PubH 6556 Health and Health Systems Fall...

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https://docs.google.com/a/umn.edu/file/d/0B7LWJ83cOEeeR1IyeDE2WkJ0cHc/edit PubH 6556 Health and Health Systems Fall 2013 Credits: 3 Meeting Days: Tuesdays, September 3 – December 10 Meeting Time: 9:05 – 11:45 am Meeting Place: W2-110 WDH Instructor: Jon B. Christianson Office Address: 15-225 Phillips Wangensteen Building Office Phone: 612-625-3849 Fax: 612-624-2196 E-mail: [email protected] Office Hours: By Appointment I. Course Description The course provides an overview of the U.S. health care system and current health policy issues. Topics are addressed from a health care management perspective. II. Course Prerequisites Students must be admitted to the University of Minnesota’s Master in Healthcare Administration Program or have consent of the instructor. III. Course Goals and Objectives Specific goals and learning objectives are listed below for each class session. IV. Methods of Instruction and Work Expectations Each topic will be introduced during the assigned class period through a didactic presentation on the part of the instructor. For each class session, PowerPoint slides and related material will be posted on the Moodle website for downloading and viewing. (To learn more about Moodle, watch Moodle: Online Orientation for Students and/or visit the Moodle support website at http://www1.umn.edu/moodle/, which has a link for “Student support” with user guides, help and FAQs.) Significant health care organization and policy issues will be identified and discussed, referencing the readings for the class period. From time to time, the class will be asked to read and discuss a short article distributed during class. In most classes, student teams will present policy “briefs” to the class on pre-assigned topics. Students will be expected to prepare for each class by completing the readings and assignments prior to class and participating in the discussion of those readings during class. 1

Transcript of PubH 6556 Health and Health Systems Fall...

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    PubH 6556 Health and Health Systems Fall 2013

    Credits: 3

    Meeting Days: Tuesdays, September 3 – December 10

    Meeting Time: 9:05 – 11:45 am

    Meeting Place: W2-110 WDH

    Instructor: Jon B. Christianson

    Office Address: 15-225 Phillips Wangensteen Building

    Office Phone: 612-625-3849

    Fax: 612-624-2196

    E-mail: [email protected]

    Office Hours: By Appointment

    I. Course Description The course provides an overview of the U.S. health care system and current health policy issues. Topics are addressed from a health care management perspective.

    II. Course Prerequisites Students must be admitted to the University of Minnesota’s Master in Healthcare Administration Program or have consent of the instructor.

    III. Course Goals and Objectives Specific goals and learning objectives are listed below for each class session.

    IV. Methods of Instruction and Work Expectations Each topic will be introduced during the assigned class period through a didactic presentation on the part of the instructor. For each class session, PowerPoint slides and related material will be posted on the Moodle website for downloading and viewing. (To learn more about Moodle, watch Moodle: Online Orientation for Students and/or visit the Moodle support website at http://www1.umn.edu/moodle/, which has a link for “Student support” with user guides, help and FAQs.) Significant health care organization and policy issues will be identified and discussed, referencing the readings for the class period. From time to time, the class will be asked to read and discuss a short article distributed during class. In most classes, student teams will present policy “briefs” to the class on pre-assigned topics. Students will be expected to prepare for each class by completing the readings and assignments prior to class and participating in the discussion of those readings during class.

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    http://www1.umn.edu/moodle/

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    V. Course Text and Readings 1. All suggested readings have links to the article following the cite. Click on the link to access the reading. If you have any

    problems accessing assigned readings online, contact Jane Raasch at [email protected]. If you do not have a University of Minnesota Internet ID and password, call 301-HELP and support staff will help you set up an account (or set up your own account at www.umn.edu/initiate and follow the directions.)

    2. The readings for each class session are divided into two parts: “Suggested” readings and “Further” readings. The suggested readings are organized by subtopic. For some sessions, the list of suggested readings is long, but many individual readings are quite brief. There are no “Required” readings. The more of the suggested readings that you are able to complete, the better prepared you will be for your quizzes, assignments, and class discussion; and, the better prepared you will be for your career. In sessions where there are a large number of suggested readings, you may want to divide responsibility among study group members, with each member summarizing a subset of readings. The “Further” readings provide additional information on the topics covered in each session. They are intended to be useful in clarifying areas that you feel are not covered adequately in the suggested readings, or in providing additional information on topics of particular interest to you. The following sources of information are useful in keeping up-to-date on current developments in the health care system and in health policy.

    Newspapers: New York Times (liberal perspective) Wall Street Journal (conservative perspective) Washington Post (political issues) Daily Feeds (all free): Kaiser Daily Health Policy Report/Kaiser Health News AHIP Solutions Smart Brief Ramlett, Morning Consult Websites with short “Research Briefs” on Various Health Care Topics: Center for Studying Health System Change Urban Institute MPR (Mathematica Policy Research) AcademyHealth

    VI. Course Outline/Weekly Schedule Session/Week Topics

    The U.S. Health Care System and Prospects for Reform 1 Sept. 3 Health System Performance: From Three-Legged Stool to the Triple Aim – Cost and

    Population Health 2 Sept. 10* Health System Performance: From Three-Legged Stool to the Triple Aim – Patient

    Experience [Assignment 1 due, 5 pts.]

    3 Sept. 17 The Health Policy Process: Crabs in a Bucket? Care Delivery

    4 Sept. 24 The Physician Workforce: Characteristics, Training and Projections of Future Need 5 Oct. 1 Rethinking Primary Care: What is the Future for the Family Doctor?

    [Assignment 2 due, 10 pts.] 6 Oct. 8 The Nurse Workforce: “Is There a Nurse in the House?” 7, 8 Oct. 15,

    22 The Hospital: From Doctors’ Workshop to “Big Med”

    9 Oct. 29 Long-Term Care: Balancing What We Want With What We Will Pay For [Quiz 1: Material from Sessions 1-8, 30 pts.]

    10 Nov. 5 Medical Technology and Devices: At the Cutting Edge 11 Nov. 12 Pharmaceuticals: A Regulatory Rubik’s Cube

    Financing 12 Nov. 19 Health Insurance, Uninsurance, and the Private Health Insurance Market: What Works, What

    Doesn’t and How Will Health Reform Change It? 13 Nov. 26 Medicaid: Can This “Vast Public Enterprise” Be Sustained?

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    14 Dec. 3 Financing Care for Seniors: Down the Medicare Rabbit Hole [Assignment 3 Due, 10 pts.]

    15 Dec. 10 Medicare: A Program at the Brink? [Quiz 2: Material from Sessions 9-15, 30 pts.]

    *For this class, you will listen to an audio lecture synchronized to PowerPoints. The main focus will be on patient safety. There will be a guest speaker on this topic and you will have a short assignment to complete and submit to the instructor by e-mail prior to the class.

    The U.S. Health Care System and Prospects for Reform

    Session 1 – September 3, 2013 Health System Performance: From Three-Legged Stool to the Triple Aim – Cost and Population Health The U.S. health care system is incredibly complex (some would call it a “non-system”), characterized by a variety of different financing mechanisms and delivery systems. In first two sessions of the course, we examine how the U.S. health care system performs relative to components of the Triple Aim: per capita costs, patient experience, and population health. We also compare the performance of the U.S. health care system to systems in other countries. Learning Objectives – Session 1 Students should be able to:

    1. Discuss the different components of the Triple Aim and the performance of the U.S. health care system relative to: • Cost per capita: components of costs, drivers of cost growth, variation in costs • Population health

    2. Compare and contrast different views regarding whether, or under what circumstances, health care expenditures that grow at a faster rate than the rest of the economy should be regarded with concern.

    3. Discuss and explain differences between the U.S. and other countries in health care costs and population health 4. Discuss evidence on geographic variation in health care costs in the United States.

    Suggested Readings The Triple Aim

    1*. Berwick, D.M., Nolan, T.W., Whittington, J. “The triple aim: Care, health and cost.” Health Affairs 27(3):759-769, 2008. http://content.healthaffairs.org/content/27/3/759.full.pdf+html

    2. Cauchon, D. “Health care spending is transferred out of ICU.” USA Today, March 4, 2013. Available at: http://www.usatoday.com/story/news/health/2013/03/04/health-care-spending-growth-slows/1963165/

    Spending on Health Care Trends

    1* The Henry J. Kaiser Family Foundation. “Health care costs. A primer.” May 2012. Available at: http://www.kff.org/insurance/upload/7670-03.pdf

    2. Barnes, K. “Behind the health spending numbers.” Health Affairs Blog, June 18, 2013. Available at: http://healthaffairs.org/blog/2013/06/18/behind-the-health-spending-numbers/

    3. Roehrig, C. “U.S. health spending as a share of GDP – Where are we headed?” Altarum Institute, July 16, 2013. Available at: http://www.altarum.org/forum/post/us-health-spending-share-gdp-where-are-we-headed

    Geographic Variation in Health Spending 1*. Rau, J. “Medicare spending variations mostly due to health differences, study concludes.” Kaiser Health News, May 28, 2013.

    Available at: http://www.kaiserhealthnews.org/Stories/2013/May/28/medicare-state-geographic-variation-costs.aspx 2. Joynt, K.E., Jha, A.K. “The relationship between cost and quality. No free lunch.” Journal of the American Medical Association

    307(10):1082-1083, 2012. Available at: http://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=22493&direction=P Views Regarding Health Spending 1*. Pauly, M.V. “The trade-off among quality, quantity, and cost: How to make it—if we must.” Health Affairs 30(4):574-580, 2011.

    http://content.healthaffairs.org/content/30/4/574.full.pdf+html 2. RWJF. “Consumer attitudes on health care costs: Insights from focus groups in four U.S. cities.” January 2013. Available at:

    http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf403428 3*. Altman, D., Levitt, L. “We still have a health-care spending problem.” Washington Post, April 21, 2012. Available at:

    http://articles.washingtonpost.com/2013-04-21/opinions/38717666_1_health-spending-health-costs-health-care-spending 4. Douthat, R. “Conservatives and health care costs.” New York Times, May 15, 2013. Available at:

    http://douthat.blogs.nytimes.com/2013/05/15/conservatives-and-health-care-costs/?_r=0

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    http://content.healthaffairs.org/content/27/3/759.full.pdf+htmlhttp://www.usatoday.com/story/news/health/2013/03/04/health-care-spending-growth-slows/1963165/http://www.kff.org/insurance/upload/7670-03.pdfhttp://healthaffairs.org/blog/2013/06/18/behind-the-health-spending-numbers/http://www.altarum.org/forum/post/us-health-spending-share-gdp-where-are-we-headedhttp://www.kaiserhealthnews.org/Stories/2013/May/28/medicare-state-geographic-variation-costs.aspxhttp://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=22493&direction=Phttp://content.healthaffairs.org/content/30/4/574.full.pdf+htmlhttp://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf403428http://articles.washingtonpost.com/2013-04-21/opinions/38717666_1_health-spending-health-costs-health-care-spendinghttp://douthat.blogs.nytimes.com/2013/05/15/conservatives-and-health-care-costs/?_r=0

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    Drivers of Growth in Spending 1. Acaramenico. “Poll of emergency physicians shows more than half order tests as protection against being sued.” May 26, 2011

    Available at: http://californiaprevailingwage.wordpress.com/2011/05/26/poll-of-emergency-physicians-shows-more-than-half-order-tests-as-protection-against-being-sued/

    2*. Rao, A. “IOM report focuses on $750 billion in inefficient health care spending.” Kaiser Health News Blog, September 6, 2012. Available at: http://capsules.kaiserhealthnews.org/index.php/2012/09/iom-report-focuses-on-750-billion-in-inefficient-health-care- spending/

