ECONOMICS 415*--5T

HEALTH CARE ECONOMICS

Spring, 2009

 

Instructor Name: R. Morris Coats

Office Location:  102B White Hall

Phone number: 985-448-4237

Email: morris.coats@nicholls.edu

Webpage: http://www.nicholls.edu/mcoats

Blogpage: http://www.nicholls.edu/bastiatsbastions/

Office Hours: 1-3 p.m. MWF*, 10 a.m.-noon TR and by appointment (Friday Office Hours held in 210 Powell)

Class Schedule: 2M & 4M (ECON 211); 5T (ECON 415)

 

Catalog Description: 

Economics 415*--Health Care Economics 3-3-0. The supply and demand for health services. Markets for health professionals and health care provider firms. Discusses the roles of insurance, managed care and HMO's, professional licensure, for-profit and not-for-profit provider firms, and information problems in health care markets. Regulation, government financing of health care and health care reform issues discussed. 

*Can be taken for graduate credit.

 

Prerequisites: Junior standing, QBA 282 and Economics 211. 

 

Required Text and Other Materials:

 

Required Text:

imageservlet

 

 

 

 

 

 

 

 

 

 

 

James Henderson (2009). Health Economics & Policy, 4th  ed., Thompson, South-Western College Publishing.  ISBN: 032464518X 

see also http://www.cengage.com/cengage/student.do?codeid=969E&sortby=copy&type=all_radio&courseid=EC37&product_isbn=9780324645187&disciplinenumber=413&codeFlag=true

 

 

From time to time, I may assign short readings or videos that are accessible by the Internet or Blackboard.

 

Student Outcome Objectives:

 

Overall Course Goal:

To apply economic analysis to both market and non-market (i.e. government) institutions to increase understanding of health care markets.

 

Student Learning Outcome Objectives:

 

            Successful students in this course should be able to:

 

  1. Utilize basic economic analysis and statistical tools to answer questions about issues concerning the health care industry.
  2. Apply economic theory to examine historical and current data from health related markets.
  3. Develop a detailed demand and supply model of the health care industries to predict the consequences of various possible changes in health markets, such as changes in third-­party financing of health care.   Consider the difference between catastrophic 
  4. Compare and contrast the U.S. health care market and institutions with those of selected countries from around the world.
  5. Discuss the roles of both public and private sector financing of health care and the division between public and private health care goods and services.
  6. Analyze the role of professional education, training and licensing in physician and allied health professions, and their effects on quality and cost of health care.
  7. Compare and contrast the market and the public sector as organizing forces in the structure, conduct and performance of the health industry.
  8. Examine the structure of health care markets and the public and private institutions that make up the competitive environment for the health care     organization.
  9. Compare and contrast the roles of profit and not-­for-­profit provider firms in the health care industry.
  10. Analyze the role of limited information (significant information costs), especially asymmetric information, on the competitive environment of the health care industry and its role in the problems of supplier-­induced demand and moral hazard with health insurance.
  11. Analyze problems of the U.S. health care industry and the effects of proposed solutions. Included here as problems are: high health care costs due to avoidance of litigation, supplier-­induced demand, portability of health insurance, high administrative costs, shortages of health professionals, and cost-­shifting and the uninsured. Currently proposed solutions include: universal coverage, employer mandates, price controls, tort award restrictions, single­-payer plans, and government control of health professions (limits on entry to specialties, among others).

 

Course Content:

 

Course Outline

Topics, Assignments, Exams and Holidays

Chapters from Text

Date

I. Health Care Markets: An Introduction

 

 

A. Some Problems in the Market for Health Care in the U.S.

1

20-Jan

B. Health Care and Economic Basics

2

27-Jan

C. Analyzing Health Care Markets with Economics—proposal due

3

10-Feb

II. Demand-Side Considerations

 

 

A. Demand for Health and Health Care

5

17-Feb

B. Health Insurance and 3rd Party Payers

6

3-Mar

Midterm Exam

1-3,5-6

10-Mar

III. Supply-Side Considerations

 

 

