17.315, Comparative Health Policy has two examinations. The midterm tests for background information on the U.S. system. The final examination tests the ability to draw policy lessons from comparative sections and integration of all course material. Midterm Examination
Answer in essay form two of the following questions. Each answer should be approximately five pages doubled-spaced. Cite your sources.
The market-focused changes in the American health care system that have occurred in the last decade are nearly as dramatic as would have been required under the Clinton Health Security Plan. What are the similarities and differences between the recent changes and those called for in the Clinton plan?
Who are the uninsured in America? Why are they not covered? And how would you describe the access to health services they have?
Why is health status not a very good measure with which to compare health care systems? Considering the work we have done on the US health care system what might be better measures for such comparisons?
Explain how we ended up with an employment-based, privately financed health insurance system for most of American population. What were the governmental decisions that made that structure the one that dominates? Are there some on going policies that encourage its perpetuation?
Final Examination
Write on three of the following five questions. Remember to conserve the time available to you and to give citations where possible.
Contrast any pair of the non-US health systems that were described and discussed in the course to identify and explain important differences in their system goals, structures and effects.
Given the circumstances surrounding the adoption of major health system changes in the other countries examined in the course, when should we expect major change in the US health care system?
Is it surprising or strange that the governments in nations where the public sector controls a higher percentage of national health expenditures than it does in the United States do no more, perhaps even less, than the US government does in "scientifically" planning the allocation of health care resources, access to new medical treatments, research investments or the control of health care risks? How scientific can you be about these allocations? How would someone judge one allocation better than another?
How has litigation shaped health policy in the United States? What are the costs and benefits of policy formation through litigation rather than legislation? Why is litigation's role in policy less of an issue in the other countries we studied?
Critique the Clinton Health Plan. Focus on the plan, not the politics of selling it. Would it have worked if adopted? Where would you expect the next set of problems to arise if Clinton were successful in gaining its passage? What were its best and worst features? Use what you learned about other countries if you can in your answer.