    3*. Appleby, J. “Higher prices charged by hospitals, other providers, drove health spending during downturn.” Kaiser Health News, May 21, 2012. Available at: http://www.kaiserhealthnews.org/Stories/2012/May/21/higher-health-care-prices-hospitals.aspx

    4*. Kliff, S. “Over next two decades, obesity could cost us $550 billion.” The Washington Post, September 18, 2012. Available at: http://www.washingtonpost.com/blogs/wonkblog/wp/2012/09/18/over-next-two-decades-obesity-could-cost-us-550-billion/ 5. Porter, E. “Health care’s overlooked cost factor.” New York Times, June 11, 2013. Available at:

    http://www.nytimes.com/2013/06/12/business/examinations-of-health-costs-overlook-mergers.html?pagewanted=all 6. Rosenthal, E. “The $2.7 trillion medical bill.” New York Times, June 1, 2013. Available at:

    http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?pagewanted=all

    7. Gordon, J. “The medical arms race.” Minnesota Medicine, February 2007. Available at: http://www.minnesotamedicine.com/PastIssues/PastIssues2007/February2007/FeatureFebruary2007.aspx

    8. Fuchs, V.R. “The gross domestic product and health care spending.” New England Journal of Medicine May 22, 2013. Available at: http://www.nejm.org/doi/full/10.1056/NEJMp1305298

    9. Rosenberg, Y. “Do you really need that test? Doctors warn on 90 treatments.” The Fiscal Times, February 21, 2013. Available at: http://www.thefiscaltimes.com/Articles/2013/02/21/Doctors-Warn-on-90-Overused-Medical-Treatments.aspx#page1

    10. Hiatt, K. “9 warning signs of bad care.” US News, February 26, 2013. Available at: http://health.usnews.com/health-news/best-nursing-homes/articles/2013/02/26/9-warning-signs-of-bad-care

    11. Pittman, G. “Unnecessary repeat cholesterol tests common: study.” Reuters, July 1, 2013. Available at: http://www.reuters.com/article/2013/07/01/us-unnecessary-repeat-cholesterol-idUSBRE96015420130701

    Population Health Trends

    1. Gardner, A. “America’s health a mixed bag: Report.” Health, February 16, 2011. Available at: http://news.health.com/2011/02/16/americas-health-a-mixed-bag-report/

    2*. Kelly, J. “Boomers live longer, but sicker, than parents.” Pittsburgh Post-Gazette, March 4, 2013. Available at: http://www.post- gazette.com/stories/news/health/boomers-live-longer-but-sicker-than-parents-677824/ 3*. Winslow, R. “Americans are living longer, but not necessarily healthier, study shows.” The Wall Street Journal, July 10, 2013.

    Available at: http://online.wsj.com/article/SB10001424127887324694904578597444105321914.html 4. US Burden of Disease Collaborators. “The state of US health, 1990-2010. Burden of diseases, injuries, and risk factors.” Journal

    of the American Medical Association, Published online July 10, 2013. Available at: http://jama.jamanetwork.com/onlineFirst.aspx 5. Pitman, D. “Gains made, but U.S. still lags in life expectancy.” MedPage Today, July 10, 2013. Available at:

    http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/40381 Illness-specific Measures

    1. Reinberg, S. “U.S. cancer death rate continues to drop.” USA Today, July 8, 2010. Available at: http://www.usatoday.com/news/health/2010-07-08-cancer-deaths_N.htm

    2. HealthDay. “Asthma cases continue to rise in U.S., affecting millions.” May 15, 2012. Available at: http://consumer.healthday.com/Article.asp?AID=664789

    3. USA Today. “Percentage of severely obese adults skyrockets.” October 1, 2012. Available at: http://www.usatoday.com/story/news/nation/2012/10/01/severely-obese-americans-increasing/1606469/

    4. Reuters. “U.S. cholesterol levels decline: Study.” October 16, 2012. Available at: http://www.reuters.com/article/2012/10/16/health-cholesterol-idUSL3E8LG7C120121016

    5. Reinberg, S. “Nearly 30 percent of Americans have high blood pressure: CDC.” WebMD News from HealthDay, April 4, 2013. Available at: http://www.webmd.com/hypertension-high-blood-pressure/news/20130404/nearly-30-percent-of-americans-have-high-blood-pressure-cdc

    Disparities 1*. HealthDay News. “Health disparities persist in U.S., report shows.” January 13, 2011. Available at:

    http://health.usnews.com/health-news/family-health/heart/articles/2011/01/13/health-disparities-persist-in-us-report-shows 2. Kaiser Health News. “Race plays role in diagnosis and treatment.” July 24, 2009. Available at:

    http://www.kaiserhealthnews.org/daily-reports/2009/july/24/racial-disparities.aspx?referrer=search 3. Tavernise, S. “The health toll of immigration.” New York Times, May 18, 2013. Available at:

    http://www.nytimes.com/2013/05/19/health/the-health-toll-of-immigration.html?pagewanted=all

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    http://californiaprevailingwage.wordpress.com/2011/05/26/poll-of-emergency-physicians-shows-more-than-half-order-tests-as-protection-against-being-sued/http://californiaprevailingwage.wordpress.com/2011/05/26/poll-of-emergency-physicians-shows-more-than-half-order-tests-as-protection-against-being-sued/http://capsules.kaiserhealthnews.org/index.php/2012/09/iom-report-focuses-on-750-billion-in-inefficient-health-care-%09spending/http://capsules.kaiserhealthnews.org/index.php/2012/09/iom-report-focuses-on-750-billion-in-inefficient-health-care-%09spending/http://www.kaiserhealthnews.org/Stories/2012/May/21/higher-health-care-prices-hospitals.aspxhttp://www.washingtonpost.com/blogs/wonkblog/wp/2012/09/18/over-next-two-decades-obesity-could-cost-us-550-billion/http://www.nytimes.com/2013/06/12/business/examinations-of-health-costs-overlook-mergers.html?pagewanted=allhttp://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?pagewanted=allhttp://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?pagewanted=allhttp://www.minnesotamedicine.com/PastIssues/PastIssues2007/February2007/FeatureFebruary2007.aspxhttp://www.nejm.org/doi/full/10.1056/NEJMp1305298http://www.thefiscaltimes.com/Articles/2013/02/21/Doctors-Warn-on-90-Overused-Medical-Treatments.aspx%23page1http://health.usnews.com/health-news/best-nursing-homes/articles/2013/02/26/9-warning-signs-of-bad-carehttp://health.usnews.com/health-news/best-nursing-homes/articles/2013/02/26/9-warning-signs-of-bad-carehttp://www.reuters.com/article/2013/07/01/us-unnecessary-repeat-cholesterol-idUSBRE96015420130701http://news.health.com/2011/02/16/americas-health-a-mixed-bag-report/http://online.wsj.com/article/SB10001424127887324694904578597444105321914.htmlhttp://jama.jamanetwork.com/onlineFirst.aspxhttp://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/40381http://www.usatoday.com/news/health/2010-07-08-cancer-deaths_N.htmhttp://consumer.healthday.com/Article.asp?AID=664789http://www.usatoday.com/story/news/nation/2012/10/01/severely-obese-americans-increasing/1606469/http://www.reuters.com/article/2012/10/16/health-cholesterol-idUSL3E8LG7C120121016http://www.webmd.com/hypertension-high-blood-pressure/news/20130404/nearly-30-percent-of-americans-have-high-blood-pressure-cdchttp://www.webmd.com/hypertension-high-blood-pressure/news/20130404/nearly-30-percent-of-americans-have-high-blood-pressure-cdchttp://health.usnews.com/health-news/family-health/heart/articles/2011/01/13/health-disparities-persist-in-us-report-showshttp://www.kaiserhealthnews.org/daily-reports/2009/july/24/racial-disparities.aspx?referrer=searchhttp://www.nytimes.com/2013/05/19/health/the-health-toll-of-immigration.html?pagewanted=all

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    4*. Goodell, S., Escarce, J.J. “Racial and ethnic disparities in access to and quality of health care.” Policy Brief 12, The Synthesis Project, Robert Wood Johnson Foundation, September 2007. Available at: http://www.rwjf.org/en/research-publications/find-rwjf-research/2007/09/racial-and-ethnic-disparities-in-access-to-and-quality-of-health.html

    International Comparisons Costs/Population Health

    1. Baker, S. “Study: US leads in healthcare spending, but ranks last in health.” The Hill’s Healthcare Blog, May 12, 2011. Available at: http://thehill.com/blogs/healthwatch/public-global-health/160845-study-us-leads-in-healthcare-spending-but-ranks-last-in- health-

    3. Fox, M. “Survey shows Americans pay a lot more for health care." NationalJournal, March 25, 2012. Available at: http://www.nationaljournal.com/healthcare/survey-shows-americans-pay-a-lot-more-for-health-care-20120304

    4. Laugesen, M.J., Glied, S.A. “Higher fees paid to U.S. physicians drive higher spending for physician services compared to other countries.” Health Affairs 30(9):1647-1656, 2011. http://content.healthaffairs.org/content/30/9/1647.full.pdf+html

    5. Goodwin, J. “Americans have worse health than English peers, study finds.” US News, March 9, 2011. Available at: http://health.usnews.com/health-news/family-health/boomer-health/articles/2011/03/09/americans-have-worse-health-than-english-peers-study-finds

    6*. Fuchs, V.R. “How and why US health care differs from that in other OECD countries.” New England Journal of Medicine 309(1):33-34, 2013. Available at: http://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=926163&direction=P

    7. Heavey, S. “Obesity, lack of insurance cited in U.S. health gap.” Reuters, January 9, 2013. Available at: http://www.reuters.com/article/2013/01/09/us-usa-health-ranking-idUSBRE9080ZN20130109

    8. Goldhill, D. “Other nations don’t compare to U.S. health care.” Bloomberg, June 20, 2013. Available at: http://www.bloomberg.com/news/2013-06-20/what-the-world-can-t-tell-us-about-health-care.html

    Further Readings

    1. Wayne, A. “Health cost growth slows further even as economy rebounds.” Bloomberg, June 18, 2013. Available at: http://www.bloomberg.com/news/2013-06-18/health-cost-growth-slows-further-even-as-economy-rebounds.html

    2. Goldhill, D. “Focus on health-care costs causes more spending.” Bloomberg, January 1, 2013. Available at: http://www.bloomberg.com/news/2013-01-01/focus-on-health-care-costs-causes-more-spending.html

    3. Kaiser Family Foundation. “Assessing the effects of the economy on the recent slowdown in health spending.” April 2013. Available at: http://kff.org/health-costs/issue-brief/assessing-the-effects-of-the-economy-on-the-recent-slowdown-in-health-spending-2/

    4. Steuerle, G. “A slower rate of health cost growth? What happens when an irresistible force meets an increasingly immovable object.” Altarum Institute Health Policy Forum, May 10, 2013. Available at: http://www.altarum.org/forum/post/slower-rate-health-cost-growth-what-happens-when-irresistible-force-meets-increasingly

    5. Samuelson, R.J. “Is the health-care spending slowdown for real?” The Washington Post, May 19, 2013. Available at: http://articles.washingtonpost.com/2013-05-19/opinions/39376698_1_affordable-care-act-affordable-health-coverage-health-affairs

    6. Lowrey, A. “Slowdown in health costs’ rise may last as economy revives.” The New York Times, May 6, 2013. 7. Klein, E. “One way Obamacare may already be working.” Bloomberg, May 29, 2013. Available at:

    http://www.bloomberg.com/news/2013-05-29/one-way-obamacare-may-already-be-working.html 8. Eligon, J. “An oil boom takes a toll on health care.” The New York Times, January 27, 2013. Available at:

    http://www.nytimes.com/2013/01/28/us/boom-in-north-dakota-weighs-heavily-on-health-care.html?_r=0&gwh=BE712B27B95AE737019CF8BBC3FD40D7

