California State University, Chico



HCSV 435/POLS 405                                                                           Spring 2011


Wednesday, 2:00 to 4:50 p.m.                                                                  Butte 229


Richard A. Narad, DPA, JD, FACHE                                  Phone:  (530)898-5309

Butte 627                                                                                 FAX:  (530) 898-5107

E-mail:  RNARAD@CSUCHICO.EDU                                                    


Office Hours:  Tuesday 1-5, Wednesday 11-12, or by appointment



1.    Scope of Course:  This course will analyze the political forces, both private and public, which impact upon the health industry in the United States.  It focuses on the political process as it relates to the health care delivery system and on major political/policy issues related to the delivery of health care.

2.    Reading Materials


·       Bodenheimer, Thomas and Kevin Grumbach. Understanding Health Policy: A Clinical Approach, 5th ed.

·       Halvorson, George.  Health Care Will Not Reform Itself (2009)

Health administration core library:

·       Vergil Slee, Debora Slee, & HJ Schmidt (eds.). Slee's Health Care Terms, 5th Edition (St. Paul, MN: Tringa Press, 2008)—earlier editions are acceptable.

·       Diana Hacker. A Pocket Style Manual, 5th ed. (Boston: Bedford Books of St. Martin’s Press, 2008)—earlier editions are acceptable.


·       Tom Baker “The Medical Malpractice Myth”

·       Paul J. Feldstein "Health Associations and the Legislative Process" From TJ Litman and LS Robins, eds. Health Politics and Policy       

·       Joe Flower “The Problem with Free Market Health Care”

·       “Legislative Process”

·       National Quality Forum “Serious Reportable Events in Healthcare”

For students who have not completed HCSV 431 (and/or who do not feel comfortable with their knowledge of the health care delivery system) Shi & Singh’s  Delivering Health Care in America is recommended.

3.    Course Format:  Classes will combine lectures, discussions, guest speakers, class exercises, and student presentations.

4.   Grading

Final Exam.....................................................................................




Interest group profile (paper and presentation) ............................


Friends and foes exercise..............................................................


Exercise summary.........................................................................


Health issue (paper and presentation)………………………………


System attributes paper.................................................................


 (Presentations are worth 25% of the total points for the assignment).


·         Attendance:  50 points lost for every session missed.  One excused absence will be allowed.

·         Reading quizzes:  Up to eight reading quizzes will be given during the semester.  Failure to pass the quiz will result in 25 points being deducted from your total grade, but no additional points will be added.

·         Late written assignments will be eligible for one-half credit, if received within one week of the due date.  No assignments will be accepted after one-week and no late presentations will be allowed.




930 - 1000



770 - 799


900 - 929



730 - 769


870 - 899



700 - 729


830 - 869



660 - 699


800 - 829



600 - 659


5.    Projects and Activities

·       Interest group profile: Paper and presentation on a special interest group which is involved in health care politics.

·       Friends and foes exercise: Identification of groups with whom your interest group might cooperate or compete.

·       Exercise summary:  Summary of an in-class simulation

·       Health issue: Paper and presentation on a current health policy issue.

·       System attributes:  Paper on the attributes of the ideal healthcare system.

This syllabus includes descriptions of each of the assignments.  Students should ensure that submitted papers include all of the required items and comply with the specifications listed in Section 9, below.

·       Readings:  Students are expected to have studied the assigned readings by the date indicated on the course schedule.

·       Class participation:  Attendance is expected.  Participation means more than being present in class.  Students are expected to actively participate in class activities and discussions.

6.    Confidentiality: During this course, the instructor, guest speakers, or students may share information regarding specific organizations or individuals.  Such information should be treated as confidential and not discussed outside of the classroom.  If you are in doubt regarding the confidentiality of any information, consult the instructor.

7.    Academic honesty: Students must ensure that appropriate credit is given for all materials.  Ideas taken from other persons must be properly cited.  Any direct quote must be enclosed in quotation marks and must be cited.

All papers will be checked for plagiarism at "".  Any student who engages in academic dishonestly (e.g., plagiarism, cheating, etc.) will receive a failing grade in this course and Student Judicial Affairs will be notified. 

8.    You should be aware that this class will be harder than most classes that you have taken. This is a 400 level class--you are expected to analyze topics in your papers, presentations, and class discussions; and not to merely describe them. 

Assignments should be of the same quality that is expected of an employee in a professional position in the health care field.  That means that grammar and spelling will be considered in grading assignments.  It means that due dates and project specifications are taken seriously.  It means that attendance is expected.

9.    Written papers:  All papers turned in for this course must comply with the following requirements:

·       You must turn in both a hardcopy (printed) version of your term paper (which I will grade and return to you) and an electronic version (submitted to through Vista).  The electronic version must be PC compatible and formatted as a Text (*.txt), MS-Word (*.doc or docx), or Rich-Text-Format (*.rtf) file.  Papers will be checked for plagiarism at "".

·       Use 81/2" x 11" paper, with one-inch margins on all sides.

·       Papers should be typed, with all text, including quotes, double-spaced.

·       Do not use covers or cover pages.

·       Use Courier or Courier New 12 font

·       Do not exceed the maximum length for the assignment.

·       Papers should be free of typographical and spelling errors and should be grammatically correct.

10.  Presentations:  The presentations that you make in this class must comply with the following:

·         Presentations should cover the same area as the paper, but should not be just a reading of the written paper.  DON’T READ YOUR PAPER!

·         Be prepared to respond to questions from the instructor and the class

·         Do not exceed the maximum time for the presentation.

·         Use PowerPoint.

·         Dress professionally.  This means the same way that you would dress for a job interview or a professional presentation.

11.    On-line resources:  This class requires the use of WebCT Vista.  I will place class handouts on the site prior to each week's class.  Other materials (including old exams) and relevant linkages can be found there.

