Public Health Policy and Politics
EPID 603 Jack O. Lanier, MHA, DrPH, FACHE
Public Health Policy and Politics
Semester course; 3 lecture hours. 3 credits. Provides an understanding of the
public health policy development process, the influence of politics and special
interest groups on this process, and current governmental policies for the
provision of major public health services. The legislative process is a major
focus of the course. Spring semester
Spring Semester 2006
Day/Time/Location: |
Thursdays, 2:00 – 4:50 p.m. Grant House, Room 110 1008 East Clay Street , Richmond, VA |
Credits: |
3 credit hours |
Instructor: |
Jack O. Lanier, Dr.P.H, MHA, FACHE Professor Office: McGuire Annex, Room 324 Phone: 804-828-3258 Fax: 804-225-4096 Email: jolanier@vcu.edu |
MPH Program Mission Statement
The Mission of the MPH Program at Virginia Commonwealth University is to educate individuals to become highly qualified public health professionals. Students develop the knowledge, attitudes and skills needed to identify and assess health needs of underserved and other populations; determine risk and protective factors for disease or health-related outcomes using epidemiologic and statistical methods; plan, implement and evaluate public health prevention programs; and work with communities to promote and protect their health and well-being.
Course Description:
The Course will focus on health-related issues, the structure of federal and state governments, and their role in the policymaking process. Students will gain a working knowledge of the role elected officials play in the legislative process.
Students of differing backgrounds will acquire an understanding of the determinants of health and health policy; and the political and social dimensions of the U.S. health care system. Additionally, students will learn strategies and techniques for developing legislative and regulatory initiatives. The course also provides an understanding of the influence of special interest groups on the legislative process, and the ability to track health-related issues during legislative sessions.
The Course further examines the impact of policy development and legislative initiatives pertaining to vulnerable and at-risk population groups.
Matriculation Criteria:
Graduate student status or faculty appointment at VCU is required. It is preferred that Graduate students will have completed at least one of the following core courses: EPID600 – Introduction to Public Health; EPID602 – Health Care Organization and Services; and EPID 571 – Principles of Epidemiology. Graduate studies already completed with content similar to either of these three core subjects may be considered as substitutes. Exception to this policy requires the prior approval of the course instructor.
Important Dates:
The Course is taught in 16 3-hour sessions with student research and study outside the classroom expected. Class sessions will be held each Thursday from 2:00 p.m. to 4:50 p.m., beginning January 19, 2006. The last class session is scheduled for Thursday, May 4, 2006, followed by a final examination scheduled for Thursday, May 11, 2006.
Spring vacation begins noon Saturday, March 12, 2006 and ends. Sunday,March 19, 2006. Accordingly, there will be no class Thursday, March 16, 2006. The course ends Thursday, May 11, 2006, with the final examination.
May Commencement: May 20, 2006,
Learning Objectives:
Upon completion of the course, students will be able to:
- Define health and health policy
- Identify and explain the components of the health policy-making process at the Federal and State levels of government.
- Describe the components and function of the Virginia General Assembly in crafting health legislation.
- Identify key special interest groups and their impact on the legislative process and agenda setting.
- Diagram and present a policy domain model designed to influence legislative outcomes.
- Critically examine selected health policies that may impact the health status (outcome) of targeted and at-risk population groups. .
- Identify and list significant characteristics of vulnerable and at-risk population groups.
- Design and present a process or model for agenda setting, resource allocation, and determining health outcomes.
- Research and present a scholarly health policy-related issue paper. Each student will prepare an eight-page report based on an approved research topic (research outline and guidelines follow). The issue paper must be prepared by each individual student and presented during a specified class period. The issue selected must be based on a legislative proposal or regulatory issue being considered by the 2006 Virginia General Assembly.
Expected Outcome:
A student well equipped with the essential knowledge and skills capable of participating in the health policymaking and legislative process. A student possessing a clear knowledge and understanding of the role of the nation’s political institutions and the influence of certain special interest and advocacy groups.
Reference Materials:
Required text
Longest, Beaufort B, Jr. (2006). Health Policymaking in the United States. Fourth Edition. Ann Arbor, MI: Health Administration Press.