    9. Philipson, T., Eber, M., Lakdawalla, D.N., Corral, M., Conti, R., Goldman, D.P. “An analysis of whether higher health care spending in the United States versus Europe is ‘worth it’ in the case of cancer.” Health Affairs 31(4):667-675, 2012. Available at: http://content.healthaffairs.org/content/31/4/667.full.pdf+html

    10. Lawrence, B.R. “Cutting U.S. health-care costs doesn’t have to be harmful.” The Washington Post online, July 26, 2012. Available at: http://www.washingtonpost.com/opinions/cutting-us-health-care-costs-doesnt-have-to-be-painful/2012/07/26/gJQA1ZzJCX_story.html

    11. Ledger, K. “Healthiest state?” Minnesota Medicine, May 2012. Available at: http://www.minnesotamedicine.com/PastIssues/May2012/HealthiestState.aspx

    12. Goldsmith, J. “Barking up the wrong tree: Affordability, not cost growth, is the policy challenge.” Health Affairs Blog, May 7, 2012. Available at: http://healthaffairs.org/blog/2012/05/07/barking-up-the-wrong-tree-affordability-not-cost-growth-is-the-policy-challenge/

    13. Healy, M. “Obesity in U.S. projected to grow, though pace slows: CDC study.” LA Times online, May 7, 2012. Available at: http://articles.latimes.com/2012/may/07/news/la-heb-obesity-projection-20120507

    14. Kenney, G.M., McMorrow, S., Zuckerman, S., Goin, D.E. “A decade of health care access declines for adults holds implications for changes in the Affordable Care Act.” Health Affairs 31(5):899-908, 2012. Available at: http://content.healthaffairs.org/content/31/5/899.full.pdf+html

    5

    http://www.rwjf.org/en/research-publications/find-rwjf-research/2007/09/racial-and-ethnic-disparities-in-access-to-and-quality-of-health.htmlhttp://www.rwjf.org/en/research-publications/find-rwjf-research/2007/09/racial-and-ethnic-disparities-in-access-to-and-quality-of-health.htmlhttp://thehill.com/blogs/healthwatch/public-global-health/160845-study-us-leads-in-healthcare-spending-but-ranks-last-in-%20health-http://thehill.com/blogs/healthwatch/public-global-health/160845-study-us-leads-in-healthcare-spending-but-ranks-last-in-%20health-http://www.nationaljournal.com/healthcare/survey-shows-americans-pay-a-lot-more-for-health-care-20120304http://content.healthaffairs.org/content/30/9/1647.full.pdf+htmlhttp://health.usnews.com/health-news/family-health/boomer-health/articles/2011/03/09/americans-have-worse-health-than-english-peers-study-findshttp://health.usnews.com/health-news/family-health/boomer-health/articles/2011/03/09/americans-have-worse-health-than-english-peers-study-findshttp://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=926163&direction=Phttp://www.reuters.com/article/2013/01/09/us-usa-health-ranking-idUSBRE9080ZN20130109http://www.bloomberg.com/news/2013-06-20/what-the-world-can-t-tell-us-about-health-care.htmlhttp://www.bloomberg.com/news/2013-06-18/health-cost-growth-slows-further-even-as-economy-rebounds.htmlhttp://www.bloomberg.com/news/2013-01-01/focus-on-health-care-costs-causes-more-spending.htmlhttp://www.bloomberg.com/news/2013-01-01/focus-on-health-care-costs-causes-more-spending.htmlhttp://kff.org/health-costs/issue-brief/assessing-the-effects-of-the-economy-on-the-recent-slowdown-in-health-spending-2/http://kff.org/health-costs/issue-brief/assessing-the-effects-of-the-economy-on-the-recent-slowdown-in-health-spending-2/http://www.altarum.org/forum/post/slower-rate-health-cost-growth-what-happens-when-irresistible-force-meets-increasinglyhttp://www.altarum.org/forum/post/slower-rate-health-cost-growth-what-happens-when-irresistible-force-meets-increasinglyhttp://articles.washingtonpost.com/2013-05-19/opinions/39376698_1_affordable-care-act-affordable-health-coverage-health-affairshttp://articles.washingtonpost.com/2013-05-19/opinions/39376698_1_affordable-care-act-affordable-health-coverage-health-affairshttp://www.bloomberg.com/news/2013-05-29/one-way-obamacare-may-already-be-working.htmlhttp://www.nytimes.com/2013/01/28/us/boom-in-north-dakota-weighs-heavily-on-health-care.html?_r=0&gwh=BE712B27B95AE737019CF8BBC3FD40D7http://www.nytimes.com/2013/01/28/us/boom-in-north-dakota-weighs-heavily-on-health-care.html?_r=0&gwh=BE712B27B95AE737019CF8BBC3FD40D7http://content.healthaffairs.org/content/31/4/667.full.pdf+htmlhttp://www.washingtonpost.com/opinions/cutting-us-health-care-costs-doesnt-have-to-be-painful/2012/07/26/gJQA1ZzJCX_story.htmlhttp://www.washingtonpost.com/opinions/cutting-us-health-care-costs-doesnt-have-to-be-painful/2012/07/26/gJQA1ZzJCX_story.htmlhttp://www.minnesotamedicine.com/PastIssues/May2012/HealthiestState.aspxhttp://healthaffairs.org/blog/2012/05/07/barking-up-the-wrong-tree-affordability-not-cost-growth-is-the-policy-challenge/http://healthaffairs.org/blog/2012/05/07/barking-up-the-wrong-tree-affordability-not-cost-growth-is-the-policy-challenge/http://articles.latimes.com/2012/may/07/news/la-heb-obesity-projection-20120507http://content.healthaffairs.org/content/31/5/899.full.pdf+html

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    15. Lowrey, A. “In hopeful sign, health spending is flattening out.” New York times, April 28, 2012, p.A.1. Available at: http://www.nytimes.com/2012/04/29/health/policy/in-hopeful-sign-health-spending-is-flattening-out.html?pagewanted=all

    16. Mahoney, D. “Uncontrolled hypertension deemed pervasive in U.S. adults.” Internal Medicine News, September 4, 2012. Available at: http://www.internalmedicinenews.com/single-view/uncontrolled-hypertension-deemed-pervasive-in-us-adults/e84cc5f65b0596965e8e9b606b653355.html

    17. Bipartisan Policy Center. “What is driving U.S. health care spending?” September 2012, Available at: http://bipartisanpolicy.org/sites/default/files/BPC%20Health%20Care%20Cost%20Drivers%20Brief%20Sept%202012.pdf

    18. Carroll, A. “The ‘iron triangle’ on health care: Access, cost, and quality.” JAMA Forum, October 3, 2012. Available at: http://newsatjama.jama.com/2012/10/03/jama-forum-the-iron-triangle-of-health-care-access-cost-and-quality/

    19. Detsky, A.S. “How to control health care costs.” Journal of General Internal Medicine 27(9):1095-1096, 2012. Available at: http://link.springer.com/content/pdf/10.1007%2Fs11606-012-2119-0.pdf

    20. National Institute for Health Care Management. “U.S. health care spending: The big picture.” NIHCM Foundation Data Brief, May 2012. Available at: http://www.nihcm.org/images/stories/Data_Brief_1_-_Big_Picture_FINAL.pdf

    21. Reinhardt, U.E., “Is U.S. health spending finally under control.” New York Times online, January 20, 2012. Available at: http://economix.blogs.nytimes.com/2012/01/20/is-u-s-health-spending-finally-under-control/

    22. Roehrig, C., Turner, A., Hughes-Cromwick, P., Miller, G. “When the cost curve bent – Pre-recession moderation in health care.” New England Journal of Medicine 367(7):590-593, 2012. Available at: http://www.nejm.org/doi/pdf/10.1056/NEJMp1205958

    23. Stein, R. “A dire sign of the obesity epidemic: Teen diabetes soaring, study finds.” NPR, May 21, 2012. Available at: http://www.npr.org/blogs/health/2012/05/21/153030283/a-dire-sign-of-the-obesity-epidemic-teen-diabetes-soaring-study-finds

    24. The Economist. “An incurable disease.” September 29, 2012. Available at: http://www.economist.com/node/21563714 25. Wang, S.S. “Revealing the unexpected dangers of obesity.” The Wall Street Journal, October 29, 2012. Available at:

    http://www.nytimes.com/2012/09/23/health/new-system-for-patients-to-report-medical-mistakes.html?_r=0 26. Roehrig, C.S., Rousseau, D.M. “The growth in cost per case explains far more of U.S. health spending increases than rising

    disease prevalence.” Health Affairs 30(9):1657-1663, 2011. Available at: http://content.healthaffairs.org/content/30/9/1657.full.pdf+html

    27. Rovner, J. “You really are paying a lot more for health care.” NPR, May 11, 2011. Available at: http://www.npr.org/blogs/health/2011/05/11/136213104/you-really-are-paying-a-lot-more-for-health-care

    28. Reinberg, S.. “Aging population could send cancer costs soaring.” January 12, 2011. Available at: http://news.health.com/2011/01/12/aging-population-could-send-cancer-costs-soaring/

    29. Bernstein, J., Reschovsky, J.D., White, C. “Geographic variation in health care: changing policy directions.” Policy Analysis No. 4. Washington, DC: Center for Studying Health System Change, April 2011

    30. Gardner, A. “U.S. found to be losing ground in life expectancy.” HealthDay, June 15, 2011. Available at: http://health.usnews.com/health-news/family-health/heart/articles/2011/06/15/us-found-to-be-losing-ground-in-life-expectancy

    31. Gawande, A. “The cost conundrum: What a Texas town can teach us about health care.” The New Yorker, June 1, 2009. Available at: http://go.galegroup.com/ps/retrieve.do?sgHitCountType=None&sort=DA-SORT&inPS=true&prodId=PROF&userGroupName=mnaumntwin&tabID=T003&searchId=R1&resultListType=RESULT_LIST&contentSegment=&searchType=AdvancedSearchForm&currentPosition=1&contentSet=GALE%7CA201451685&&docId=GALE|A201451685&docType=GALE&role=&docLevel=FULLTEXT

    32. Escarce, J.J. “Racial and ethnic disparities in access to and quality of health care.” Research Synthesis Report No. 12. Robert Wood Johnson Foundation, September 7, 2007. Available at: http://www.rwjf.org/en/research-publications/find-rwjf-research/2007/09/racial-and-ethnic-disparities-in-access-to-and-quality-of-health.html

    33. Banks, J., Marmot, M., Oldfield, Z., Smith J.P. “Disease and disadvantage in the United States and in England.” JAMA 2006;295(17):2037-2045. http://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=5022&direction=P

    Session 2 – September 10, 2013 Health System Performance: From Three-Legged Stool to the Triple Aim – Patient Experience Assignment 1 Due There is widespread concern across political boundaries that patients’ experiences in the health care system leave much to be desired. Critics cite under use, over use, and inappropriate use of health services. Access to services is a major issue for population subgroups, and medical care costs continue to be a contributing factor to personal bankruptcies. And, for the last 12 years, the public spotlight has focused on “preventable” medical errors. Historically, medical errors were attributed to the failures of individuals, but the literature on patient safety also focuses on creating health care environments that limit the potential for human error. Nevertheless, estimates are that over 100,000 people die each year from avoidable errors. There is also a growing body of evidence that poor communication between providers and patients, along with inadequate coordination of care, contribute to poor quality care, medical errors, and patient frustrations with the health care system.

