
March 1 Session 17
Presentations on Health Care Platforms of US Presidential Candidates
GROUP PRESENTATIONS ON HEALTH CARE PLATFORMS OF US
PRESIDENTIAL CANDIDATES DUE
March 3 Session 18
Special Populations: Homeless, HIV, Immigrants/Refugees
Guest Speakers
Ralph Pothel, MD, Heartland Health Outreach
Wendy Siegel, Millennia Consulting
Readings
O’Connell, J, (1999). ‘Utilization and Costs of Medical Services by Homeless
Persons,’ Health Care for the Homeless Branch, Division of Programs for Special

Populations, Bureau of Primary Health Care, US Department of Health and
Human Services.
(*) Siegel, WL, and Kappaz. ‘Strengthening Illinois’ Immigrant Policy:
Improving Health and Human Services for Immigrants and Refugees,’ Illinois
Immigrant Policy Project, Millennia Consulting, 2002. Access
www.consultmillenia.com. From home page, click on ‘Library.’ Click on report.
Lewin, ME, and Altman, S. (2000). America’s Safety Net: Intact but Endangered.
Institute of Medicine. Washington, DC: National Academy Press, pp. 47-80.
March 8 Session 19
The Uninsured
Guest Speaker
To be determined
FINAL PAPER PROBLEM DEFINITION DUE
March 10 Session 20
Group Discussion: Health Policy Final Paper Topics
Complete CTEC Evaluation
March 17
FINAL PAPER DUE