Key Web Sites:
Virginia General Assembly: http://legis.state.va.us/LegislativeInformationSystem
Joint Commission on Health Care: http://legis.state.va.us/jchc/jchchome.htm
Governor’s proposed budget (Key priorities):http://www.vcu.edu/govre1/ga.shtm1
Governor’s 2006-08 budget recommendations pertaining to VCU:
http://www.finance.vcu.edu/pdfs/governorbudgethightlights.pdf
Supplemental references (at students’ discretion)
Carpini, Michael X. Delli, & Keeter, Scott. (1996). What Americans Know about Politics and Why It Matters. New Haven, CT: Yale University Press.
Cater, Douglas, & Lee, Philip R. (1972). Politics of Health. New York: MEDCOM.
Falk, Erika (2002). Print and Television: Legislative Issue Advertising in the Nation’s
Capital in 2001. Annenburg Public Policy Center.
Feldstein, Paul J. (1996). The Politics of Health Legislation: An Economic Perspective. 2 nd Ed. Ann Arbor, MI: Health Administration Press.
Fuchs, Victor R. (1974). Who Shall Live? Health, Economics, and Social Choice. New York: Basic Books.
Melhado, Evan M, Feinberg, Walter, & Swartz, Harold M., Eds. (1988). Money, Power, and Health Care. Ann Arbor, MI: Health Administration Press.
Novick, Lloyd F., Woltring, Carol S., and Fox, Daniel M. (1997). Public Health Leaders Tell Their Stories. Gaithersburg, MD: Milbank Memorial Fund.
Patrick, Donald L., & Erickson, Pennifer. (1993). Health Status and Health Policy: Allocating Resources to Health Care. New York: Oxford University Press (Chapters 1, 2, 14 & 15).
Serow, Ann G., Shannon, W. Wayne, & Ladd, Everett C., Eds. 1993). The American Polity Reader. 2 nd Ed. New York: W.W. Norton & Co.
Shively , W. Phillips. (1995). Power & Choice: An Introduction to Political Science. 4 th Ed. New York: McGraw-Hill.
Starr, Paul. (1992). The Logic of Health Care Reform: Transforming American Medicine for the Better. Knoxville, TN: Grand Rounds Press.
Starr, Paul. (1982). The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast University. New York: Basic Books.
Additionally, students are encouraged to read and become thoroughly familiar with several significant health policy-related journals and current professional publications to include:
The American Journal of Public Health
Business and Health
Health Affairs
Inquiry
JAMA
The Journal of Health Politics, Policy and Law
Milbank Memorial Fund Quarterly
The Nation’s Health
The New England Journal of Medicine
The New York Times
The Wall Street Journal
The Washington Post Health Section (published each Tuesday in the Post).
To access the Virginia General Assembly: http://legis.state.va.us
Student and Course Evaluation:
The EPID 603 course is designed to provide students with the cognitive skills to better understand the development and practical aspects of health policy and politics. An in-class mid-term examination will be given to assess the student’s progress to date. Additionally, each student must identify a health-related issue, research the problem, and prepare a scholarly report to present during a specified class period.
- A final examination also will be administered at the end of the course: May 11, 2006.
- A letter grade will be assigned at the end of the course based on the following criteria and course requirements:
- Attendance and in-class participation (essential) 10%
- Mid-term examination 25%
- Development and presentation of a research issue paper 40%
- Final examination 25%
Health Policy Issue Paper Presentation:
- A major course requirement is a well-researched health-related issue paper, demonstrating knowledge of the policymaking process. The paper shall contain no more than eight (8) typewritten pages inclusive of the cover and reference pages, double-spaced, with one-inch margins all around.
- The issue paper should be based on a health-related proposal introduced during the 2006 legislative session of the Virginia General Assembly.
- The required format for the research paper follows: Please adhere strictlyto the outline prescribed below. Also, it is recommended for students to consult with the course instructor during the initial phase of getting started.
Requirement: Identify and select a health-related legislative or regulatory proposal introduced before the 2006 Virginia General Assembly. Research and present a scholarly paper, demonstrating a clear understanding of the policymaking process.