    6

    http://www.nytimes.com/2012/04/29/health/policy/in-hopeful-sign-health-spending-is-flattening-out.html?pagewanted=allhttp://www.internalmedicinenews.com/single-view/uncontrolled-hypertension-deemed-pervasive-in-us-adults/e84cc5f65b0596965e8e9b606b653355.htmlhttp://www.internalmedicinenews.com/single-view/uncontrolled-hypertension-deemed-pervasive-in-us-adults/e84cc5f65b0596965e8e9b606b653355.htmlhttp://bipartisanpolicy.org/sites/default/files/BPC%20Health%20Care%20Cost%20Drivers%20Brief%20Sept%202012.pdfhttp://newsatjama.jama.com/2012/10/03/jama-forum-the-iron-triangle-of-health-care-access-cost-and-quality/http://link.springer.com/content/pdf/10.1007%2Fs11606-012-2119-0.pdfhttp://www.nihcm.org/images/stories/Data_Brief_1_-_Big_Picture_FINAL.pdfhttp://economix.blogs.nytimes.com/2012/01/20/is-u-s-health-spending-finally-under-control/http://www.nejm.org/doi/pdf/10.1056/NEJMp1205958http://www.npr.org/blogs/health/2012/05/21/153030283/a-dire-sign-of-the-obesity-epidemic-teen-diabetes-soaring-study-findshttp://www.economist.com/node/21563714http://www.nytimes.com/2012/09/23/health/new-system-for-patients-to-report-medical-mistakes.html?_r=0http://content.healthaffairs.org/content/30/9/1657.full.pdf+htmlhttp://www.npr.org/blogs/health/2011/05/11/136213104/you-really-are-paying-a-lot-more-for-health-carehttp://news.health.com/2011/01/12/aging-population-could-send-cancer-costs-soaring/http://health.usnews.com/health-news/family-health/heart/articles/2011/06/15/us-found-to-be-losing-ground-in-life-expectancyhttp://go.galegroup.com/ps/retrieve.do?sgHitCountType=None&sort=DA-SORT&inPS=true&prodId=PROF&userGroupName=mnaumntwin&tabID=T003&searchId=R1&resultListType=RESULT_LIST&contentSegment=&searchType=AdvancedSearchForm&currentPosition=1&contentSet=GALE%7CA201451685&&docId=GALE|A201451685&docType=GALE&role=&docLevel=FULLTEXThttp://go.galegroup.com/ps/retrieve.do?sgHitCountType=None&sort=DA-SORT&inPS=true&prodId=PROF&userGroupName=mnaumntwin&tabID=T003&searchId=R1&resultListType=RESULT_LIST&contentSegment=&searchType=AdvancedSearchForm&currentPosition=1&contentSet=GALE%7CA201451685&&docId=GALE|A201451685&docType=GALE&role=&docLevel=FULLTEXThttp://go.galegroup.com/ps/retrieve.do?sgHitCountType=None&sort=DA-SORT&inPS=true&prodId=PROF&userGroupName=mnaumntwin&tabID=T003&searchId=R1&resultListType=RESULT_LIST&contentSegment=&searchType=AdvancedSearchForm&currentPosition=1&contentSet=GALE%7CA201451685&&docId=GALE|A201451685&docType=GALE&role=&docLevel=FULLTEXThttp://go.galegroup.com/ps/retrieve.do?sgHitCountType=None&sort=DA-SORT&inPS=true&prodId=PROF&userGroupName=mnaumntwin&tabID=T003&searchId=R1&resultListType=RESULT_LIST&contentSegment=&searchType=AdvancedSearchForm&currentPosition=1&contentSet=GALE%7CA201451685&&docId=GALE|A201451685&docType=GALE&role=&docLevel=FULLTEXThttp://www.rwjf.org/en/research-publications/find-rwjf-research/2007/09/racial-and-ethnic-disparities-in-access-to-and-quality-of-health.htmlhttp://www.rwjf.org/en/research-publications/find-rwjf-research/2007/09/racial-and-ethnic-disparities-in-access-to-and-quality-of-health.htmlhttp://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=5022&direction=P

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    Learning Objectives Students should be able to:

    1. Discuss issues and evidence relating to access to care and deficiencies on the quality of health care in the United States 2. Discuss the evidence regarding prevalence of medical errors in the U.S. health care system and their sources. 3. Use terminology related to “medical errors” appropriately. 4. Discuss basic approaches being used in hospitals and other providers to reduce medical errors. 5. Discuss how poor communication and care coordination can affect patient outcomes.

    Suggested Readings Patient Safety and Medical Errors: Concepts, Terminology, and Impact Overview

    1*. Leape, L. “Error in medicine.” Journal of the American Medical Association 272(23):1851-1857, 1994 (Posted on Moodle) 2. “Hospital infections killed 48,000, report shows.” Reuters, February 22, 2010. Available at:

    http://www.reuters.com/article/2010/02/22/us-hospitals-infections-usa-idUSTRE61L51D20100222 3*. Van Den Bos, J., Rustagi, K., Gray, T., Halford, M., Ziemkiewicz, E., Shreve, J. “The $17.1 billion problem: The annual cost of

    measurable medical errors.” Health Affairs 30(4):596-603, 2011. Available at: http://content.healthaffairs.org/content/30/4/596.full.pdf+html

    4. Young, J. “Hospital errors occur 10 times more than reported, study finds.” Bloomberg.com, April 6, 2011. Available at: http://www.bloomberg.com/news/2011-04-07/hospital-errors-occur-10-times-more-than-reported-study-finds.html

    5. Weber, T., Ornstein, C., Allen, M. “Why can’t medicine seem to fix simple mistakes? ProPublica, July 20, 2012. Available at: http://www.propublica.org/article/why-cant-medicine-seem-to-fix-simple-mistakes

    6. Welch, H.G. “Testing what we think we know.” New York Times online, August 19, 2012. Available at: http://www.nytimes.com/2012/08/20/opinion/testing-standard-medical-practices.html

    7*. Boodman, S.G. “Doctors’ diagnostic errors are often not mentioned but can take a serious toll.” Kaiser Health News, May 6, 2013. Available at: http://www.kaiserhealthnews.org/stories/2013/may/07/doctor-errors-misdiagnosis-more-common-than-known-serious-impact.aspx

    8. Ofri, D. “My near miss.” The New York Times, May 28, 2013. Available at: http://www.nytimes.com/2013/05/29/opinion/addressing-medical-errors.html

    Causes of Medical Errors 1*. Volpp, K.G.M., Grande, D. “Residents’ suggestions for reducing errors in teaching hospitals.” New England Journal of Medicine

    348(9):851-855, 2003. Available at: http://www.nejm.org/doi/pdf/10.1056/NEJMsb021667 2. Johnson, C.K. “Poor infection control at many surgery centers.” MSNBC, June 8, 2010. Available at:

    http://www.msnbc.msn.com/id/37577363 3. Sittig, D.F., Singh, H. “Defining health information technology—related errors.” Archives of Internal Medicine 171(14):1281-1284,

    2011. Available at: http://archinte.jamanetwork.com/Issue.aspx?journalid=71&issueID=22519&direction=P 4. Schiff, G.D. “Medical error. A 60-year-old man with delayed care for a renal mass.” Journal of the American Medical

    Association 305(18):1890-1898, 2011. Available at: http://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=20328&direction=P

    5. Richtel, M. “As doctors use more devices, potential for distraction grows.” New York Times, December 15, 2011, p. A.1. Available at: http://www.nytimes.com/2011/12/15/health/as-doctors-use-more-devices-potential-for-distraction-grows.html?pagewanted=all&_r=0

    6*. Couse-Baker, R. “Even a doctor can’t keep his father safe in the hospital.” Cognoscenti, April 5, 2013. Available at: http://cognoscenti.wbur.org/2013/04/05/medical-errors-ashish-jha

    7. Harris, G. “U.S. inaction lets look-alike tubes kill patients.” The New York Times, August 20, 2010. Available at: http://www.nytimes.com/2010/08/21/health/policy/21tubes.html?pagewanted=all

    8. Robertson, J. “Digital health records’ risks emerge as deaths blamed on systems.” Bloomberg, June 25, 2013. Available at: http://www.bloomberg.com/news/2013-06-25/digital-health-records-risks-emerge-as-deaths-blamed-on-systems.html

    9. Smith, K. “For doctors, too much information.” Politico, March 5, 2013. Available at: http://www.politico.com/story/2013/03/electronic-alert-glut-overloads-doctors-88394.html

    10. Sun, L.H. “’Alarm fatigue’ leads hospital caregivers to ignore beeps, posing risks for patients.” Bangor Daily News, July 23, 2013. Available at: http://bangordailynews.com/2013/07/08/health/alarm-fatigue-leads-hospital-caregivers-to-ignore-beeps-posing-risks-for-patients/

    Proposals to Reduce Medical Errors 1*. Gawande, T. “The Checklist.” New Yorker, 83(39):86-95, December 10, 2007. Available at:

    http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande 2. Millenson, M.L. “Analysis: Is a new federal patient safety effort doing enough to curb medical errors?” Kaiser Health News,

    February 22, 2012. Available at: http://www.kaiserhealthnews.org/stories/2012/february/23/millenson-hens.aspx 3. Ledger, K. “Safety first. How anesthesiologists launched the patient-safety movement.” Minnesota Medicine, March 2011.

    Available at: http://www.minnesotamedicine.com/PastIssues/PastIssues2011/March2011/SafetyFirst.aspx 7

    http://www.reuters.com/article/2010/02/22/us-hospitals-infections-usa-idUSTRE61L51D20100222http://content.healthaffairs.org/content/30/4/596.full.pdf+htmlhttp://www.bloomberg.com/news/2011-04-07/hospital-errors-occur-10-times-more-than-reported-study-finds.htmlhttp://www.propublica.org/article/why-cant-medicine-seem-to-fix-simple-mistakeshttp://www.nytimes.com/2012/08/20/opinion/testing-standard-medical-practices.htmlhttp://www.kaiserhealthnews.org/stories/2013/may/07/doctor-errors-misdiagnosis-more-common-than-known-serious-impact.aspxhttp://www.kaiserhealthnews.org/stories/2013/may/07/doctor-errors-misdiagnosis-more-common-than-known-serious-impact.aspxhttp://www.nytimes.com/2013/05/29/opinion/addressing-medical-errors.htmlhttp://www.nejm.org/doi/pdf/10.1056/NEJMsb021667http://www.msnbc.msn.com/id/37577363http://archinte.jamanetwork.com/Issue.aspx?journalid=71&issueID=22519&direction=Phttp://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=20328&direction=Phttp://www.nytimes.com/2011/12/15/health/as-doctors-use-more-devices-potential-for-distraction-grows.html?pagewanted=all&_r=0http://www.nytimes.com/2011/12/15/health/as-doctors-use-more-devices-potential-for-distraction-grows.html?pagewanted=all&_r=0http://cognoscenti.wbur.org/2013/04/05/medical-errors-ashish-jhahttp://www.nytimes.com/2010/08/21/health/policy/21tubes.html?pagewanted=allhttp://www.bloomberg.com/news/2013-06-25/digital-health-records-risks-emerge-as-deaths-blamed-on-systems.htmlhttp://www.politico.com/story/2013/03/electronic-alert-glut-overloads-doctors-88394.htmlhttp://bangordailynews.com/2013/07/08/health/alarm-fatigue-leads-hospital-caregivers-to-ignore-beeps-posing-risks-for-patients/http://bangordailynews.com/2013/07/08/health/alarm-fatigue-leads-hospital-caregivers-to-ignore-beeps-posing-risks-for-patients/http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawandehttp://www.kaiserhealthnews.org/stories/2012/february/23/millenson-hens.aspxhttp://www.minnesotamedicine.com/PastIssues/PastIssues2011/March2011/SafetyFirst.aspx

