We tend to be ethnocentric in our views of health care organization and policy. A look abroad, however, can provide insights about problems at home. In spite of differences in the or-ganization and financing of their health care systems, most countries share a number of common problems with the United States. First, is the question of deciding - or not explicitly deciding - what proportion of GNP should be devoted to health and welfare. Second, is the problem of agreeing on appropriate criteria to allocate health and social service expenditures. Third, is the problem of how to implement established policies: through regulation, promotion of competition, budgeting, or reimbursement incentives directed at health care providers.
In this class, I will ask students to become "experts" about a health system of their choice outside the United States but in a wealthy nation belonging to the Organization of Economic Co-operation and Development (OECD). Those with a special interest in developing nations or the transitional economies of Central and Eastern Europe may choose to become an expert in a sec-ond health system, as well, but all students must choose one wealthy nation that they can com-pare to the United States. We will examine a range of health systems with respect to their own published data, as well as data collected, and analyses conducted, by international organizations, e.g. the World Health Organization (WHO), OECD, the World Bank, and UNICEF.
The readings, lectures and class discussions will focus on the common problems and themes noted above and how they affect the organization and financing of health systems in wealthy nations. We begin with a discussion of how health care systems differ around the world and then focus on alternative ways of understanding health care systems. We also will examine how selective evidence is often marshaled to evaluate health care systems in the U.S. and abroad. Finally, and this is the heart of the class, we apply a range of different approaches to the empiri-cal analysis of health systems in selected nations, and examine the extent to which the available evidence supports or refutes widely shared views of different health care systems.
Prerequisites:CORE-GP.1018, CORE-GP.1022, HPAM-GP.1830 or HPAM-GP.1831; HPAM-GP.4830 (recommended), HPAM-GP.2836 (recommended)