- Problem/issue identification: Identify and state the scope and magnitude of the issue and its impact (or potential) on an organization(s), a community, or a specific population group. Also include the title of the issue paper. The legislative patron, sponsor or special interest group(s) should be identified and acknowledged as well. State why the issue has come before the Virginia General Assembly.
- Objective(s) of the research paper. State the objective of the legislative proposal, and the purpose/rationale for selecting the topic. What was the legislative proposal designed to do? And why?
- Literature review: Be scholarly in your approach. Provide relevant supporting background information from appropriate professional publications. Include health policy-related citations in references.
- Include policy-related material pertaining to the issue selected. Provide useful examples of similar strategies and action taken by other legislative bodies
- Identify and reference relevant federal, state, or local legislation (if any) bearing on the issue/problem.
- Significance of the issue/problem
- Explain the impact on any organizations, communities, or targeted population group(s) identified.
- State the relevance of any health policy having a bearing on the health status (outcomes) of individuals or communities identified.
- Identify and explain any resource requirement, financial or budgetary consideration pertaining to legislative proposal selected.
- Identify any advocacy or special interest groups, organizations, or institutions involved in the issue or problem:
- State their role and function.
- Explain their position and any influence efforts.
- Identify any resource or financial support devoted to the issue selected.
- Explain and outline the political process and policies pertaining to the issue selected
- Findings and Conclusion
- Summarize the findings and assessment of the issue researched
- Suggest or recommend strategies that may alleviate or minimize the problem, or lessen the impact given the outcome of the legislative action
- Identify and specify any further legislative or policy fix deemed appropriate.
NOTE: Each section of the research issue paper must include a topical
heading as indicated above. Remember: Eight (8) pages are the
limit of the paper.
Preparation and Submission of Issue Paper
Students will be assigned to work in groups. Even though a single group may work on a single issue, each student must present his/her own research paper based on the single issue identified and addressed collectively by the group.
Students should have identified and begun research on a health-related policy issue by the fourth week of the course ( 2/09/06). Please seek further guidance or clarification from the course instructor, if necessary.
All student issue papers (a single copy from each student) are due to the instructor (typed according to format described above) by March 30, 2006, at the end of the class period. Consideration may be given to any student with unusual or extenuating circumstances if the deadline becomes problematic.
The instructor is available to provide additional guidance and direction to any student in need of such assistance. Also, students are encouraged to consult with their VCU/MCV faculty advisor, members of the Virginia General Assembly, state and city cabinet officials, members of special interest groups, and local and national health policy officials, as may be necessary.
Research Issue Paper Presentation
Each student must present an oral report of his/her selected health policy issue. Each student should demonstrate an understanding of the course objectives, course content, and the ability to analyze and present a particular legislative issue. The use of visual aids is optional, and at the discretion of the student. Each student group will be allotted 20 minutes for the in-class presentation, unless otherwise advised by the instructor in advance. Each student paper should reference and address at least one of the learning objectives included in the course syllabus.
Thoughts to Ponder:
“Remember, in politics as in business, you don’t get what you deserve, you get what you negotiate.”
- “All politicians are susceptible to the will of the people.”
- “Practical politics consists of ignoring the facts.”
- “Get to know them before you need them.”
- The rule in policy-politics: “Expect the unexpected.”
F. “Our position gives us authority, our behavior gives us respect,”
Irwin Federman, CEO, Monolitic Memories.
Schedule and Outline of Class Sessions:
WEEK 1 : January 19, 2006 Introduction to Health-Related Issues, Health
Determinants, and the Policymaking Process
Objectives : At the conclusion of this session, students will be able to:
- Demonstrate an understanding of the course objectives and course requirements
- Define health and health policy.
- Identify and describe the role of elected public officials in the policymaking process.
- Describe and discuss the policymaking process at the Federal and State level
References :
Longest, Chapters 1 and 2
Somers, A. R. (1971). Health Care in Transition: Directions for the Future. Chicago: Hospital Research and Education Trust.
Carpini, M. X. D., & Keeter, S. (1996). What Americans Know about Politics and Why It Matters. New Haven, CT: Yale University Press
WEEK 2 : January 26, 2006 A Model for Health Policymaking In the U.S.
