Public Health Policy and Politics
EPID 603 Jack O. Lanier, Dr.PH, MHA, 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 2007
Day/Time/Location: |
Thursdays, 2:00 – 4:50 p.m. |
Credits: |
3 credit hours |
Instructor: |
Jack O. Lanier, Dr.PH, MHA, FACHE |
MPH Program Mission Statement
The mission of the MPH Program at Virginia Commonwealth
University is to promote health and well-being through commitment to
public health education, excellence in research, and dedication to community
service.
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 students’ 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: EPID 600 – Introduction
to Public Health; EPID 602 – Public Health
Organization and Management; 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 18, 2007.
The last class session is scheduled for Thursday, May 3, 2007,
followed by a final examination scheduled for Thursday, May
10, 2007.
Spring vacation begins noon Saturday, March 10, 2007 and
ends. Sunday, March 18, 2007. Accordingly, there
will be no class Thursday, March 15, 2007. The
course ends Thursday, May 10, 2007, with the
final examination.
May Commencement: Saturday, May 19,
2007
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.
- Identify key special interest groups and their impact on the legislative process.
- 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 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). An 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 2007 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.
Recommended text
Barbie K. Day & Becky Dale(2005). Notes from the Sausage Factory.
First Edition. Lawrenceville, VA: Brunswick Publishing Corporation.
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 2007-08 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. Additionally, each student must identify a health-related
issue, research the problem, and prepare a scholarly report to present
during a specified class period. The course assessment and evaluation
will include the following:
- An in-class mid-term examination to assess the student’s progress to date
- A final examination also will be administered at the end of the course: May 10, 2007.
- A letter grade 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 scholarly research issue paper 40%
- Final examination 25%
- Students will be required to provide an end-of-course evaluation at the end of the semester
Health Policy Issue Paper Presentation:
- A major course requirement is a well-researched, health-related issue paper, demonstrating each student’s 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 must be based on a health-related proposal introduced during the 2007 legislative session of the Virginia General Assembly.
- The required format for the research paper follows: Please adhere strictly to 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 2007 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. Specify what the legislative proposal was designed to do. And why.
- Literature review: Scholarship is required. Provide and cite relevant supporting background information from appropriate professional publications. Include health policy-related citations as 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 (pro or con) 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.
- State the final 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
Each student may select or will be assigned a policy-related issue.
Each student should have identified and begun research on a health-related
policy issue by the fourth week of the course (2/08/07). Students
should seek further guidance or clarification from the course instructor,
if necessary.
Each student’s issue paper (a single copy) is due to the instructor
(typed according to format described above) by March 29, 2007,
at the end of the class period. Consideration may be given to any student
with an unusual or extenuating circumstance, 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, local and national health policy officials, as may be
necessary.
Research Issue Paper Presentation
Each student must present an in-class oral report of his/her selected health
policy issue. Each student should demonstrate an understanding of the course
objectives, course content, 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 will be allotted 15 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 seven (7) 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.”
- “People who love the law or good sausage should never watch either
being made.”
- German Chancellor Otto von Bismarck, 1815-1898 - “Our position gives us authority, our behavior gives us respect”
Irwin Federman, CEO, Monolitic Memories.
Schedule and Outline of Class Sessions:
WEEK 1 : January 18, 2007 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
- Identify and explain the role and purpose of each branch of the federal and state government.
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 25, 2007 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 different categories of health policy (Longest, Chap 1)
- Distinguish the connection between health policy and health (Longest, Chap 1)
WEEK 3 : February 01, 2007 The Virginia General Assembly’s
2007 Health-Related Legislative Agenda
Guest speaker: JoAnne Kirk Henry, Ed.D, RN. Director, VCU
Office of Health Policy and Associate Dean (Emeritus), 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 2007 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 08, 2007 The Policymaking Components
of Federal and State Government
Guest speaker: Donald C. J. Gehring, JD, VCU Vice President
for Government and Community Relations
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 and describe a health-related issue introduced before the 2007 Virginia General Assembly to research.
- Describe the process for originating and drafting legislative proposals (Longest, Chapters 5 and 6).
WEEK 5 : February 15, 2007 Politics and the Inner-Workings
of the Virginia General Assembly.
Guest speaker : Delegate Jennifer L. McClellan, 71st
District (Richmond)
Assigned Readings : Longest, Chapters 6 and 7
Objectives : At the conclusion of this session, students
will be able to:
- Describe the anatomy and legislative process of the Virginia General Assembly.
- Explain key practical approaches to effective legislative agenda setting
- Discuss the impact of special interest groups in the legislative process.
- Describe the role and significance of Committee assignments.
WEEK 6 : February 22, 2007 Virginia Politics: Past, Present
and Future
Guest speaker : Senator John S. Edwards, 21st District
(Roanoke)
Assigned Readings: Longest, Chapters 8 and 9
Objectives : At the end of this session, students will
be able to:
- Discuss the Virginia State Board of Health’s policymaking role
- Discuss and describe the organization of Virginia state government
- 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
- State the purpose and expected outcome of the governor’s Health Reform Commission
WEEK 7 : March 01, 2007 Global Economic Issues and their
Impact on World Health
Guest speaker : Harry (Bob) R. Purkey, 82nd District,
Virginia Beach
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 08, 2007 SPRING BREAK. No Class
WEEK 09 : March 22, 2007 Mid-Term Examination
WEEK 10 : March 29, 2007 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, Washington, DC
and Baltimore, MD
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 as a watchdog of governmental actions
Paper Presentations Begin
All Student Legislative Policy Research issue papers due to
instructor
WEEK 11: April 06, 2007 Student Legislative Research Policy
Issue
Objective: At the end of this and the following sessions,
students will be able to demonstrate their knowledge and understanding
of the legislative process
WEEK 12 : April 12, 2007 Student Legislative Research
Policy Issue
WEEK 13 : April 19, 2007 Student Legislative Policy
Issue Research
WEEK 14 : April 26, 2005 Student Legislative Policy
Issue
WEEK 15 : May 3, 2007 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 2007 Virginia General Assembly.
- Describe and discuss the policymaking process involved in the health-related issue selected.
WEEK 16 : May 10, 2007 Administer In-Class Final
Examination
Objective : At the end of the semester, students will
be able to:
- Demonstrate a thorough knowledge of the determinants of health and the impact of policy on health outcomes.
- Demonstrate an understanding and mastery of the legislative and policymaking process
Graduation: VCU/MCV Commencement: Saturday, May 19, 2007
Guest Speaker List
Instructor: Jack O. Lanier, Dr.P.H., MHA, FACHE
Spring semester 2007
February 02, 2007 |
JoAnne Kirk Henry, Ed.D, RN, MPH |
Emeritus Director, Office of Health Policy,
VCU, and Associate Professor, Maternal-Child Nursing, VCU School
of Nursing |
February 08, 2007 |
Donald C. J. Gehring, JD |
Vice President for External Relations,
VCU |
February 15, 2007 |
Delegate Jennifer L. McClellan |
71st District, Richmond |
February 22, 2007 |
Senator John S. Edwards |
21st District, Roanoke |
March 01, 2007 |
Bob Purkey |
Delegate, 82nd District ( Virginia Beach) |
March 29, 2007 |
Sheilah Kast |
Anchor, The Weekend News, PBS |