A. Managed Care

7

17-Mar

B. Health Care Professionals

8

24-Mar

C. Hospitals Services

9

26-Mar

D. Pharmaceuticals Market--first draft due

10

2-Apr

E. Confounding Factors

11

7-Apr

V. Public Policy in Medical Care

 

 

A. Policies to Enhance Access

12

21-Apr

B. Policies to Contain Costs

13

23-Apr

C. Medical Care Systems Worldwide

14

28-Apr

B. Policies to Contain Costs—working draft due

15

30-Apr

C. Lessons for Public Policy—critique due

 

16

5-May

 

Final Exam

Final Manuscript of Paper Due 6:30 PM

 

7-16

15-May

 

Course Requirements:

 

1.      Text readings as in Course Content, below, as well as articles, handouts, or materials on reserve in the library or made available on the web.

2.      Viewing videos on the internet or Blackboard as assigned.

3.      Attendance at all class meetings.

4.      Students must write or co-author and present a research paper or project (not a review of the literature) incorporating applied economic analysis.

5.      Students must provide a critique on at least one paper by their classmates.

6.      Knowledge of basic principles of economics and statistics.

7.      Midterm and Final Examinations must be taken.

8.      Both undergraduates and graduate students are to write one course paper.  Graduate students’ papers must incorporate statistical analysis of data.

 

 

Graduate Student Requirements: 

 

While no students are expected to use primary data (data you collect yourself), data from published sources will suffice, graduate students are required to use basic statistical methods to test some proposition or to estimate an important relationship. Graduate students’ work on papers is expected to be at a higher level than what is expected of undergraduates.  Exams for graduate students will also be different and will be more rigorous.    

 

Methods of Evaluation

 

Research Paper:

Papers may be co-authored with no more than one other class member. Papers may include topics such as statistical estimates of facility cost functions, production functions, organization survivor analysis (economies of scale), the extent of cost-shifting, effects of smoking regulations and taxes on cigarette demand or cigarette taxes and birth outcomes (you really need to talk to me at length about this!), the re-importation of pharmaceuticals, and regulation and tort law in blood products in the shadow of AIDS, the causes of the explosion of Medicaid expenditures in Louisiana, or even the cost drivers in ambulance service (there is a great deal of interest in this topic locally because it has implications on the what is the lowest cost way of serving Lafourche Parish.  Yet another paper topic is the geographic distribution of nurses employed at a particular hospital addressing labor supply issues. Another project topic is a survey of nursing homes and hospitals of their hurricane evacuation policies.

 

Try to say something in your paper--­­dare to be original. Use data and statistical analysis to support a thesis.  Please, do not merely review what a dozen authors have already said. I will help you in putting your paper together.  Do not put off talking to me about your paper.

 

Paper Critiques:

You will all be involved in critiquing the papers of classmates, with a short type-written list of points of concern.  Critiques affect the grades of those writing the critiques, not the person or group whose work is being critiqued (students will not be assessing peers).  You can think of this a form of cooperative learning. I will do my best to match students up with someone doing related work. The critique gives authors some chance to revise their papers and improve upon their grade.

 

Paper Co-authors:

 

You may work in pairs on your major paper, though this is not required. Let me know if your co-author is slacking. 

 

Paper Deadlines:

 

Proposals (1-3 pages) for pre-approved paper topics must be approved by September 12th.  Since this may involve lengthy discussion to arrive at an appropriate topic, make an appointment to see me ASAP.  The first draft for the paper is due on October 24th.  A working draft of the paper is due on November 7th. Critiques are due November 14th.  

 

 

 

Paper Guidelines:

 

A more complete guideline for papers will be handed out soon.  Written and Oral Communication and PowerPoint Presentation Grading Rubrics will be on Blackboard.

 

Length:  10 to ­20 pages (only a guide)

Bare Minimum References: 

3 books (other than textbooks)

10 academic journal articles (not magazines, if you do not know the difference, journal articles contain many references, magazines seldom contain any) 

2 federal or other government documents

Follow basic APA style.