(Longest)
Assigned Readings: Longest, Chapter 1 and 2
Objectives : At the conclusion of this session, students will be able to:
Identify and appraise determinants of health and health policy
Describe and diagram the role of the Virginia General Assembly in developing health policy
Discuss the role of the General Assembly’s Legislative Information Service (LIS) in crafting legislative proposals
- Identify and define categories of health policy (Longest, Chap 1)
- Distinguish the connection between health policy and health (Longest, Chap 1)
WEEK 3 : February 02, 2006 The Virginia General Assembly’s
2006 Health-Related Legislative Agenda
Guest speaker: JoAnne Kirk Henry, Ed.D, RN. Director, VCU Office of
Health Policy and Associate Dean, VCU School of Nursing
Assigned Readings: Longest, Chapters 3 and 4
Objective : At the conclusion of this session, students will be able to:
- Describe and discuss major health-related legislative proposals introduced before the 2006 Virginia General Assembly.
- Identify and list the key components of policy implementation.
- Identify and list 5 demanders and 5 suppliers of health policies (Longest, Chap 3).
WEEK 4 : February 09, 2006 The Policymaking Components of
Federal and State Government
Assigned Readings : Longest, Chapters 5 and 6
Objectives: At the conclusion of this session, students will be able to:
- Discuss and describe the constitutional branches of federal and state governments.
- Discuss and describe the agenda setting phase of policy formulation.
- Identify and describe the role of special interest groups and advocates in policy formulation.
- Identify and describe the role of key legislative committees responsible for
health-related legislation.
- Identify a health-related issue introduced before the 2006
Virginia General Assembly to research.
- Describe the process for originating and drafting legislative proposals
(Longest, Chapters 5 and 6).
WEEK 5 : February 16, 2006 Politics and the Inner-Workings of the Virginia
General Assembly.
Guest speaker : Donald C. J. Gehring, JD, VCU Vice President
for
Government and Community Relations,
Assigned Readings : Longest, Chapters 6 and 7
Objectives : At the conclusion of this session, students will be able to:
- Describe the anatomy and legislative processes of the Virginia General Assembly.
- Explain key practical approaches to effective legislative agenda setting (Gehring’s Great Eight policy axioms).
- Discuss the impact of special interest groups in the legislative process.
- Describe the role and significance of Committee assignments.
WEEK 6 : February 23, 2006 Virginia Politics: Past, Present and Future
Guest speaker : Robert D. Holsworth, Ph.D, Interim Dean,
College of
Humanities & Sciences & Director, VCU Center for
Public
Policy.
Assigned Readings: Special In-Class Handouts
Objectives : At the end of this session, students will be able to:
- Identify and discuss major political events in Virginia’s history.
- Describe the evolution of Virginia politics from early history to present.
- Identify and discuss the role of the major political parties in Virginia.
- Identify and determine the role of Virginia politics and policies related to health outcomes
WEEK 7 : March 02, 2006 Local Governments’ Responsiveness to health and
Social Needs of its Citizenry.
Guest speaker : L. Douglas Wilder, Mayor, City of Richmond
and Former
Governor of Virginia
Assigned Readings : VanHorn’s Policy Domains ( In-class handout)
Objectives : At the end of this session, students will be able to:
- Identify and describe the policymaking apparatus of city (including city Council Members) and county (including Supervisors and Administrators) governments. (See RTD schematic of Richmond City Government ( 01-01-05).
- Describe and discuss VanHorn’s six policy domains.
- Discuss and contrast VanHorn’s six policy domains and their application to the City of Richmond and local politics.
WEEK 08 : March 09, 2006 SPRING BREAK. No Class
WEEK 09 : March 23, 2006 Mid-Term Examination
WEEK 10 : March 30, 2005 The Role of the Media in Policy
Formulation and the Legislative Process
Guest speaker : Sheilah Kast, Anchor, The Weekend
News, PBS
Host, National Public Radio – Sunday Morning
Assigned Readings :
- Falk, Erika. Nov. 2001. Print and Television: Legislative Issue Advertising in the Nation’s Capital in 2001. Annenburg Public Policy Center.
