HCMI 4225: Health and Social Insurance
Fall 2019 12:30 PM – 1:45 PM Mon & Wed Room BUSN 203
Instructor: Shane Murphy; Email: shane@uconn.edu; Office: BUSN 460
Office Hours: Mon & Wed 1:45 PM – 3:00 PM and by appointment

This is the website for HCMI 4225: Health and Social Insurance. The syllabus can be found here.

On this page you can find a calendar which includes links to materials from each week and the weeks readings. Homework assignments are here.

Quiz make-up assignment description is here. Articles for quiz make-ups should be chosen from Health Affairs Blog, News@JAMA, or Kaiser Health News

Information about the midterm exam is here.

Information about the final exam is here.

Information about the final paper is here

Course Schedule:

August 26: Health Landscape and Health Costs (slides)
Readings:
*Fuchs, Victor R. “Major trends in the US health economy since 1950.” New England Journal of Medicine 366, no. 11 (2012): 973-977.
Optional Readings
*Dieleman, Joseph L., et al. “US spending on personal health care and public health, 1996-2013.” Jama 316.24 (2016): 2627-2646.
*Dieleman, Joseph L., Ellen Squires, Anthony L. Bui, Madeline Campbell, Abigail Chapin, Hannah Hamavid, Cody Horst et al. “Factors associated with increases in US health care spending, 1996-2013.” Jama 318, no. 17 (2017): 1668-1678.

August 28: The Right(?) to Health and to Health Care (slides)
Readings:
*Gawande, Atul. “Is health care a right?” New Yorker, October 2, 2017
*Section I (pages 5-10) of Ruger, Jennifer Prah. “Toward a theory of a right to health: capability and incompletely theorized agreements.” Yale Journal of Law & the Humanities 18, no. 2 (2006): 3.
Optional Readings:
*Hamel, Mary Beth, Jennifer Prah Ruger, Theodore W. Ruger, and George J. Annas. “The elusive right to health care under US Law.” N Engl J Med 372, no. 26 (2015): 2558-63.
*Ruger, Jennifer P. “The moral foundations of health insurance.” Journal of the Association of Physicians 100, no. 1 (2007): 53-57.

September 4: Health insurance and social insurance as public goods (slides)
Readings:
*Karsten, Siegfried G. “Health care: private good vs. public good.” American Journal of Economics and Sociology 54, no. 2 (1995): 129-144.
*Galea, Sandro. “Public health as a public good.” Boston University School of Public Health, January 10, 2016, https://www.bu.edu/sph/2016/01/10/public-health-as-a-public-good/ (optional)

September 9: Economics of insurance – utility, expected utility, and pooling (slides)
Readings:
*Klein, Robert. (2014). A Primer on The Economics of Insurance.

September 11: Economics of insurance – utility, expected utility, and pooling (slides)
Readings:
*Klein, Robert. (2014). A Primer on The Economics of Insurance.

September 16: Economics of Health Insurance (slides)
Readings:
Nyman, John A. “Is ‘moral hazard’ inefficient? The policy implications of a new theory.” Health Affairs 23, no. 5 (2004): 194-199.
Cutler, David M., and Richard J. Zeckhauser. “Adverse selection in health insurance.” In Forum for Health Economics & Policy, vol. 1, no. 1. De Gruyter, 1998. (optional)

September 18: History of Insurance: Social Insurance (slides)
Readings:
*Wilbur J.. Cohen, and Milton Friedman. Social Security: Universal or Selective?. American enterprise institute for public research, 1972.
on youtube or in print
*Also read the Wikipedia pages on Cohen and Friedman
*Cutler, David M., and Richard Johnson. “The birth and growth of the social insurance state: Explaining old age and medical insurance across countries.” Public Choice 120, no. 1-2 (2004): 87-121.
*Hu, Aiqun, and Patrick Manning. “The global social insurance movement since the 1880s.” Journal of Global History 5, no. 1 (2010): 125-148.