Journals (a partial list):

Economics journals (in the library):
Journal of Health Economics, American Economic Review, Quarterly Journal of Economics, Journal of Political Economy, Review of Economics and Statistics, Review of Economic Studies, Econometrica, Applied Economics, Southern Economic Journal, the Journal of Law and Economics, the Journal of Legal Studies and Economic Inquiry.  Many more available through

JSTOR.

 

Health care and hospital journals (in the library):
Health Care Financing Review, Health Care Management Review, Health Services Reports, Health Services Research, Healthcare Financial Management, Hospital Progress, Hospital Topics, Hospital and Health Services Administration, Hospitals, and Hospitals and Health Networks.

 

Late Penalties:

 

Written assignments are due by 6:30 PM on the due date and if turned after that time, the assignment is considered late and late penalties will be assessed. Written assignments that are late get a penalty of 20 percent of the possible points for each day that it is late. For the purposes of assessing late penalties, days for this class end at 4 PM, so that if the assignment is turned in after 4:00 PM the day after class (on Tuesday), it will be at least two days late. You may avoid late penalties by using e-mail or fax to get the assignment to me. If you are late getting the copies of your draft to classmates doing the critique, the classmate assigned to do the critique will be exempt from the critique assignment and neither they nor I will provide you with feedback to help you improve your paper.

 

Exams:

 

There will be two exams: one is a midterm and the other is the final. The exams will be essay-type exams, with some short "define, identify or explain" questions and some more involved essay questions. The final is not comprehensive. The exams for graduate students will be more rigorous than those given to undergraduates.

 

Grade Computation:

The course grade will be computed on the basis of the total points accumulated during the course, with 1000 points being possible for the course.

 

Breakdown of Possible Points for the Course:

 

PAPER PROJECT

 

 

 

 

Proposal

20

 

 

First draft

30

 

 

Working draft (presented version)

50

 

 

Final Version

250

 

TOTAL POINTS FROM PAPER

 

 

 

350

CRITIQUE OF PEER'S PAPER

 

 

 

50

EXAMS

 

 

 

 

Midterm

250

 

 

Final

350

 

TOTAL POINTS FROM EXAMS

 

 

 

600

TOTAL POINTS POSSIBLE

 

 

1000

 

Grading  Scale:

 

 

 

letter grade

minimum score

A

900

B

800

C

700

D

600

 

Class Photos: I am terrible at remembering names of students (or names of my dear relatives--I will tell you about it in class).  I have a compensating mechanism for dealing with that forgetfulness--digital photos.  Please send me a digital photo, cropped, of only your full face (no profile images or photos with your hair covering half of your face.  I will NOT post your photo.  Instead, I will use it to help in taking attendance and learning your names.

Make-up Procedure:  All students are expected to take all of the exams on schedule.  If you miss the midterm and have an acceptable excuse, please get with me as soon as possible to arrange a retake before I give exams back to the class.  All students must take the final exam.

 

Academic Honesty Policy: The University statement on academic integrity, says in relevant part:

 

“As members of the Nicholls State University community, students are expected to uphold the highest standards of academic and personal conduct. Academic dishonesty violates these standards as well as the trust and commitment among students and faculty to instill and to maintain the principles of integrity, responsibility, and respect for others.”

 

For more information, please see:

 

http://www.nicholls.edu/documents/student_life/code_of_conduct.pdf

 

All work that bears on my evaluation of your performance must be yours alone.  It is your responsibility to ensure that your behavior conforms fully both to spirit and letter of the academic integrity statement.  If you have any questions, do not hesitate to ask me.

 

Turnitin Policy: 

By taking this course, students agree that all assignments are subject to submission to Turnitin.com, an online plagiarism prevention and detection service.  All work submitted to Turnitin.com will be added to its database of papers.  Turnitin’s privacy policy and a description of the service available at http://www.turnitin.com.  Specifically, this service compares your paper with Internet webpages, articles in databases, and all papers previously submitted from this university or any other.  Turnitin then either confirms the originality of your work or gives the source of plagiarism.  In cases of detected plagiarism, the paper and supporting evidence will be handled in compliance with the Student Code of Conduct (http://www.nicholls.edu/life/policy/code_of_conduct.pdf).