  • https://docs.google.com/a/umn.edu/file/d/0B7LWJ83cOEeeR1IyeDE2WkJ0cHc/edit

    4*. Shaw, G. “Researchers: CPOE averted 17.4 million medication errors in one year.” FierceHealthIT, February 22, 2013. Available at: http://www.fiercehealthit.com/story/researchers-cpoe-averted-174-million-medication-errors-one-year/2013-02-22

    5. Hartocollis, A. “With money at risk, hospitals push staff to wash hands.” The New York Times, May 28, 2013. Available at: http://www.nytimes.com/2013/05/29/nyregion/hospitals-struggle-to-get-workers-to-wash-their-hands.html?_r=0

    6. Southwick, F.S. “Losing my leg to a medical error.” The New York Times, February 19, 2013. Available at: http://www.nytimes.com/2013/02/20/opinion/losing-my-leg-to-a-medical-error.html?smid=pl-share&_r=0

    7. Drolet, B.C., Khokhar, M.T., Fischer, S.A. “The 2011 duty-hour requirement — a survey of residence program directors.” The New England Journal of Medicine 368(8):694-697, 2013. Available at: http://www.nejm.org/doi/pdf/10.1056/NEJMp1214483

    8*. Shekelle, P.G., Pronovost, P.J., Wachter, R.M., et al. “The top patient safety strategies that can be encouraged for adoption now.” Annals of Internal Medicine 158(5-Part 2):365-368. Available at: http://annals.org/issue.aspx?journalid=90&issueID=926462&direction=P

    Care Coordination and Communication Issues 1. Pham, H.H., Grossman, J.M., Cohen, G., Bodenheimer, T. “Hospitalists and care transitions: The divorce of inpatient and

    outpatient care.” Health Affairs 27(5):1315-1327, 2008. Available at: http://content.healthaffairs.org/content/27/5/1315.full.pdf+html

    2. Blendon, R.J., Buhr, T., Cassidy, E.F., Perez, D.J., Sussman, T., Benson, J.M., et al. “Disparities in physician care: Experiences and perceptions of a multi-ethnic America. Health Affairs 27(2):507-517, 2008. Available at: http://content.healthaffairs.org/content/27/2/507.full.pdf+html

    3. Levinson, W., Pizzo, P.A. “Patient-physician communication. It’s about time.” Journal of the American Medical Association 305(17):1802-1803, 2011. Available at: http://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=20327&direction=P

    4*. Schoen, C., Osborn, R., Squires, D., Doty, M., Pierson, R., Applebaum, S. “New 2011 survey of patients with complex care needs in eleven countries finds that care is often poorly coordinated.” Health Affairs 30(12):2437-2448, 2011. Available at: http://content.healthaffairs.org/content/30/12/2437.full.pdf+html

    How Patients Experience the Health Care System 1. Mayer, M.L. “On being a ‘difficult’ patient.” Health Affairs 27(5):1416-1421, 2008. Available at:

    http://content.healthaffairs.org/content/27/5/1416.full.pdf+html 2*. Jauhar, S. “Referral system turns patients into commodities.” The New York Times, May 26, 2009, p.D.5. Available at:

    http://www.nytimes.com/2009/05/26/health/26essa.html?scp=12&sq=health%20care&st=cse 2. Colwill, J.M. “A case of ‘medical homelessness’.” Health Affairs 29(5):1067-1070, 2010. Available at:

    http://content.healthaffairs.org/content/29/5/1067.full.pdf+html 3. Butler, K. “My father’s broken heart.” New York Times, June 20, 2010, p. 38. Available at:

    http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?src=me&ref=homepage 4. Kapadia, R., Scherzer, L. “10 things your hospital won’t tell you.” SmartMoney Magazine, August 11, 2010. Available at:

    http://www.smartmoney.com/spending/rip-offs/10-things-your-hospital-wont-tell-you-20059/ 5. Dimick, J., Ruhter, J., Sarrazin, M.V., Birkmeyer, J.D. “Black patients more likely than Whites to undergo surgery at low-quality

    hospitals in segregated regions.” Health Affairs 32(6):1046-1053, 2013. Available at: http://content.healthaffairs.org/content/32/6/1046.full.pdf+html

    Access to Care 1*. Galewitz, P. “Health care increasingly out of reach for millions of Americans.” Kaiser Health News, May 7, 2012. Available at:

    http://www.kaiserhealthnews.org/stories/2012/may/07/health-affairs-care-increasingly-out-of-reach-for-millions.aspx 2. Pecquet, J. “Report: Americans still struggling with medical debt.” The Hill, March 7, 2012. Available at:

    http://thehill.com/blogs/healthwatch/health-insurance/214759-report-americans-still-struggling-with-medical-debt 3. Kenney, G.M., McMorrow, S., Zuckerman, S., Goin, D.E. “A decade of health care access declines for adults hold implications

    for changes in the Affordable Care Act.” Health Affairs 31(5):899-908, 2012. Available at: http://content.healthaffairs.org/content/31/5/899.full.pdf+html

    4. HealthDay. “Many lacked preventive care before health reform law: U.S. report.” June 14, 2012. Available at: http://consumer.healthday.com/Article.asp?AID=665762

    5. HealthDay. “Fewer U.S. patients getting weight counseling from doctors.” U.S. News, January 10, 2013. Available at: http://health.usnews.com/health-news/news/articles/2013/01/10/fewer-us-patients-getting-weight-counseling-from-doctors

    Quality of Care 1. Maugh, T.H. “Nearly 70,000 Americans die needlessly each year because they are not given optimal heart failure therapy.” June

    6, 2011. Available at: http://www.latimes.com/health/boostershots/la-heb-heart-failure-06062011,0,4047246.story?track=rss 2. Reuters. “Cardiac arrest survival improving in U.S. hospitals: Study.” July 16, 2012. Available at:

    http://www.reuters.com/article/2012/07/17/us-heart-idUSBRE86G01F20120717 3. HealthDay. “Many lacked preventive care before health reform law: U.S. report.” June 14, 2012. Available at:

    http://consumer.healthday.com/Article.asp?AID=665762 4*. PR Newswire. “U.S. physician groups identify commonly used tests or procedures they say are often not necessary.” April 4,

    2012. Available at: http://www.prnewswire.com/news-releases/us-physician-groups-identify-commonly-used-tests-or-procedures-they-say-are-often-not-necessary-146046345.html

    8

    http://www.fiercehealthit.com/story/researchers-cpoe-averted-174-million-medication-errors-one-year/2013-02-22http://www.nytimes.com/2013/05/29/nyregion/hospitals-struggle-to-get-workers-to-wash-their-hands.html?_r=0http://www.nytimes.com/2013/02/20/opinion/losing-my-leg-to-a-medical-error.html?smid=pl-share&_r=0http://www.nejm.org/doi/pdf/10.1056/NEJMp1214483http://annals.org/issue.aspx?journalid=90&issueID=926462&direction=Phttp://content.healthaffairs.org/content/27/5/1315.full.pdf+htmlhttp://content.healthaffairs.org/content/27/2/507.full.pdf+htmlhttp://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=20327&direction=Phttp://content.healthaffairs.org/content/30/12/2437.full.pdf+htmlhttp://content.healthaffairs.org/content/27/5/1416.full.pdf+htmlhttp://www.nytimes.com/2009/05/26/health/26essa.html?scp=12&sq=health%20care&st=csehttp://content.healthaffairs.org/content/29/5/1067.full.pdf+htmlhttp://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?src=me&ref=homepagehttp://www.smartmoney.com/spending/rip-offs/10-things-your-hospital-wont-tell-you-20059/http://content.healthaffairs.org/content/32/6/1046.full.pdf+htmlhttp://www.kaiserhealthnews.org/stories/2012/may/07/health-affairs-care-increasingly-out-of-reach-for-millions.aspxhttp://thehill.com/blogs/healthwatch/health-insurance/214759-report-americans-still-struggling-with-medical-debthttp://content.healthaffairs.org/content/31/5/899.full.pdf+htmlhttp://consumer.healthday.com/Article.asp?AID=665762http://health.usnews.com/health-news/news/articles/2013/01/10/fewer-us-patients-getting-weight-counseling-from-doctorshttp://www.latimes.com/health/boostershots/la-heb-heart-failure-06062011,0,4047246.story?track=rsshttp://www.reuters.com/article/2012/07/17/us-heart-idUSBRE86G01F20120717http://consumer.healthday.com/Article.asp?AID=665762http://www.prnewswire.com/news-releases/us-physician-groups-identify-commonly-used-tests-or-procedures-they-say-are-often-not-necessary-146046345.htmlhttp://www.prnewswire.com/news-releases/us-physician-groups-identify-commonly-used-tests-or-procedures-they-say-are-often-not-necessary-146046345.html

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    5. Abelson, R., Creswell, J. “Hospital chain inquiry cited unnecessary cardiac work.” New York Times online, August 6, 2012. Available at: http://www.nytimes.com/2012/08/07/business/hospital-chain-internal-reports-found-dubious-cardiac-work.html?pagewanted=all

    6. Mohammed, K.A., Bullard, K.M., Saaddine, J.B., Cowie, C.C., Imperatore, G., Gregg, E.W. “Achievement of goals in U.S. diabetes care, 1999-2010.” The New England Journal of Medicine, 2013;368(17):1613-1624. Available at: http://www.nejm.org/doi/pdf/10.1056/NEJMsa1213829

    Further Readings

    1. Seaman, A.M. “Surgeons-in-training dislike new work hours: survey.” Reuters, May 17, 2013. Available at: http://news.yahoo.com/surgeons-training-dislike-hours-survey-194513540.html

    2. Commins, J. “Diagnostic errors common, costly, and harmful.” HealthLeaders Media, April 23, 2013. Available at: http://www.healthleadersmedia.com/page-1/QUA-291407/Diagnostic-Errors-Common-Costly-and-Harmful##

    3. PRWeb. “Global computerized physician order entry systems market to reach US$1.5 billion by 2018, according to new report by Global Industry Analysts, Inc.” July 13, 2012. Available at: http://www.prweb.com/releases/computerized_physician/order_entry_CPOE_systems/prweb9693652.htm

    4. Kennedy, K. “HHS: Hospitals ignoring requirements to report errors.” USA Today online, July 20, 2012. Available at: http://www.usatoday.com/news/health/story/2012-07-19/hospitals-preventable-errors-report/56343348/1

    5. Lerner, M. “In new safety test, not all Minnesota hospitals earn A: National report card rates 38 state hospitals for patient safety.” Star Tribune, June 7, 2012, p. B3. Available at: http://www.startribune.com/lifestyle/health/157309745.html

    6. O’Connell, K. “Two arms, two choices: If only I’d known then what I know now.” Health Affairs 31(8):1895-1899, 2012. Available at: http://content.healthaffairs.org/content/31/8/1895.full.pdf+html

    7. Andrews, M. “New book offers checklists to help hospital patients.” Kaiser Health News, March 5, 2012. Available at: http://www.kaiserhealthnews.org/features/insuring-your-health/2012/patient-checklists-michelle-andrews-03052012.aspx?referrer=search

    8. Welch, H.G. “Testing what we think we know.” New York Times online, August 19, 2012. Available at: http://www.nytimes.com/2012/08/20/opinion/testing-standard-medical-practices.html

    9. Pryor, D., Hendrich, A., Henkel, R.J., Beckmann, J.K., Tersigni, A.R. “The quality ‘journey’ at Ascension Health: How we’ve prevented at least 1,500 avoidable deaths a year — and aim to do even better.” Health Affairs 30(4):604-611, 2011. Available at: http://content.healthaffairs.org/content/30/4/604.full.pdf+html

    10. Pronovost, P.J., Marsteller, J.A., Goeschel, C.A. “Preventing bloodstream infections: A measurable national success story in quality improvement.” Health Affairs 30(4):628-634, 2011. Available at: http://content.healthaffairs.org/content/30/4/628.full.pdf+html