Program objectives:  This course is required for Health Services Administration majors and meets the following program objectives:

#1.    The graduate in Health Services Administration will have knowledge, skills, and beliefs related to the health care delivery system and will: 

·           Identify participants in the system and describe their roles, responsibilities, and trends and issues related to them.

·           Discuss, describe, and analyze the impact of politics and economics on the health care delivery system and on healthcare organizations; and be able to participate in influencing political decisions

#4.    The graduate in Health Services Administration will have competent communication skills, including written and spoken communication, use of electronic media and formal presentations/business reports.

The complete objectives of the B.S. Health Science with an option in Health Services Administration are available at







1 (1/26)


Overview of health politics


2 (2/2)

Role of government in healthcare

On-line library tour

B&G1, 5, 6

3 (2/9)

Policy analysis

Health financing

B&G 2, 4


4 (2/16)

Interest groups

B&G 16


5 (2/23)

Interest groups profiles

Profile paper

6 (3/2)

Interest groups profiles (cont)

Friends and foes exercise


7 (3/9)

Legislative process

Legislative  analysis

Legislative process

Legislative Process chart

Friends and foes paper


NO CLASS—Spring Break


8 (3/23)


Bill drafting exercise


9 (3/30)

Health system design alternatives

Exercise summary

B&G 14, 15

10 (4/6)

Health policy issues:

·      Cost of care

Health issue paper

B&G 8, 9, 13


11 (4/13)

Health policy issues:

·      Access to care

 B&G 3

12 (4/20)

Health policy issues:

·      Quality of care

·      State reform issues

B&G 10, 11

National Quality Forum

13 (4/27)

Health policy issues:

·      Patient Protection and Affordable Care Act (PPACA)

·      Malpractice reform

B&G 7, 12


14 (5/4)

In search of the ideal healthcare system

Halvorson (all)

System attributes paper

15 (5/11)

Developing a political philosophy

Course review

B&G 17

16 (5/18)



B&G = Bodenheimer and Grumbach



Assignment:  Identify a special interest group which is involved in health care politics in California.  Sign up at the second class session.


Content:  The paper and presentation should include:

1.    General description of the group

·         Who are the members?

·         What is the general purpose of the organization?

2.    General goals/policies regarding the health care delivery system

·         What position did it take on the 2010 health reform debate?

·         What does it want the health system to be like?

·         Generally, what does it want to accomplish in legislation?

3.    Positions on specific health issues

·         What positions has it taken?

·         Using Feldstein’s model (from the article on WebCT), why has it taken these positions?

4.    The group's power

·         How successful/influential is it?

Your primary source of information will be the group itself.  You should contact it early because sending you information may not be its highest priority.  In addition to written information that the group provides, you will probably need to interview a staff member, either in person or on the telephone.  Some information is available from their web pages.  Where possible, these are linked to our class page.

Do not depend only on the information that they provide.  You should also look at the bills the groups supports and opposes and consider the reasons that it take the positions that it does

Papers should be a maximum of three pages (plus endnotes).  Presentations should be five minutes.



Assignment:  Based on the class presentations, identify three groups that you would expect to cooperate with your group on legislation and three groups that you would expect your group to compete with (that is, they would oppose your legislation and visa versa).



1. Identify your group and give a brief summary of its general goals for the health system.

2. Identify three groups that would be your friends and three groups that would be your foes.  For each, explain why you believe this about them. 


Papers should be a maximum of two pages.



Assignment:  Summarize your participation in the bill drafting exercise.

Content:  The analysis should include:

1.      Name of your group

2.      What was your initial position on the bill and why?

3.      What changes did you want on the bill and why?

4.      What groups did you ally with?  What did you have to give up to get their support?  What did they give you?

5.      Did you change your position at the end?  Why or why not?


Papers should be a maximum of one page.



Assignment:  Select a current health policy issue (sign up at the second class session).  Prepare a written summary of the issue and a presentation. 

Content:  The paper and presentation should include:

1.    A summary of the issue—identify the issue and what problems are perceived to exist

2.    Potential policy options for solving these problems, including your analysis of their strengths and weakness

3.    Any current California or federal legislation (if any) on this topic

4.    A summary of recent actions (if any) on the issue.

5.    Your prediction regarding the likely position regarding major interest groups (not necessarily the group that you have used for other assignments).

Papers should be a maximum of three pages (plus endnotes).  Presentations should be ten minutes.



Assignment:  Identify attributes of the ideal healthcare system, evaluate our current system, and suggest a solution.

Content:  The paper should:

1.      Identify three attributes (one each addressing cost, quality, and access) that you believe are important for an ideal health system.  Briefly explain why you think this attribute is important.

2.      Evaluate the current status of that attribute in the US healthcare system

3.      Identify what you believe is the best way to achieve this attribute.  Briefly explain why you think this approach is desirable.

An attribute is defined as “a quality or characteristic inherent in or ascribed to someone or something.”  You should use the format “An ideal healthcare system would . . .  because . . . “ in stating your attributes.

NOTE:  “universal coverage” is used as an example below, so don’t use this one.



·      Attribute:  An ideal healthcare system would ensure universal coverage because it will maximize access to the healthcare system and will ensure appropriate reimbursement to healthcare providers.

·      Current status:  Currently, no state ensures universal coverage.  An estimated 17% of Americans do not have health insurance.  In addition, an estimated 22% have inadequate insurance (e.g., doesn’t cover prior existing conditions or reimbursement is so low that no providers are willing to take it).

·      Solution:  The best mechanism to ensure universal coverage is an individual mandate.  It would require each person to have insurance without impacting employers although employers could provide it if they desired. 

Papers should be a maximum of two pages (plus endnotes)