Department of Social Work, National Taiwan University
HEALTH CARE POLICY (310 15800) Fall 2005
https://ceiba.ntu.edu.tw/941spsl/
Fridays 9:10~12:10 at Room 209, Sociology/Social Work Building

INSTRUCTOR:
Jen-Huoy Tsay, Ph.D.
E-mail：jhtsay@ntu.edu.tw
TEL：(O) 33661249
Office: R. 413, Sociology/Social Work Building
Office Hours: by appointment

COURSE OBJECTIVES:
The objective of this course is to address the major issues facing the government and the public as they debate for reform of Taiwan's national health insurance system. Topics include profiles of Taiwan's health care system, economics and political theories in health care policy analysis, equity in health care and health, health care reform issues. With respect to the instructor's research interests, issue discussion is especially emphasized on the "demand side" (instead of supply side) perspective and the "equity" dimensions of health care policy with the balance of efficiency concern.
Each lecture of topics will include the introduction of current empirical studies and statistics as well as the theoretical knowledge. Multiple assignments are designed to facilitate students' learning of the material. After the class, students are expected to think health care issues precisely. In addition, students will advance their ability in literature review and paper writing through assignment practice.

PREREQUISITES:
There are no prerequisites, required or suggested.

COURSEWORK AND GRADING:
1. Assignment I (15%): analysis of health statistics. Five unfinished tables are assigned. Students should pick 2 out of 5, complete the tables and write a short essays to analyze the result. 09/23 assigned. 10/14 due.
2. Assignment II (15%): summary of one English article. Pick one from required reading list for schedule 10/28~11/18. 10/28 due.
3. Assignment III (10%): summary of one Chinese article. Pick one from suggested reading list for schedule 11/25~12/23. The reading list is posted on the ceiba. A guideline of summarizing a research article is also provided. 11/25 due.
4. Assignment IV (10%): analysis of news events. Pick one news event which is health care policy concerned. Write a two-to-three-page essays to analyze the event. The essays writing should apply the concepts you have learned from the class. 12/2 due.
5. Term Paper (40%):
(1) Submitting topics and outline (5%): by 11/18. The topics may be any health care issue of any specific vulnerable populations. The specific populations may be specified by age (e.g., infants, children, teens, the elderly, …), by sex (e.g., women, gay, …), by economics status (the poor, the uninsured, ...), by ethnics (e.g., the aboriginal, immigrant labor, …), by region (e.g., remote area, a specific city/county, …), by physical (e.g., the disabled, …), by employment (e.g., the unemployed, …), by health behavior (e.g., drug abuse, smoking, …). Health care issues may concern their health status, or health service utilization, or the delivery of health care for them.
(2) Oral presentation (10%): use of power point is encouraged. Scheduled by 11/28 and will be posted on ceiba.
(3) Written report (25%): a guideline of writing the term paper will be provided.
6. Class participation (10%):