    11. Joyce, J.D., Cioffi, G.A., Petriwsky, J.G., Robinson, J.S. “Legacy health’s ‘big aim’ initiative to improve patient safety reduced rates of infection and mortality among patients.” Health Affairs 30(4):619-627, 2011. Available at: http://content.healthaffairs.org/content/30/4/619.full.pdf+html

    12. Crosby, J. “Getting it right (or left); Wrong-site surgeries continue to plague hospitals, but a new campaign hopes to ensure everyone takes a “timeout” before surgery.” Star Tribune, June 20, 2011, p. D.1. Available at: http://www.highbeam.com/doc/1G1-259321876.html

    13. Simmons, J. “AHRQ: Hospitals give themselves high marks for patient safety.” FierceHealthcare, March 23, 2011. Available at: http://www.fiercehealthcare.com/story/ahrq-hospitals-give-themselves-high-marks-patient-safety/2011-03-23

    14. Boodman, S.G. “Effort to end surgeries on wrong patients or body part falters.” Kaiser Health News, June 20, 2011. Available at: http://www.kaiserhealthnews.org/Stories/2011/June/21/wrong-site-surgery-errors.aspx

    15. McCoy, J. “7 medical error disclosure deterrents.” HealthLeaders Media, February 9, 2011. Available at: http://www.healthleadersmedia.com/content/PHY-260817/7-Medical-Error-Disclosure-Deterrents.html

    16. Goodman, J.C., Villarreal, P., Jones, B. “The social cost of adverse medical events, and what we can do about it.” Health Affairs 30(4):590-595, 2011. Available at: http://content.healthaffairs.org/content/30/4/590.full.pdf+html

    17. Moisse, K. “HHS announces partnership for patients to save lives, money.” abc News, April 12, 2011. Available at: http://abcnews.go.com/Health/Wellness/hospital-safety-government-industry-team-reduce-errors/story?id=13355460

    18. Kolata, G. “Sports medicine said to overuse a popular scan.” New York Times, October 29, 2011, p. A.1. Available at: http://www.nytimes.com/2011/10/29/health/mris-often-overused-often-mislead-doctors-warn.html?pagewanted=all&gwh=9206356E07CA1B10B397D83D480CB224

    19. Terry, T. “Electronic prescriptions have as many errors as written prescriptions.” FierceHealthIT, June 30, 2011. Available at: http://www.fiercehealthit.com/story/prescription-errors-equal-whether-written-or-electronic/2011-06-30

    20. Wakefield, J.G., McLaws, M-L., Whitby, M., Patton, L. “Patient safety culture: factors that influence clinician involvement in patient safety behaviours.” Quality and Safety in Health Care 19(6):585-591, 2010. Available at: http://qualitysafety.bmj.com/content/19/6/585.full.pdf+html

    21. “Study Puts Cost of Medical Errors at $19.5 Billion.” Wall Street Journal (online), August 9, 2010. Available at: http://blogs.wsj.com/health/2010/08/09/study-puts-cost-of-medical-errors-at-195-billion/

    9

    http://www.nytimes.com/2012/08/07/business/hospital-chain-internal-reports-found-dubious-cardiac-work.html?pagewanted=allhttp://www.nytimes.com/2012/08/07/business/hospital-chain-internal-reports-found-dubious-cardiac-work.html?pagewanted=allhttp://www.nejm.org/doi/pdf/10.1056/NEJMsa1213829http://news.yahoo.com/surgeons-training-dislike-hours-survey-194513540.htmlhttp://www.healthleadersmedia.com/page-1/QUA-291407/Diagnostic-Errors-Common-Costly-and-Harmfulhttp://www.prweb.com/releases/computerized_physician/order_entry_CPOE_systems/prweb9693652.htmhttp://www.usatoday.com/news/health/story/2012-07-19/hospitals-preventable-errors-report/56343348/1http://www.startribune.com/lifestyle/health/157309745.htmlhttp://content.healthaffairs.org/content/31/8/1895.full.pdf+htmlhttp://www.kaiserhealthnews.org/features/insuring-your-health/2012/patient-checklists-michelle-andrews-03052012.aspx?referrer=searchhttp://www.kaiserhealthnews.org/features/insuring-your-health/2012/patient-checklists-michelle-andrews-03052012.aspx?referrer=searchhttp://www.nytimes.com/2012/08/20/opinion/testing-standard-medical-practices.htmlhttp://content.healthaffairs.org/content/30/4/604.full.pdf+htmlhttp://content.healthaffairs.org/content/30/4/628.full.pdf+htmlhttp://content.healthaffairs.org/content/30/4/619.full.pdf+htmlhttp://www.highbeam.com/doc/1G1-259321876.htmlhttp://www.fiercehealthcare.com/story/ahrq-hospitals-give-themselves-high-marks-patient-safety/2011-03-23http://www.kaiserhealthnews.org/Stories/2011/June/21/wrong-site-surgery-errors.aspxhttp://www.healthleadersmedia.com/content/PHY-260817/7-Medical-Error-Disclosure-Deterrents.htmlhttp://content.healthaffairs.org/content/30/4/590.full.pdf+htmlhttp://abcnews.go.com/Health/Wellness/hospital-safety-government-industry-team-reduce-errors/story?id=13355460http://www.nytimes.com/2011/10/29/health/mris-often-overused-often-mislead-doctors-warn.html?pagewanted=all&gwh=9206356E07CA1B10B397D83D480CB224http://www.nytimes.com/2011/10/29/health/mris-often-overused-often-mislead-doctors-warn.html?pagewanted=all&gwh=9206356E07CA1B10B397D83D480CB224http://www.fiercehealthit.com/story/prescription-errors-equal-whether-written-or-electronic/2011-06-30http://qualitysafety.bmj.com/content/19/6/585.full.pdf+htmlhttp://blogs.wsj.com/health/2010/08/09/study-puts-cost-of-medical-errors-at-195-billion/

  • https://docs.google.com/a/umn.edu/file/d/0B7LWJ83cOEeeR1IyeDE2WkJ0cHc/edit

    22. Salamon, M. “Despite efforts, study finds no decline in medical errors.” HealthDay News, November 24, 2010. Available at: http://news.health.com/2010/11/24/despite-efforts-study-finds-no-decline-in-medical-errors/

    23. Bennett, A. “Lessons of a $618,616 death.” Bloomberg Businessweek, March 4, 2010. Available at: http://www.businessweek.com/magazine/content/10_11/b4170032321836.htm

    24. Metzger, J., Welebob, E., Bates, D.W., Lipsitz, S., Classen, D.C. “Mixed results in the safety performance of computerized physician order entry.” Health Affairs 29(4):655-663, 2010. Available at: http://content.healthaffairs.org/content/29/4/655.full.pdf+html

    25. O’Callaghan, T. “Study: Fatal medication mistakes surge in July.” New York Times, June 2, 2010. Available at: http://www.nytimes.com/2009/12/17/health/17chen.html?_r=1&pagewanted=print

    26. Moffeit, M. “DMN investigates: Lax supervision of residents at U.S. teaching hospitals puts patients at risk.” Dallas Morning News, December 19, 2010. Available at: http://www.dallasnews.com/health/medicine/20101219-lax-supervision-of-residents-at-u.s.-teaching-hospitals-puts-patients-at-risk.ece

    27. Kaiser Health News. “Race Plays Role in Diagnosis and Treatment.” July 24, 2009. Available at: http://www.kaiserhealthnews.org/daily-reports/2009/july/24/racial-disparities.aspx?referrer=search

    28. Tong, A. “Hospitals stem mistakes with colored socks and sashes. Simple things send a safety signal.” The Sacramento Bee, September 14, 2009. p. B.1. Available at: http://s3.amazonaws.com/external_clips/104582/Hospitals_stem_mistakes_with_colored_socks_a.PDF?1345612636

    29. Szabo, L. “Studies: Surgeons could save lives, $20B by using checklist.” USA Today, January 14, 2009. Available at: http://www.usatoday.com/news/health/2009-01-14-surgery-checklist_N.htm

    30. Garbutt, J., Waterman, A.D., Kapp, J.M., Dunagan, W.C., Levinson, W., Fraser, V., Gallagher, T.H. “Lost opportunities: How physicians communicate about medical errors.” Health Affairs 27(1):246-255, 2008. Available at: http://content.healthaffairs.org/content/27/1/246.full.pdf+html

    31. Skinner, J., Chandra, A., Goodman, D., Fisher, E.S. “The elusive connection between health care spending and quality.” Health Affairs – Web Exclusive 28(1):w119-w123, published online December 4, 2008. Available at: http://content.healthaffairs.org/content/28/1/w119.full.pdf+html

    32. Koppel, R., Wetterneck, T., Telles, J.L., Karsh, B-T. “Workarounds to barcode medication administration systems: Their occurrences, causes, and threats to patient safety.” Journal of the American Medical Informatics Association 15(4):408-423, 2008. Available at: http://www.sciencedirect.com/science/journal/10675027/15/4

    33. Buerhaus, P.I. “Is hospital patient care becoming safer? A conversation with Lucian Leape.” Health Affairs – Web Exclusive 26(6):w687-w696, published online October 9, 2007. Available at: http://content.healthaffairs.org/content/26/6/w687.full.pdf+html

    34. “States making it OK for docs to say ‘sorry’.” MSNBC, April 11, 2007. Available at: http://www.msnbc.msn.com/id/18059841/ 35. Pronovost, P.J., Miller, M.R., Wachter, R.M. “Tracking progress in patient safety. An elusive target.” JAMA 296(6):696-699,

    2006. Available at: http://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=5031&direction=P 36. Asch, S.M., Kerr, E.A., Keesey, J., Adams, J.L., Setodji, C.M., Malik, S., McGlynn, E.A. “Who is at greatest risk for receiving

    poor-quality health care?” New England Journal of Medicine 354(11):1147-1156, 2006. Available at: http://www.nejm.org/doi/pdf/10.1056/NEJMsa044464

    37. Leape, L. “Reporting of adverse events.” New England Journal of Medicine 347(20):1633-1638, 2002. Available at: http://www.nejm.org/doi/pdf/10.1056/NEJMNEJMhpr011493

    Session 3 – September 17, 2013 The Health Policy Process: Crabs in a Bucket? The government plays a major role in shaping the U.S. health care system and its performance. About half of all health care spending in the United States flows through government programs, and every aspect of health care is subject to relatively extensive government oversight. In each subsequent session of the course, key health policy issues will be identified and described. This session provides a foundation for subsequent sessions. First, a general overview of the public policy process and its key participants is presented. Then, the politics of health care reform is discussed in the context of the recently passed, and continually challenged, federal health reform legislation. Learning Objectives Students should be able to:

    1. Demonstrate an understanding of the political process as it relates to health care. 2. Describe the key components in the recently passed federal health reform legislation. 3. Discuss the role that various health care interest groups played in the passage of the federal health reform legislation and its

    implementation to date.

