PHS 371– Comparative Health Care Systems

Course Overview
This course is a 4 credit asynchronous court that
introduces students to the principal components
of the American health care system and how the American
system compares to health care systems around the world. In this
course, we begin with an overview of the history of the health
care system, the role of government in health care and the
organization of health care in the U.S. We will then compare the
American system to health care systems of countries, like Britain,
Germany, Japan, France and Canada, while paying particular
attention to how well these systems provide access to quality
health care to all members of society, including vulnerable
populations, at a sustainable cost. Students will consider the
future of the American health care system with a greater
understanding of the socio-political factors that might hinder or
facilitate reform. Students will also gain an appreciation for how
disparities in access to healthcare are social injustices that can
amount to structural violence

Course Objectives
At the completion of this course, it is my expectation that students will
be able to…
 Identify and describe the key characteristics, components, and
problems of the current U.S. health care system – including how
health services are financed, organized, accessed, and delivered
 Analyze strengths and weaknesses of the US healthcare system
related to access, cost and quality of care
 Identify and propose solutions to the unique challenges faced
by underserved populations in accessing health care
 Understand the role of governments and health care
professions in health care systems
 Articulate how lack of healthcare access to vulnerable
populations is a social injustice
 Explain frameworks for comparing international health care
systems, and compare the operations, achievements, and

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 weaknesses of national health care systems using these
frameworks
 Describe key characteristics and components of health care
systems from selected countries
 Describe the forces currently influencing health care and
evaluate their impact on the likely future of U.S. and
international health care systems

Peace and Conflict Studies

This course counts towards courses for a minor in Peace and

Conflict Studies, because it explores how inequities in healthcare
provision are forms of structural violence. The interdisciplinary
minor in Peace and Conflict Studies explores the nature, dynamics,
and causes of conflict and/or violence at different levels (inter-
personal, community, inter-state, and/or global). The minor also
investigates processes and strategies of conflict resolution,
peacemaking, and/or resistance to conflict and violence. This also
includes strategies to combat social injustice. For more information
on this minor, please contact Coordinator Federico Pous
([email protected]) and check out the
website:https://www.elon.edu/u/academics/arts-and-
sciences/peace-conflict-studies/ .

Course Delivery
This course is an asynchronous, online course, with web
content delivered via Moodle. Each week you will have
a module to complete. The module is set up in six
components: Module Learning Objectives, Read, View, Do, Review and
Interact. The following is a summary of each component.

Learning Objectives: Begin by reading the learning

objectives for the module. By the time you complete the
module, it is my expectation that you will have
accomplished the learning objectives for the module. The
learning objectives highlight the key concepts and skills for the module
and provide you with focusing points to guide you in your completion
of the other module components. It is good practice to return to the
module objectives after you complete the other components and to
check to them to make sure you have indeed accomplished them.

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 Read: The “Read” component will contain your expected
readings for the module.

View: The view section contains instructor-prepared

PowerPoint presentations or videos covering key-concepts
for the module.

Do: We learn not only be reading, but also by doing. The

“Do” component will require you to apply what you learn to
current events and issues in health care systems.

Review: This component will ask you to engage in tasks

that help you review your “do” performance by reflecting
on your exercise or providing anonymous feedback to
classmates.

Interact: If online learning is done in a silo, it can be isolating.

To prevent this, the interact component provides you
opportunities to interact with your classmates and professor,
in ways that can advance your learning.

Assessment Schedule

Assessment Percent of Grade Due Date

Do Component 25% Weekly

Country 25%
Presentation
Policy Memo 50%

Disabilities Resources

It is the policy of Elon University to offer reasonable accommodations to qualified students with
disabilities, in accordance with the Americans with Disabilities Act (ADA) and Section 504 of the
Rehabilitation Act of 1973.

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Students with documented disabilities (learning disabilities, ADD/ADHD, vision impairment, hearing
impairment, mobility problems, psychological disabilities, and health related problems) may request
special services and/or appropriate accommodations under the Americans with Disabilities Act. Students
who need to discuss such needs should contact the Coordinator of Disability Services, Susan Wise, who
reviews documentation and consults with the student to arrange for appropriate classroom/campus
accommodations. Call 278-6500 for more information or come by the Advising Center, Duke 108.
Additional information may also be found at www.elon.edu/disabilities. Accommodations cannot be
applied retroactively.