 

 

Here are some further rules:

 

 

CHEATING AND PLAGIARISM

CHEATING

A.  On Exams:

1.  During an exam

a. wearing a hat or cap

b. looking on another exam or letting someone see your answers.

c. any communication, including electronic, between (among) students.

d. looking at notes, books, cheat sheets, etc., during the exam unless the instructor informs you that the exam is open book or open notes in advance, or allows a formula or "cheat" sheet.

e. taking a copy of the exam out of the room without specific authorization to do so, that is, if the instructor doesn't specifically say one way or another if you may take a copy of the exam. Taking a copy of the exam would constitute cheating.

f. not reporting any cheating you observe.

g. having anything written on clothing, skin, etc., that would give the student an advantage.

h. phoning, texting or otherwise communicating with someone in the class or outside of class.

2.  Not during an exam.

a. asking a fellow student who has previously taken an exam anything about the exam other than is it difficult or long.

b. stealing, receiving, or copying any unauthorized copy of the exam.

c. not reporting any cheating you observe which includes not reporting someone who tells you of another's cheating but does not report.

d. any planning with another to steal an exam even if the plans are not carried out.

B.  On other assignments:

1. Copying any answer to assigned questions or problems constitutes cheating unless the project is a group project, and then only from members of your group.

2. Asking or answering any questions concerning the assignment other than the instructor or the instructor's assistant with the exception of the question:  When is it due?

3. Allowing someone access to your assignment answers or gaining access to another's assignment answers.  It is acceptable to photocopy someone's assignment questions as long as there are no answers.

4. Getting someone else to do any computation or computer work for you or doing it for another, including having someone else do the statistics for you for a paper.

C. Any bribe or threat or hint of an attempt at bribe or threat will be considered cheating,
including something like the following:

1. I will do anything for an A (or B or C etc.) or

2. What can I do to get a better grade? It is acceptable to ask the instructor what you need to work on to improve your performance. Giving unfair aid is as serious as receiving it. Knowing about others cheating without reporting it to the instructor or the instructor's department chairman is also cheating. This does not mean that you cannot seek help from another to understand a concept or even how to work a problem similar to the one you cannot see how to work.  Also, though collaboration on assignments is cheating, I wish to encourage you to study together, discuss paper topics, etc.

Penalty for infractions of cheating rules is an F in the course and a recommendation for dismissal from the university.

10 Easy Ways to Get Caught Cheating

Top 10 Consequences of Cheating

PLAGIARISM

A.  Copying any assignment or any part of an assignment by someone else without giving that person credit. This is particularly relevant to any out-of-class assignment in this class. Also, do not talk to others that would give them special clues to solve some puzzle in an assignment.

B.  Letting or asking anyone to copy a paper.

C.  Having someone else write papers for you.  It is allowable for someone else to type your paper for you, but typists, even when paid, should be acknowledged.

D.  Any comments from another person on your paper's topic should be properly acknowledged.

E.  Knowledge of someone handing in work not their own.

F.  Copying word for word or even almost word for word constitutes plagiarism without identifying the words as a quotation.

G. Paraphrasing without citation.

H. Copy another's ideas without citation

Penalty for infractions of the plagiarism rules is an F in the course and a recommendation for dismissal from the university.

10 Easy Ways to Get Caught Cheating

Top 10 Consequences of Cheating

 

Attendance Policy:  Attendance is required by University policy and will affect your grade. 

Class rules: I am charged with ensuring that students are provided an environment that is conducive to learning. It is your responsibility to ensure that your behavior is not disrupting that environment. Disruptive behavior can not and will not be tolerated. Outstanding class participation (either positive or negative) may affect your final grade. If you are considerate and refrain from distracting and rude behavior, you will have no trouble.

 

There are two simple rules for this class:

(1) Don’t be rude, and
(2) Don’t distract from the class activity.