    10

    http://news.health.com/2010/11/24/despite-efforts-study-finds-no-decline-in-medical-errors/http://www.businessweek.com/magazine/content/10_11/b4170032321836.htmhttp://content.healthaffairs.org/content/29/4/655.full.pdf+htmlhttp://www.nytimes.com/2009/12/17/health/17chen.html?_r=1&pagewanted=printhttp://www.dallasnews.com/health/medicine/20101219-lax-supervision-of-residents-at-u.s.-teaching-hospitals-puts-patients-at-risk.ecehttp://www.dallasnews.com/health/medicine/20101219-lax-supervision-of-residents-at-u.s.-teaching-hospitals-puts-patients-at-risk.ecehttp://www.kaiserhealthnews.org/daily-reports/2009/july/24/racial-disparities.aspx?referrer=searchhttp://s3.amazonaws.com/external_clips/104582/Hospitals_stem_mistakes_with_colored_socks_a.PDF?1345612636http://www.usatoday.com/news/health/2009-01-14-surgery-checklist_N.htmhttp://content.healthaffairs.org/content/27/1/246.full.pdf+htmlhttp://content.healthaffairs.org/content/28/1/w119.full.pdf+htmlhttp://www.sciencedirect.com/science/journal/10675027/15/4http://content.healthaffairs.org/content/26/6/w687.full.pdf+htmlhttp://www.msnbc.msn.com/id/18059841/http://jama.jamanetwork.com/Issue.aspx?journalid=67&issueID=5031&direction=Phttp://www.nejm.org/doi/pdf/10.1056/NEJMsa044464http://www.nejm.org/doi/pdf/10.1056/NEJMNEJMhpr011493

  • https://docs.google.com/a/umn.edu/file/d/0B7LWJ83cOEeeR1IyeDE2WkJ0cHc/edit

    Suggested Readings Overview of the Policy Process

    1*. Marmor, T.R., Christianson, J.B. “The political market for government health policies.” Chapter 3 in Health Care Policy. A Political Economy Approach. Beverly Hills, CA: Sage Publications, 1982 (Posted on Moodle)

    2. Murray, T.H. “American values and health care reform.” New England Journal of Medicine 362(4):285-287, 2010. Available at: http://www.nejm.org/doi/pdf/10.1056/NEJMp0911116

    3*. Kaiser Family Foundation. “KaiserEDU.org Tutorial: U.S. Congress and health policy.” June 29, 2011. Available at: http://www.kff.org/us-congress-and-health-policy.cfm

    4. Vaida, B., Weaver, C. “Scorecard: How health industry PACs placed their election bets. Spending reflected view on health law.” Kaiser Health News, November 23, 2010. Available at: http://www.kaiserhealthnews.org/Stories/2010/November/17/health-industry-pacs-election-bets.aspx

    5. Israel, J. “Top health information technology firms prefer ‘revolving door’ lobbyists.” iWatchNews, August 22, 2011. Available at: http://www.iwatchnews.org/2011/08/22/5859/top-health-information-technology-firms-prefer-revolving-door-lobbyists

    6. Reinhardt, U.E. “Is there hope for the uninsured?” Health Affairs – Web Exclusive, pp.w3-376-w3-390, published online August 27, 2003. Available at: http://content.healthaffairs.org/content/early/2003/08/27/hlthaff.w3.376.full.pdf+html

    PPACA 1*. Kaiser Family Foundation. “KaiserEDU.org Tutorial – Health reform: An overview.” October 1, 2010. Available at: http://www.kff.org/healthreform/kEDU_health_reform_overview_100110.cfm 2*. Klein, E. “As health-care reform law turns 1, some clarity on what it does and how it does it.” Washington Post, March 22, 2011,

    p. A.12. Available at: http://articles.washingtonpost.com/2011-03-21/business/35260878_1_health-care-reform-law-affordable-care-act-insurance

    3. Berwick D.M. “Putting health care on the right track.” Washington Post online Opinions, June 21, 2012. Available at: http://www.washingtonpost.com/opinions/putting-health-care-on-the-right-track/2012/06/21/gJQAtBGltV_story.html

    4. Samuelson, R.J. “Why Obamacare is oversold.” Washington Post, May 9, 2013. Available at: http://articles.washingtonpost.com/2013-05-09/opinions/39133432_1_affordable-care-act-health-care-uninsured-and-medicaid-recipients

    5. Deparle, N-A. “The successes of Obamacare.” Washington Post, May 9, 2013. Available at: http://articles.washingtonpost.com/2013-05-09/opinions/39133432_1_affordable-care-act-health-care-uninsured-and-medicaid-recipients

    6. Keller, B. “Five Obamacare myths.” The New York Times, July 15, 2012. Available at: http://www.nytimes.com/2012/07/16/opinion/keller-five-obamacare-myths.html?pagewanted=all&_r=0

    7. Carroll, A.E., Frakt, A.B., “New evidence supports, challenges, and informs the ambitions of health reform.” Journal of the American Medical Society 309(24):2600-2601, 2013. Available at: http://jama.jamanetwork.com/issue.aspx?journalid=67&issueid=927181&direction=P

    The Supreme Court Decision 1. Brooks, D. “Modesty and audacity.” [Op-Ed] New York Times, June 29, 2012, p. A.25. Available at:

    http://www.nytimes.com/2012/06/29/opinion/modesty-and-audacity.html?_r=0 2*. Rau, J., Appleby, J. “Justices uphold individual mandate, set limits on Medicaid expansion.” Kaiser Health News, June 28,

    2012. Available at: http://www.kaiserhealthnews.org/stories/2012/june/28/supreme-court-upholds-individual-mandate.aspx 3. Jost, T.S. “The affordable care act largely survives the Supreme Court’s scrutiny – but barely.” Health Affairs 31(8):1659-1662,

    2012. Available at: http://content.healthaffairs.org/content/31/8/1659.full Implementation of PPACA

    1*. Schouten, F. “Health care law opponents dominate advertising wars.” USA Today, July 10, 2013. Available at: http://www.usatoday.com/story/news/politics/2013/07/10/affordable-care-act-ads-nfl-president-obama-republicans-attacks/2506633/

    2*. Bolton, A. “Government shutdown looms over ObamaCare.” The Hill, July 23, 2013. Available at: http://thehill.com/homenews/administration/312727-shutdown-looms-over-obamacare

    3*. Cheney, K. “House GOP unveils death by 1,000 cuts.” Politico, July 17, 2012. Available at: http://www.politico.com/news/stories/0712/78627.html

    4*. Editorial Board. “Obamacare’s tricky next phase.” The Washington Post, May 19, 2013. Available at: http://articles.washingtonpost.com/2013-05-19/opinions/39376708_1_health-insurance-health-coverage-obamacare-s

    5. Millman, J. “Exchanges, but not as envisioned.” Politico, April 8, 2013. Available at: http://www.politico.com/story/2013/04/obamacare-health-care-exchanges-states-tout-employee-choice-89719.html

    6. Pear, R. “Racing to spread word about new health plans.” The New York Times, April 23, 2013. Available at: http://www.nytimes.com/2013/04/24/health/racing-to-inform-millions-unaware-of-new-health-coverage.html?pagewanted=all&_r=0

    7. Gold, J. “Worries mount about enrolling consumers in federally run insurance exchanges.” Kaiser Health News, April 7, 2013. Available at: http://www.kaiserhealthnews.org/stories/2013/april/08/health-insurance-exchanges-marketing.aspx

    11

    http://www.nejm.org/doi/pdf/10.1056/NEJMp0911116http://www.kff.org/us-congress-and-health-policy.cfmhttp://www.kaiserhealthnews.org/Stories/2010/November/17/health-industry-pacs-election-bets.aspxhttp://www.kaiserhealthnews.org/Stories/2010/November/17/health-industry-pacs-election-bets.aspxhttp://www.iwatchnews.org/2011/08/22/5859/top-health-information-technology-firms-prefer-revolving-door-lobbyistshttp://content.healthaffairs.org/content/early/2003/08/27/hlthaff.w3.376.full.pdf+htmlhttp://www.kff.org/healthreform/kEDU_health_reform_overview_100110.cfmhttp://articles.washingtonpost.com/2011-03-21/business/35260878_1_health-care-reform-law-affordable-care-act-insurancehttp://articles.washingtonpost.com/2011-03-21/business/35260878_1_health-care-reform-law-affordable-care-act-insurancehttp://www.washingtonpost.com/opinions/putting-health-care-on-the-right-track/2012/06/21/gJQAtBGltV_story.htmlhttp://articles.washingtonpost.com/2013-05-09/opinions/39133432_1_affordable-care-act-health-care-uninsured-and-medicaid-recipientshttp://articles.washingtonpost.com/2013-05-09/opinions/39133432_1_affordable-care-act-health-care-uninsured-and-medicaid-recipientshttp://articles.washingtonpost.com/2013-05-09/opinions/39133432_1_affordable-care-act-health-care-uninsured-and-medicaid-recipientshttp://articles.washingtonpost.com/2013-05-09/opinions/39133432_1_affordable-care-act-health-care-uninsured-and-medicaid-recipientshttp://www.nytimes.com/2012/07/16/opinion/keller-five-obamacare-myths.html?pagewanted=all&_r=0http://jama.jamanetwork.com/issue.aspx?journalid=67&issueid=927181&direction=Phttp://www.nytimes.com/2012/06/29/opinion/modesty-and-audacity.html?_r=0http://www.kaiserhealthnews.org/stories/2012/june/28/supreme-court-upholds-individual-mandate.aspxhttp://content.healthaffairs.org/content/31/8/1659.fullhttp://www.usatoday.com/story/news/politics/2013/07/10/affordable-care-act-ads-nfl-president-obama-republicans-attacks/2506633/http://www.usatoday.com/story/news/politics/2013/07/10/affordable-care-act-ads-nfl-president-obama-republicans-attacks/2506633/http://thehill.com/homenews/administration/312727-shutdown-looms-over-obamacarehttp://www.politico.com/news/stories/0712/78627.htmlhttp://articles.washingtonpost.com/2013-05-19/opinions/39376708_1_health-insurance-health-coverage-obamacare-shttp://www.politico.com/story/2013/04/obamacare-health-care-exchanges-states-tout-employee-choice-89719.htmlhttp://www.nytimes.com/2013/04/24/health/racing-to-inform-millions-unaware-of-new-health-coverage.html?pagewanted=all&_r=0http://www.nytimes.com/2013/04/24/health/racing-to-inform-millions-unaware-of-new-health-coverage.html?pagewanted=all&_r=0http://www.kaiserhealthnews.org/stories/2013/april/08/health-insurance-exchanges-marketing.aspx

  • https://docs.google.com/a/umn.edu/file/d/0B7LWJ83cOEeeR1IyeDE2WkJ0cHc/edit

    8. Krugman, P. “Insurance and freedom.” The New York Times, April 7, 2013. Available at: http://www.nytimes.com/2013/04/08/opinion/krugman-insurance-and-freedom.html

    9. Brooks, D. “Health chaos ahead.” The New York Times, April 25, 2013. Available at: http://www.nytimes.com/2013/04/26/opinion/brooks-health-chaos-ahead.html

    10. Kessler, D.P. “The coming Obamacare shock.” The Wall Street Journal, April 29, 2013. Available at: http://online.wsj.com/article/SB10001424127887324874204578441032081716170.html

    11. Calmes, J. “New worries for Democrats on health law.” The New York Times, May 6, 2013. Available at: http://www.nytimes.com/2013/05/07/us/politics/gop-is-readying-a-new-offensive-over-health-law.html?pagewanted=all

    12. Kessler, G. “Is Long Beach really limiting the hours of 1,600 workers because of ‘Obamacare’?” The Washington Post, May 6, 2013. Available at: http://www.washingtonpost.com/blogs/fact-checker/post/is-long-beach-really-limiting-the-hours-of-1600-workers-because-of-obamacare/2013/05/05/81e9a5b6-b4fe-11e2-9a98-4be1688d7d84_blog.html

    13*. Klein, E., Soltas, E. “Wonkbook: House Republicans hate Obamacare. But they also kind of need it.” The Washington Post, May 17, 2013. Available at: http://www.washingtonpost.com/blogs/fact-checker/post/is-long-beach-really-limiting-the-hours-of-1600-workers-because-of-obamacare/2013/05/05/81e9a5b6-b4fe-11e2-9a98-4be1688d7d84_blog.html

    14*. Samuelson, D., Cunningham, P.W. “Obamacare repeal now about the IRS.” Politico, May 16, 2013. Available at: http://www.politico.com/story/2013/05/obamacare-repeal-irs-91520.html