COURSE CALANDAR AND READINGS (◎ required, ※ suggested, △ optional):
09/23 Introduction and Overview
Design of course. Confirmation of coursework and grading system.
SECTION I. PROFILE OF TAIWAN'S HEALTH CARE SYSTEM
09/30 Health Care Policy: Definition and development
Handout: Assignment I
◎ Lum, D. (1982). Problem Context of Health Care Policy. In Lum, D. (ed). Social Work and Health Care Policy. Totowa, NJ: Allanheld, Osmum & Co. Ch.1, 3-13.
△ Dhooper, S.S., (1997) Introduction. In Dhooper, S.S. Social Work in Health Care in the 21st Century. Thousand Oaks, California: Sage Publications. Ch1. 1-48.
△ Magner, G., (1996) Health Care and Rationing. In Raffoul, P.R., & McNeece, C.A. Future Issues for Social Work Practice. Needham Heights, Massachusetts: Allyn & Bacon. Ch4 39-48.
△ Rosenberg, G.(1997) Challenges of Managed Care for Health Professionals: Implications for Social Work Practice. In Kats, A.J., Lurie, A.& Vidal, C. Critical Social Welfare Issues - Tools for Social Work and Health Care Professionals. Binghamton, NY: The Haworth Press. Ch9. 143-160.
10/07 Health Status, Health Utilization, and Health Care Delivery: Overview
◎ Chiang, T. L.(1999). The Medical Policy: Taiwan's Experience. Taipei: Gi-Liou Press. (in Chinese).
※ Department of Health. (2004). Health and Vital Statistics I: General Health Statistics: 2003, Republic of China. Taipei: Department of Health, Executive Yuan, Taiwan, R.O.C. (in Chinese)
△ Hu, S. C. (2000). The Challenge and Turning-point of Taiwan Public Health in Globalization: Politics, Economics and Health. Chinese Journal of Public Health 19(1). (in Chinese).
△ Li, C. H., & Chou, Y. J. (2000). The Multinational Comparative Research of Health Insurance Statistical Charts: Cross-national Comparison (II). (Department of Health Technical Report DOH88-NH-037). (in Chinese).
10/14 National Health Insurance: Historical Review
Assignment I due.
◎ Chiang, T. (1997). Taiwan's 1995 health care reform. Health Policy 39: 225-239.
※ Cheng, S.H., & Chiang, T.L. (1997). The effect of universal health insurance on health care utilization. JAMA 278:89-93.
10/21 National Health Insurance: Current
※ Lu, J. R., Hsiao, W. C. (2003, May/June). Does universal health insurance make health care unaffordable? Lessons from Taiwan. Health Affairs 22(3): 77- 88.
※ Cheng, T. M. (2003, May/June). Taiwan's new national health insurance program: Genesis and experience so far. Health Affairs 22(3): 61-76.
SECTION II. THEORETICAL BACKGROUND
10/28 Why the state intervenes the distribution of health care resources?
Assignment II due.
◎ Barr, N. 3rd ed. (1998). The Economics of the Welfare State. Oxford: Oxford University Press. Part of Ch. 4, 77-92, 103-106.
11/04 The politics and health care policy
◎ Patel, K., & Rushefsky, M. E. 2nd ed. (1999). Health Care Politics and Policy in America. NY: M. E. Sharpe. Ch. 1, 1-24.
11/11 Why insures health care? And, why socializes health insurance?
◎ Arrow, K. J. (1963, December). Uncertainty and the welfare economics of medical care. American Economic Review 53(5), 941-973.
◎ Barr, N. 3rd ed. (1998). The Economics of the Welfare State. Oxford: Oxford University Press. Part of Ch. 5, 120-128.
11/18 The tradeoff of efficiency and equity for health care policy
Submit the topic and outline of term paper.
◎ Haveman, R. H. (1985). Does the Welfare State Increase Welfare? Reflections on Hidden Negatives and Observed Positives. Leiden: Stenfert Kroese. (pp.30)
SECTION III. EQUITY IN HEALTH CARE AND HEALTH
11/25 Equity of Health Care Finance
Assignment III due.
※ 11/25~12/23 Suggested reading list posted on the ceiba.
12/02 Equity of Health Service Utilization/Delivery
Assignment IV due.
12/09 Equity of Health
12/16 Health Care Issues for the vulnerable populations (I)
Oral presentation of term paper.
12/23 Health Care Issues for the vulnerable populations (II)
Oral presentation of term paper.
◎ Anderson, R. M., & Davidson, P. L. (1999). Measuring access and trends. In Williams, S. J., & Torrens, P. R. eds. 5th ed. Introduction to Health Services, 87-109.
SECTION IV. HEALTH CARE REFORM
12/30 The Reform of NHI: Financing
Oral presentation of term paper.
※ Barr, N. 3rd ed. (1998). The Economics of the Welfare State. Oxford: Oxford University Press. Part of Ch. 4, 92-101, 106-107.
※ Newhouse, J. (1992). Medical Care Costs: How Much Welfare Loss? Journal of Economic Perspectives 6(3), 3-21.
01/06 The Reform of NHI: Approaches
Video watch and Discussion.
Term paper due.