Here are some things that would be considered distracting or rude and are not allowed:

1.      Eating in the classroom before, during or after class. Drinking water, sodas, coffee or tea is permitted.

2.      Packing your things away before class is over and you have been dismissed.*

3.      Use of any tobacco or alcohol product during class.

4.      Reading newspapers, magazines, textbooks, workbooks, or novels during class.*

5.      Using a Walkman, iPod, iPhone, or other personal entertainment device.*

6.      Looking at a laptop, unless requested.*

7.      Talking or texting on a cell phone or similar device.*

8.      Talking, whispering, and note passing during class. Leaving early (unless you have permission or suddenly become ill).

9.      Working on class assignments for other classes or studying for other classes during our class period.*

10.  Ringing cell phones or pagers.*

11.  Sleeping in class (this behavior is particularly distracting and quite rude).

12.  Taking notes in your text in class by highlighting. While flipping through pages to find a passage in the text that supports what is being said in lecture is distracting and rude, the primary reason for this rule is to encourage you to think about what is being said during class so that you will engage in active learning, and you will be in a position to engage in meaningful discussion.  Instead, take notes on Powerpoint slide handouts printed from Blackboard.  If you are preoccupied with searching a textbook, it will be virtually impossible for you to benefit from the lecture/discussion going on at the same time. Hint: Read the book before class and highlight material that you recall from the lecture after class. Have your economics text out only when I direct your attention to the text or when you are asking questions about your reading that you did not understand. Do bring your book to class, however. Just do not use your text to take notes during class.

13.  Any other behavior that would reasonably be considered distracting or rude.

A few guidelines for out-of-class interaction with your professor:

14.  Do not come to my office a few minutes before class.

15.  Do not come to me before class with some paper that I am supposed to sign, including drop slips. I do not sign papers before class.

16.  Do not ask me "Is this going to be on the test?"
On its face, this seems like a reasonable question. This question tells your professor that the only things you think are worth knowing from his class are those items on the exams. Exams do not cover all of the course, but only sample your knowledge. If you set your sights on learning the subject instead of getting good grades, the grades will take care of themselves.

17.  Do not ask "Did I miss anything important yesterday?" or "Am I going to miss anything important tomorrow?"
These questions tell your professor that you expect the answer to be "no." If a professor were not going to cover anything important, he would stay in his office that class period and dismiss class.

 

*Please note that I am well within my rights and obligations (to maintain order in class) to CONFISCATE laptops, cell phones, iPods, textbooks from other classes or anything else you are using in class that draws your and your classmates’ attention away from our classroom tasks.  I also have the right and the responsibility to administratively withdraw students from my class who repeatedly violate these policies.

 

DROP DATE:  The last day to drop a course with a “W” is:  Friday, April 3, 2009

 

Americans With Disabilities Act:

If you have a documented disability that requires assistance, you will need to register with the Office of Disability Services for coordination of your academic accommodations.  The Office of Disability Services is located in Peltier Hall, Room 100-A.  The phone number is (985) 448-4430 (TDD 449-7002).

 

Academic Grievances:

The proper procedure for filing grade appeals or grievances related to academic matters is listed in Section 5 of the Code of Student Conduct and at the following link: 

http://www.nicholls.edu/documents/student_life/code_of_conduct.pdf

 

Continued Learning following an Extreme Emergency:

In order to make continued learning possible following an extreme emergency:

 

Students are responsible for:

1.                  Reading regular emergency notifications on the NSU website

2.                  Knowing how to use and access Blackboard (or university designated electronic delivery system);

3.                  Being familiar with emergency guidelines

4.                  Evacuating  textbooks and other course materials

5.                  Knowing their Blackboard (or designated system) student login and password

6.                  Contacting faculty regarding their intentions for completing the course.

 

Faculty are responsible for:

·                     Their development in the use of the Blackboard (or designated) software;

·                     Having a plan for continuing their courses using only Blackboard and email;

·                     Continuing their course in whatever way suits the completion of the course best, and being creative in the continuation of these courses;

·                     Making adjustments or compensations to a student’s progress in special programs with labs, clinical sequences or the like only in the immediate semester following the emergency.

 

Disclaimer: This syllabus is a plan of action, not a contract.  I reserve the right to change it, within reason, as circumstances dictate.