- “A Measure of Media Bias,” a survey report of media bias by Tim Groseclose and Jeffrey Milyo
(www.politicalcortex.com/story/2005/12/21/20174
Quote : “There are known knowns; there are things
we know we know.
We also know there are known unknowns: that is to say we know
there are some things we do not know. But there are also unknown
unknowns - the ones we don’t know we don’t know.”
Donald Rumsfeld, Secretary of Defense, 2004.
Objective : At the end of this session, students will be able to:
- Describe and discuss the role of the media and its influence on public opinion and policy formulation
- Explain the impact of the media in highlighting health-related issues during the agenda setting phase of the policymaking process.
- Determine the impact and role of the media in reporting governmental actions during legislative sessions.
WEEK 11: April 06, 2006 Global Economic Issues and Their Impact
on World Health.
Guest speaker : Harry R. (Bob) Purkey (R), 82nd District,
Virginia
Beach
Objective: At the end of this session, students will be able to:
- Identify and discuss at least two global issues that impact health and health policy in the United States.
- Describe and discuss U.S. foreign policy that may impact health outcomes (Pandemic Flu, AIDS, SARS) at the Federal and State level
WEEK 12 : April 13, 2006 Student Legislative Research Policy Issue
Paper Presentations Begin
All Student Legislative Policy Research issue papers due to instructor
Objective : At the end of this session, students will be able to:
- Identify and present a health-related issue included in the 2006 Virginia General Assembly’s legislative session.
- Describe and discuss the policymaking process involved in the health-related issue selected (Refer to guidelines, page 6 of Syllabus) .
WEEK 13 : April 20, 2006 Student
Legislative Policy Issue Research
Paper Presentations Continue
O bjective : At
the end of this session, students will be able to:
- Identify and present a health-related issue included in the 2006 Virginia General Assembly ‘s legislative session
- Describe and discuss the policymaking process involved in the health-related issue selected
WEEK 14 : April 27, 2005 Student Legislative Policy Issue
Research Paper Presentations Continue
Objective : At the end of this session, students will be able to:
- Identify and present a health-related issue included in the 2006 Virginia General Assembly legislative session
- Describe and discuss the policymaking process involved in the health-related issue selected.
WEEK 15 : May 4, 2006 Student Legislative Policy Issue
Research Paper Presentations Conclude
Objective : At the end of this session, students will be able to:
- Identify and present a health-related issue included in the 2006 Virginia General Assembly.
- Describe and discuss the policymaking process involved in the health-related issue selected.
WEEK 16 : May 12, 2005 Administer In-Class Final Examination
Objective : At the end of the semester, students will be able to:
- Demonstrate their mastery and understanding of the legislative process
- Demonstrate a thorough knowledge of the determinants of health and the impact of policy on health outcomes.
Graduation: VCU/MCV Commencement: Saturday, May 20, 2006
Guest Speaker List
Instructor: Jack O. Lanier, Dr.P.H., MHA, FACHE
Spring semester 2006
February 02, 2006 |
JoAnne Kirk Henry, Ed.D, RN, MPH |
Director, Office of Health Policy, VCU, and Associate Professor, Maternal-Child Nursing, VCU School of Nursing 828-2011
|
February 16, 2006 |
Donald C. J. Gehring, JD |
Vice President for External Relations, VCU 828-1235
|
February 23, 2006 |
Robert D. Holsworth, Ph.D |
Interim Dean, School of Humanities and Sciences, Professor and Director, VCU Center for Public Policy, 828-6837
|
March 02, 2006 |
L. Douglas Wilder |
Mayor, City of Richmond Former Governor, Commonwealth of Virginia 804-646-6260 ldwilder@ci.richmond.va.us
|
March 30, 2006 |
Sheilah Kast |
Anchor, The Weekend News, PBS Host, National Public Radio, Washington, DC and Baltimore, MD – Sunday Morning (301) 441-8045
|
April 06, 2006 |
Bob Purkey |
Delegate, 82 nd District ( Virginia Beach) Virginia General Assembly, Room 415 |