    15. Carey, M.A. “GOP fears about IRS’ access to medical records disputed.” Kaiser Health News Blog, May 20, 2013. Available at: http://capsules.kaiserhealthnews.org/?p=19604

    16. Bogardus, K. “Labor unions break ranks with White House on Obamacare.” The Hill, May 21, 2013. Available at: http://thehill.com/business-a-lobbying/300881-labor-unions-break-ranks-on-health-law

    17. Weisman, J., Pear R. “Partisan gridlock thwarts effort to alter health law.” The New York Times, May 26, 2013. Available at: http://www.nytimes.com/2013/05/27/us/politics/polarized-congress-thwarts-changes-to-health-care-law.html?pagewanted=all

    18. Esenstadt, A. “Democrats’ 2014 strategy: Own Obamacare.” Politico, June 4, 2013. Available at: http://www.politico.com/story/2013/06/dems-2014-strategy-own-obamacare-92172.html

    19*. Baker, S. “Court challenges could tear down major pieces of Obamacare.” The Hill, June 2, 2013. Available at: http://thehill.com/blogs/healthwatch/health-reform-implementation/302895-court-challenges-could-tear-down-major-pieces-of-obamacare

    Other Efforts to Expand Coverage for the Uninsured 1. Henry J. Kaiser Family Foundation. “Massachusetts health care reform: Six years later.” Issue Brief, May 2012. Available at:

    http://www.kff.org/healthreform/upload/8311.pdf 2*. Goldman, D. Leive, A. “Why ‘Medicare-for-all” is not the answer.” Health Affairs Blog, May 14, 2013. Available at: http://healthaffairs.org/blog/2013/05/14/why-medicare-for-all-is-not-the-answer/ 3. Hsiao, W.C. “State-based, single-payer health care — A solution for the United States?” New England Journal of Medicine

    364(13):1188-1190, 2011. Available at: http://www.nejm.org/doi/pdf/10.1056/NEJMp1100972 Further Readings

    1. Accenture. “Are you ready? Private health insurance exchanges are looming,” 2013. Available at: http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Are-You-Ready-Private-Health-Insurance-Exchanges-Are-Looming.pdf

    2. Goodnough, A. “Critics of health care law outspending its supporters on ads.” The New York Times, June 4, 2013. Available at: http://www.nytimes.com/2013/06/05/us/politics/critics-of-health-care-law-outspending-its-supporters-on-ads.html?gwh=36412B4E76FE81E688FB25886FB8FE9F

    3. Baker, S. “HHS delays Obamacare option for small businesses, saying it’s too complicated.” The Hill, May 31, 2013. Available at: http://thehill.com/blogs/healthwatch/health-reform-implementation/302769-hhs-finalizes-delay-in-obamacare-option-for-small-businesses

    4. Baker, S. “Despite talk, no effort in Congress to change Obamacare’s employer mandate.” The Hill, May 19, 2013. Available at: http://thehill.com/blogs/healthwatch/health-reform-implementation/300489-despite-talk-no-effort-to-change-obamacares-employer-mandate

    5. Viebeck, E. “Botched Obamacare rollout tops Democratic fears for 2014 election.” The Hill, May 1, 2013. Available at: http://thehill.com/blogs/healthwatch/health-reform-implementation/297103-botched-obamacare-tops-dem-fears-for-14

    6. Klein, E. “Republicans will clobber Obamacare until they hug it.” Bloomberg, April 24, 2013. Available at: http://www.bloomberg.com/news/2013-04-24/republicans-will-clobber-obamacare-until-they-hug-it.html

    7. Pittman, D. “Docs must take active role in reform, HHS says,” Medpage Today, February 12, 2013. Available at: http://www.medpagetoday.com/Washington-Watch/Reform/37336

    8. Vestal, S. “Lack of competition might hamper health exchanges.” Kaiser Health News, April 23, 2013. Available at: http://www.kaiserhealthnews.org/stories/2013/april/23/stateline-lack-of-competition-hamper-health-exchanges.aspx

    9. Chen, L. “How Obamacare will distort the health-care market.” Bloomberg, April 7, 2013. Available at: http://www.bloomberg.com/news/2013-04-07/how-obamacare-will-distort-the-health-care-market.html

    12

    http://www.nytimes.com/2013/04/08/opinion/krugman-insurance-and-freedom.htmlhttp://www.nytimes.com/2013/04/26/opinion/brooks-health-chaos-ahead.htmlhttp://online.wsj.com/article/SB10001424127887324874204578441032081716170.htmlhttp://www.nytimes.com/2013/05/07/us/politics/gop-is-readying-a-new-offensive-over-health-law.html?pagewanted=allhttp://www.washingtonpost.com/blogs/fact-checker/post/is-long-beach-really-limiting-the-hours-of-1600-workers-because-of-obamacare/2013/05/05/81e9a5b6-b4fe-11e2-9a98-4be1688d7d84_blog.htmlhttp://www.washingtonpost.com/blogs/fact-checker/post/is-long-beach-really-limiting-the-hours-of-1600-workers-because-of-obamacare/2013/05/05/81e9a5b6-b4fe-11e2-9a98-4be1688d7d84_blog.htmlhttp://www.washingtonpost.com/blogs/fact-checker/post/is-long-beach-really-limiting-the-hours-of-1600-workers-because-of-obamacare/2013/05/05/81e9a5b6-b4fe-11e2-9a98-4be1688d7d84_blog.htmlhttp://www.washingtonpost.com/blogs/fact-checker/post/is-long-beach-really-limiting-the-hours-of-1600-workers-because-of-obamacare/2013/05/05/81e9a5b6-b4fe-11e2-9a98-4be1688d7d84_blog.htmlhttp://www.politico.com/story/2013/05/obamacare-repeal-irs-91520.htmlhttp://capsules.kaiserhealthnews.org/?p=19604http://thehill.com/business-a-lobbying/300881-labor-unions-break-ranks-on-health-lawhttp://www.nytimes.com/2013/05/27/us/politics/polarized-congress-thwarts-changes-to-health-care-law.html?pagewanted=allhttp://www.politico.com/story/2013/06/dems-2014-strategy-own-obamacare-92172.htmlhttp://thehill.com/blogs/healthwatch/health-reform-implementation/302895-court-challenges-could-tear-down-major-pieces-of-obamacarehttp://thehill.com/blogs/healthwatch/health-reform-implementation/302895-court-challenges-could-tear-down-major-pieces-of-obamacarehttp://www.kff.org/healthreform/upload/8311.pdfhttp://healthaffairs.org/blog/2013/05/14/why-medicare-for-all-is-not-the-answer/http://www.nejm.org/doi/pdf/10.1056/NEJMp1100972http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Are-You-Ready-Private-Health-Insurance-Exchanges-Are-Looming.pdfhttp://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Are-You-Ready-Private-Health-Insurance-Exchanges-Are-Looming.pdfhttp://www.nytimes.com/2013/06/05/us/politics/critics-of-health-care-law-outspending-its-supporters-on-ads.html?gwh=36412B4E76FE81E688FB25886FB8FE9Fhttp://www.nytimes.com/2013/06/05/us/politics/critics-of-health-care-law-outspending-its-supporters-on-ads.html?gwh=36412B4E76FE81E688FB25886FB8FE9Fhttp://thehill.com/blogs/healthwatch/health-reform-implementation/302769-hhs-finalizes-delay-in-obamacare-option-for-small-businesseshttp://thehill.com/blogs/healthwatch/health-reform-implementation/302769-hhs-finalizes-delay-in-obamacare-option-for-small-businesseshttp://thehill.com/blogs/healthwatch/health-reform-implementation/300489-despite-talk-no-effort-to-change-obamacares-employer-mandatehttp://thehill.com/blogs/healthwatch/health-reform-implementation/300489-despite-talk-no-effort-to-change-obamacares-employer-mandatehttp://thehill.com/blogs/healthwatch/health-reform-implementation/297103-botched-obamacare-tops-dem-fears-for-14http://www.bloomberg.com/news/2013-04-24/republicans-will-clobber-obamacare-until-they-hug-it.htmlhttp://www.medpagetoday.com/Washington-Watch/Reform/37336http://www.kaiserhealthnews.org/stories/2013/april/23/stateline-lack-of-competition-hamper-health-exchanges.aspxhttp://www.bloomberg.com/news/2013-04-07/how-obamacare-will-distort-the-health-care-market.html

  • https://docs.google.com/a/umn.edu/file/d/0B7LWJ83cOEeeR1IyeDE2WkJ0cHc/edit

    10. Carey, M.A. “How the ‘fiscal cliff’ affects health care: Six questions.” Kaiser Health News, December 4, 2012. Available at: http://www.kaiserhealthnews.org/stories/2012/december/05/fiscal-cliff.aspx

    11. Dionne Jr., E.J. “A victory for Obama – and for Roberts.” Washington Post online Opinions, June 28, 2012. Available at: http://www.washingtonpost.com/opinions/ej-dionne-jr-a-win-for-obama--and-roberts/2012/06/28/gJQAlWta9V_story.html

    12. Horwitz, J., Levy, H. “Health care economics 101 and the Supreme Court.” Health Affairs Blog, May 23, 2012. Available at: http://healthaffairs.org/blog/2012/05/23/health-care-economics-101-and-the-supreme-court/

    13. Steuerle, C.E. “How much did the Supreme Court settle?” Urban Institute Research of Record, July 2, 2012. Available at: http://www.urban.org/publications/901516.html

    14. Gawande, A. “Something wicked this way comes.” The New Yorker online, June 28, 2012. Available at: http://www.newyorker.com/online/blogs/comment/2012/06/something-wicked-this-way-comes.html

    15. Kessler, G. “Fact checker: Does Romney’s assessment of the economic impact of Obama’s health-care law hold up?” Washington Post online Politics, June 16, 2012. Available at: http://www.washingtonpost.com/politics/fact-checker-does-romneys-assessment-of-the-economic-impact-of-obamas-health-care-law-hold-up/2012/06/16/gJQAJjsqhV_story.html

    16. Daschle, T. “Obama’s 4 major ACA hurdles to go.” Politico, July 8, 2012. Available at: http://www.politico.com/news/stories/0712/78207.html

    17. Gerstein, J., Haberkorn, J. “Supreme Court health care ruling: 6 takeaways.” Politico, June 28, 2012. Available at: http://www.politico.com/news/stories/0612/77986.html

    18. Parker-Pope, T. “What you need to know in the first year.” New York Times, March 30, 2010, p. D.1. Available at: http://ic.galegroup.com/ic/suic/NewsDetailsPage/NewsDetailsWindow?failOverType=&query=&prodId=SUIC&windowstate=normal&contentModules=&mode=view&displayGroupName=News&limiter=&currPage=&disableHighlighting=false&displayGroups=&sortBy=&source=&search_within_results=&action=e&catId=&activityType=&scanId=&documentId=GALE%7CA222455099

    19. Rago, J. “The Massachusetts health-care ‘train wreck’.” The Wall Street Journal, July 7, 2010, p. A.17. Available at: http://online.wsj.com/article/SB10001424052748704324304575306861120760580.html

    20. Pear, R. “Short of repeal, G.O.P. will chip at health law.” New York Times, September 21, 2010, p. A.1. Available at: http://ic.galegroup.com/ic/suic/NewsDetailsPage/NewsDetailsWindow?failOverType=&query=&prodId=SUIC&windowstate=normal&contentModules=&mode=view&displayGroupName=News&limiter=&currPage=&disableHighlighting=false&displayGroups=&sortBy=&source=&search_within_results=&action=e&catId=&activityType=&scanId=&documentId=GALE%7CA237499337

    21. Cafarella, N., Carrk, T.


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