Required Readings
Healthcare Delivery in the United States (11th edition), eds. Knickman & Kovner, Springer
Publishing (ISBN: 978-0-8261-2527-9), and additional readings available through Moodle.

Final Course Grades

Final course grades will be assigned according the University’s standard grading
scheme.
A 93-100 C+ 77-79
A- 90-92 C 73-76
B+ 87-89 C- 70-72
B 83-86 D+ 67-69
B- 80-82 D 60-66
Any grade below a 60 will earn an “E.”

Material Synthesis
For the first 3 weeks: Each week you will be required to write a weekly material
synthesis. The synthesis allows you to synthesize reading materials with in-class
lectures, activities, videos and current events discussions from that week. You will also
be required to provide at least one personal experience that you may have had with the
topics that we discuss for the week. Lastly, you will be expected to tie explain the
relationship between our readings and class discussion to current events in U.S. Health
policy. A rubric will be available on Carmen for this assignment and you will submit
this assignment via Carmen. You must use complete sentences and cannot exceed 3
double spaced pages. Make sure to include citations in either APA or MLA format to
any material that you summarize that is not common knowledge. I will be looking for at
least two citations to the book and two citations to class lectures.

Individual Project
Design your own health care system for the United States

Drawing on all that you have learned in the course thus far, design a health care system for the
United States. Be creative! Feel free to make your system as similar to or different from the
current system as you would like. Model the system after that of another nation, if you’d like, or
design one that is completely original. Make sure to take into consideration that the values and
needs of the American people in designing your system. Also, include the following elements in
your design:
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  The role of federal, state, and local governments
 The role of insurance companies
 The role of employers
 The role of providers
 The role of consumers
 How health care would be paid for
 The advantage of your system over the existing one
 The biggest criticism your opponents would have of your system
 How you would answer this criticism
 Make sure to discuss how you will improve access, decrease cost, and increase quality

You may present your health care system in a PowerPoint presentation with 15 to 20 slides, a
multimedia presentation, or a 1,000-word paper.

Midway through the semester, you will submit an outline of your project and you will get
feedback from two peers. You will also be required to give feedback to two of your classmates,
as well.

Country Presentation
PowerPoint presentation giving an overview of the health care system of another nation (aside from the
U.S.).

Your professor will post a list of countries and you may pick one country to present on. Your
professor will also post a list dates and you are to pick one date on which you will submit your
presentation (with audio recorded). (I will explain the technological how-to’s). You will then
share the video in a forum for the rest of your classmates to view. This exercise allows us to
learn about the health care systems of many more countries than if your professor was just
presenting on them!

Prepare a PowerPoint presentation that includes 15 to 20 slides. You must include the following
information in your presentation:

 History of the health care system, including changes and recent developments
 Type of health care system currently in place (roles of government, private sector,
providers)
 Major features of the current system
 Current population of the nation
 Total expenditure on health care each year (in the nation’s monetary unit, in U.S. dollars,
and as a percentage of gross domestic product)
 Expenditure on health care per capita
 World Health Organization rankings in major indices of health (infant mortality, life
expectancy, etc.)
 Strengths and weaknesses of the system compared with those of other nations
 Popularity of system among citizens
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Please record audio Please submit a copy of your Powerpoint in Moodle.

Participation
Participation: Participation is required. In the online environment, participation is based on the
student’s interaction with the course and other students. Participation includes viewing presentations,
completing accompanying knowledge checks, engaging in discussion board dialogues, contributing peer
feedback or otherwise engaging with the materials in our Moodle course. All students are expected to
participate in the course at least 3 days out of each 7-day seminar week. The purpose of the 3 day
participation rule is to encourage students to pace their learning throughout the week and to avoid
cramming all learning activities to the final day of the week.

Attendance Policy: Attendance is recorded each week. Attendance is defined as submission of

homework, assignments, quizzes, or discussion board posting. If you fail to take part in all activities for
the week, you will be marked absent for that week.

Late Work Policies

All assignments, including quizzes, exams and projects, are due at the date and time
noted below. Late assignments are not accepted unless prearranged. So, plan
accordingly. If you need additional time to complete an assignment due to extreme
circumstances or family emergencies, you must email the instructor before the
assignment is due and request an extension. However, understand that extensions are
granted at the complete discretion of the professor and are not, by any means,
guaranteed.

