Health systems around the world are grappling with problems of cost, access, equity and quality of health care, and the tradeoffs among these objectives. Economic and political reforms designed to promote markets, manage competition, organize systems for public contracting, improve management, and change financial incentives in the health sector have been debated in most countries, and in many cases, implemented. While health system reform has received more attention than public health, there has also been increasing attention to what is often termed the “new public health.” As reforms to improve population health have been added to the political agenda, there have been new efforts to rekindle health reform.
In this seminar, we will apply some perspectives and tools of public policy analysis, and draw on international comparisons of health systems to analyze efforts at health system and public health reform. The readings, lectures and class discussions should make students more knowledgeable about policy options and policy changes in different countries. The seminar opens with an overview of how forces of “globalization” may affect health system reform. Next, we focus on ideas, concepts and theories of health care reform. We then attempt to go beyond the OECD and controversial WHO approach to health system performance and examine what may be learned in the United States from health systems and reform efforts in wealthy industrialized nations. The course provides a special focus on the experience of Britain, Germany and France. Each case will apply a common, general framework for analyzing health systems and reform while emphasizing different perspectives for approaching these topics. Students are required to select a wealthy OECD nation and become “experts” about the health system and efforts to reform it.
Prerequisites:CORE-GP.1022, HPAM-GP.1830 or HPAM-GP.1831, HPAM-GP.4830