September 23: History of Insurance: Social Security
Readings:
*Wilbur J.. Cohen, and Milton Friedman. Social Security: Universal or Selective?. American enterprise institute for public research, 1972.
on youtube or in print
*Also read the Wikipedia pages on Cohen and Friedman
*Cutler, David M., and Richard Johnson. “The birth and growth of the social insurance state: Explaining old age and medical insurance across countries.” Public Choice 120, no. 1-2 (2004): 87-121.
*DeWitt, Larry. “Research Note #25: Ponzi Schemes vs. Social Security.” Historians Office, Social Security Administration.

September 25: Social Security (slides)
*Wilbur J.. Cohen, and Milton Friedman. Social Security: Universal or Selective?. American enterprise institute for public research, 1972.
on youtube or in print
*Also read the Wikipedia pages on Cohen and Friedman
*Cutler, David M., and Richard Johnson. “The birth and growth of the social insurance state: Explaining old age and medical insurance across countries.” Public Choice 120, no. 1-2 (2004): 87-121.
*DeWitt, Larry. “Research Note #25: Ponzi Schemes vs. Social Security.” Historians Office, Social Security Administration.
*Goss, Stephen C. “The future financial status of the social security program.” Soc. Sec. Bull. 70 (2010): 111. (optional)

September 30: History of Public Health Insurance in the US (slides)
*Quadagno, Jill. “Why the United States has no national health insurance: Stakeholder mobilization against the welfare state, 1945-1996.” Journal of Health and Social Behavior (2004): 25-44.
*Blendon, Robert J., and John M. Benson. “Americans’ views on health policy: a fifty-year historical perspective.” Health Affairs 20, no. 2 (2001): 33-46.

October 2: History of Public Health Insurance in the US (slides)
*Quadagno, Jill. “Why the United States has no national health insurance: Stakeholder mobilization against the welfare state, 1945-1996.” Journal of Health and Social Behavior (2004): 25-44.
*Blendon, Robert J., and John M. Benson. “Americans’ views on health policy: a fifty-year historical perspective.” Health Affairs 20, no. 2 (2001): 33-46.

October 7: History of private insurance (slides)
Readings:
*CSPAN: Harry and Louise Ads, 1993
*Amadeo, Kimberly. Hillarycare, the Health Security Act of 1993 The Balance, March 13, 2019
*Mertens, Maggie. Chart: Comparing Health Reform Bills: Democrats and Republicans 2009, Republicans 1993. Kaiser Health News, February 24, 2010

October 9: Exam review (slides)

October 14: Midterm exam Ten points of extra credit on the midterm grade is available. See the midterm exam page for details.

October 16: Title X (slides)
*Vamos, Cheryl A., Ellen M. Daley, Kay M. Perrin, Charles S. Mahan, and Eric R. Buhi. “Approaching 4 decades of legislation in the national family planning program: an analysis of Title X’s history from 1970 to 2008.” American journal of public health 101, no. 11 (2011): 2027-2037.
Optional:
*Rosoff, Jeannie I., and Asta M. Kenney. “Title X and Its Critics.” Family planning perspectives 16, no. 3 (1984): 111-119.
*Bailey, Martha J. “Reexamining the impact of family planning programs on US fertility: evidence from the War on Poverty and the early years of Title X.” American Economic Journal: Applied Economics 4, no. 2 (2012): 62-97.

October 21: Costs, Payments, and Quality (slides)
* Mendelson, Aaron, Karli Kondo, Cheryl Damberg, Allison Low, Makalapua Motúapuaka, Michele Freeman, Maya O’neil, Rose Relevo, and Devan Kansagara. “The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review.” Annals of internal medicine 166, no. 5 (2017): 341-353.