Grading Questions
If you have a question about a grade, please bring it directly to the professor. In order
to do so, thoroughly read any feedback you have been given, prepare a respectful
request or question in writing, and present it to your professor in person (or via skype).
All such questions will be given serious consideration, but changes in points or grades
are subject to the professor’s discretion.
Syllabus
This syllabus is a contract between students and the professor. You are invited to ask
any questions you have about it, but you are required to know its contents and all
specifications contained within the syllabus are binding. Any changes that must be
made to the syllabus will be announced at least twice in class and posted on Moodle.

Etiquette
Please do not refer to any instructors, TA’s or guest speakers by their first name. A Mr.,
Ms., Professor, or Dr. followed by their last name is the appropriate way to address
such persons.

Email Etiquette
Please use appropriate email etiquette to communicate with the professor. All emails
should be composed of a greeting line, a signature line, full sentences and organized
paragraphs, specific questions, and respectful language. Do not send the first draft of

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an email – reading it over first will increase your chances of getting the response you
want. For more general guidance about online communications, see:
https://owl.english.purdue.edu/owl/resource/636/01/

Academic Difficulties
If you find yourself struggling in the course or concerned about your performance,
please contact the professor as soon as possible. There are many resources and
supports we can provide to help you, but it is your responsibility to ask for help.

Communication
The professor will communicate with students through in-class announcements,
Moodle postings & announcements, and emails. You are responsible for attending
class, getting announcements from a peer if you miss class, checking Moodle at least
twice/week, and checking your email at least once every 48 hours.

Students are encouraged to communicate with the professor. I am happy to hear from
students, and encourage you to get in touch.

Please note the following important points, however:

 The response time for emails is 48 hours. Please plan ahead and do not ask
questions at the last minute. You may hear back from an instructor in less than
48 hours, but you should not expect to. So, please, do not leave concerns or
questions until the last minute.
 Please stay on top of content and announcements in Moodle and consult your
syllabus frequently. Questions that are answered in Moodle or on the syllabus
will not be answered via email. This rule ensures that the professor and TA can
spend their time helping students with the content of the course, as well as other
individual problems and questions.

Sample Course Outline –Dates and readings to be updated.

Date Topics Readings Assignments
Section 1: Introduction & Framework for Understanding Health Care Policy Process
6/19 Course Introduction & Social Syllabus; Chapter 1 Check in with Groups on
Policy Overview; Review of Carmen by Thursday 6/22
U.S. Government Structure & before class.
Policymaking process
6/21 History of the U.S. Healthcare PDF Reading on Carmen titled Material Synthesis #1 due
System; Overview of Problems Chapter 1; Chapter 2 Monday June 25th by
facing the U.S. Health System 11:59pm

Section 2: The Government’s Role in Healthcare & General Organization of Healthcare Systems
6/26 The Role of the U.S. Chapter 3 Group Submission: 2
Government in Healthcare; Chapter 11 country names via
General Structure of the U.S. Carmen due Wednesday
6/28.

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 Healthcare System; Healthcare
Financing

6/28 Organization of Healthcare; Chapter 9; Ch. 10; Material Synthesis #2 due

the Healthcare Workforce; Ch14 pg. 297-306 Monday July 2rd by
Healthcare Management 11:59pm

Section 3: Comparative Health Systems and Population Health

7/3 Comparative Health Systems Chapter 4

7/5 Public Health vs. Medical Chapter 5 Material Synthesis #3 due
Orientation to Health Systems Monday July 9th by
11:59pm

Section 4: Access, Cost, & Quality

7/10 Disparities; Healthcare Costs Chapter 8; Chapter 12
& Values
7/12 High Quality Healthcare Chapter 13 Outline of Individual
Project Due Monday July
17th by 11:59pm

Section 5: The Future of US Healthcare

7/17 Public Health Policy; Health Chapter 6 Groups 1, 2, 3 Present
Behaviors Chapter 7
7/19 Mental Health Policy; Readings on Carmen Groups 4, 5, 6 Present
Governance of Addiction

Section 6:
7/24 Healthcare Information Chapter 15 Before Class, Your
Technology Review of 2 of your peers’
outlines are due.
7/26 The Future of Health Chapter 16
Care Delivery and
Health Policy; Final
project reviews.
Final Project is DUE via Moodle