October 23: Negotiating the Affordable Care Act (slides)
ACA pre-Quiz: watch ACA and AHCA: Don Berwick Breaks It Down to prepare
*Obama, Barack. “United States health care reform: progress to date and next steps.” Jama 316, no. 5 (2016): 525-532.
*“Summary of the Affordable Care Act.” KFF, April 23, 2013: http://files.kff.org/attachment/fact-sheet-summary-of-the-affordable-care-act
*Biskupic, Joan. “The inside story of how John Roberts negotiated to save Obamacare”. cnn.com, March 25, 2019

October 28: Legal and Legislative Challenges to the ACA (slides)
*Obama, Barack. “United States health care reform: progress to date and next steps.” Jama 316, no. 5 (2016): 525-532.
*“Summary of the Affordable Care Act.” KFF, April 23, 2013: http://files.kff.org/attachment/fact-sheet-summary-of-the-affordable-care-act
*Biskupic, Joan. “The inside story of how John Roberts negotiated to save Obamacare”. cnn.com, March 25, 2019

October 30: Effects of the ACA: Consumers and Providers (slides)
*Obama, Barack. “United States health care reform: progress to date and next steps.” Jama 316, no. 5 (2016): 525-532.
*Courtemanche, Charles, James Marton, Benjamin Ukert, Aaron Yelowitz, and Daniela Zapata. “Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health.” Southern Economic Journal 84, no. 3 (2018): 660-691.
*Antonisse, Larisa, Rachel Garfield, Robin Rudowitz, and Samantha Artiga. “The effects of Medicaid expansion under the ACA: Updated findings from a literature review.” (2017). KFF

November 4: Effects of the ACA: Private Insurance (slides)
*Obama, Barack. “United States health care reform: progress to date and next steps.” Jama 316, no. 5 (2016): 525-532.
*Courtemanche, Charles, James Marton, Benjamin Ukert, Aaron Yelowitz, and Daniela Zapata. “Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health.” Southern Economic Journal 84, no. 3 (2018): 660-691.
*Antonisse, Larisa, Rachel Garfield, Robin Rudowitz, and Samantha Artiga. “The effects of Medicaid expansion under the ACA: Updated findings from a literature review.” (2017). KFF

November 6: Industrial Organization and Finances of Insurance Companies (slides)
* Reinhardt, Uwe. “Where does the health insurance premium dollar go?.” Jama 317, no. 22 (2017): 2269-2270.
* America’s Health Insurance Plans (AHIP), Where does the health insurance premium dollar go? May 22, 2018
* Rosenthal, Elisabeth. “Those indecipherable medical bills? They’re one reason health care costs so much hospitals have learned to manipulate medical codes—Often resulting in mind-boggling bills.” New York Times Magazine (2017).

November 11: Discussion day: Costs of Health Care in the US – Discussion sign up sheet (slides)

November 13: Reform proposals (slides)

November 18: Reform Class Discussion – Discussion sign up sheet – sign up for two readings and at least one reading which is described as a “Plan”. The homework is to be based on only one reading.

November 20: Consolidation, Mergers, and the CVS-Aetna Merger (slides)

December 2: Final review (slides)

December 4: Final exam

Snow day 1: New evidence on the effects of health insurance: RAND, Oregon, Wellness
*Youtube video: The RAND Health Insurance Experiment: A Retrospective at 40 Years
*Youtube video: Randomized evaluations & the power of evidence | Amy Finkelstein | TEDxPennsylvaniaAvenue
*Conover, Chris.Does The Oregon Health Study Show That People Are Better Off With Only Catastrophic Coverage? Forbes.com, May 7, 2013 (optional)
*Drum, Keven. What We Know—And What We Don’t—About the Oregon Medicaid Study, Mother Jones, May 6, 2013 (optional)

Snow day 2: Consolidation, Mergers, and the CVS-Aetna Merger
* Zycher, Benjamin. “Benefits of CVS/Aetna merger far outweigh the costs” June 6, 2018, The Hill