MASTERS OF HEALTH ADMINISTRATION PROGRAM
DEPARTMENT OF HEALTH POLICY AND MANAGEMENT
UNIVERSITY OF KANSAS MEDICAL CENTER
Survey of the Health Care System (HP&M 810)
Marcia J. Nielsen, PhD, MPH
Vice Chancellor for Public Policy and Planning
Assistant Professor, Department of Health Policy and Management
Office hours by appointment
Phil Pereira, PhD Student
Time and place:
Orr Major 1015
This three credit hour survey course provides an introduction to the U.S. health
“system” and gives students a foundation of factual knowledge, concepts, and
vocabulary requisite for subsequent courses in the Masters of Health Services
Administration curriculum. Together we will examine the components and
characteristics of the U.S. health care system and explore current issues confronting
the system, as well as possible means for resolving these issues in the future.
1. To gain factual knowledge and acquire vocabulary pertaining to health services
delivery in the United States.
2. To acquire historical perspective on the development of the U.S. health system.
3. To describe and understand the components of the U.S. health care system, as
well as how they interact.
4. To apply concepts from the social sciences to understand the structure and
function of health care.
5. To gain an understanding of the criteria that can be used to evaluate health care
6. To acquire and enhance skills in gathering and presenting information about the
U.S. health care system.
We will use a variety of methods, such as reading, class discussions, field experiences,
lectures, and examinations to accomplish course objectives. Students will be asked to
set up an Angel account as a means to obtain lecture material, discuss readings and
current events, etc.
1. Preparations: In order to best achieve the objectives outlined above, it is important
that we facilitate one another’s learning. This course is designed to be highly
participatory, which requires that students as well as the instructor come to class
prepared. There is a significant amount of reading for this course. Please read the
assigned materials before coming to class so that you are prepared to discuss. The
instructor reserves the right to have unscheduled pop quizzes over the reading
2. Current events: In addition to reading the required chapters from the course
textbooks and additional journal articles, you are asked to keep current on health
related issues in the media. Each week we will be discussing these issues in class,
and you will later be expected to comment upon them in your midterm and final
You are asked to subscribe to the Kaiser Daily Report at www.kff.org. A free
daily report will be sent directly to your e-mail account outlining the latest
health related news.
3. Ownership. This class is yours and your contributions to it will greatly enhance the
course for everyone. You are invited to question your instructor and classmates in a
thoughtful and professional manner that is conducive to group learning. Please turn
off cell phones in class.
4. Professional Conduct. All relevant policies regarding academic integrity apply in
this course. Academic integrity is based on mutual respect and trust between and
among faculty and students. Any actions that breach this trust, on the part of the
instructor or students, undermine the educational process and thus all policies
regarding academic honesty will be enforced.
5. Writing: Writing skills are tremendously important for health care executives.
Students will be expected to appropriately cite all references used in presentations or
written materials. Please be very mindful of not presenting someone else’s research
or intellectual ideas as your own. Additionally, please take the time and effort to
ensure that your written work is free from misspellings, typos and major
grammatical errors. For your class project, you are expected to consult the assigned
readings on effective business writing as well as the writing guidelines at the end of
the syllabus. Work that is not clearly organized and reasonably well written will be
returned for a re-write.
6. Accommodation for students with disabilities. Any student who because of a
disability needs accommodation to complete course requirements should contact the
instructors or the ADA/504 coordination (913-588-7813).
7. Meet and greet with the instructor: Although office hours for specific questions
and concerns are by appointment, every student is also encouraged to set up a “meet
and greet” with the instructor and/or the teaching assistant to open a dialogue about
the student’s academic and career goals. Students are asked to email the instructor
with a request to meet. This is not a mandatory meeting, but is encouraged for those
students who are interested.
As mentioned earlier, this course requires a significant amount of reading.
Accordingly, there are two texts and several assigned readings. The first text will give
students a historical/theoretical perspective on the US health care structure and will
help provide an explanation for its current design (Starr, 1982). The second text will
serve as a simple guide/resource to understand the various components of the US
health care system. Please read – do not study – the assigned readings before
class. Any materials from the readings upon which you will be tested will be
discussed in class. These books can be purchased on-line.
Starr, Paul (1982). The Social Transformation of American Medicine. Basic
Books, New York.
Shi and Singh (2010). Essentials of the US Health Care System. Second Edition.
Jones and Bartlett Publishers, Sudbury, MA. [This is a shorter version than the
one sold by the bookstore; either will work].
Course Requirements and Evaluation
Students will be evaluated on the following:
Contribution to class discussions 25 points
Facilitated class discussion 25 points
Course project 50 points
Midterm Examination 50 points
Final Examination 50 points
90-100 percent = A
80-89 percent = B
70-79 percent = C
< 70 percent = F
The instructor will also be evaluated at the end of the term, using the form adopted by
the Department of Health Policy and Management.
1. Class Contribution: Students will be graded on both attendance as well as class
contribution. Points will be deducted from your overall class contribution grade for
unexcused absences. If you must miss a class, please contact the instructor or the
teaching assistant prior to the missed class. You will be responsible for obtaining
lecture notes for any missed classes. (25 points maximum)
2. Facilitated Discussion: Each student will be assigned to a small group to facilitate a
brief 8-10 minute class discussion regarding health related current events. Every
class will begin with this facilitated discussion. Students are expected to prepare a
brief powerpoint and guide the class as we discuss each week’s current events and
their implications on the larger health care system (each student will present at least
one but no more than three powerpoint slides). As part of facilitating the class
discussion, each group should have at least three thoughtful questions prepared in
order to promote class discussion. The group will turn in the outline and questions at
the end of the presentation – every student will be graded separately based on their
part of the presentation (25 points maximum).
3. Course Project: Informational Interview: To learn more about the role that
various professionals play in the US health care system, students will identify a
profession of interest (potentially one that the student is considering exploring as
a career) and will interview an individual currently working in that field.
Students are asked to interview someone who they do not personally know and
are expected to:
• Identify the individual they would like to interview, and contact that
individual both in a formal letter and via email requesting an interview of no
more than one hour, at a time convenient for the individual. DUE
• Provide a list of 7 to 10 questions they would like to explore with this
individual PRIOR to the interview and including your resume’ or
biosketch for reference. Due October 8th.
• Conduct the interview in person (dressing in business attire appropriately
for the occasion) and follow up with a written thank you note to the
• Write a 8-10 page paper describing your interview. This paper should
include: (1) information about the training, licensure, and certification of
professionals in this position; (2) this individual’s role in the
organization (a job description may be helpful); (3) a general description
of what you learned during your interview; (4) a description of current
challenges for this individual or for the organization in which the
individual works; and (5) a final section describing how individuals
working in this position have the potential to have an impact on the overall
health care system. (50 points maximum). Due November 19th.
There are three deadlines for this class project as listed above. First, the selection
of who you plan to interview will be turned in on Sept. 17th (emailed to both the
instructor and teaching assistant). A copy of your interview questions and
resume/biosketch should be turned in by October 8th (emailed to both the
instructor and the teaching assistant). The final paper will be turned in on
November 19th. Turning in a paper copy is preferred (emailed will be accepted).
These deadlines are designed to minimize interference with exam dates.
4. Examinations: The mid-term will be closed book and will take place on
October 1st. It will cover course material through September 24th. The format of the
exam will be in-class and students will have 75 minutes to complete the exam. (50
points maximum). The final examination will cover material from the last half of
class and is scheduled for Dec. 10th. This will also be an in-class examination (50
points maximum). Exams will include essay, short answer, and fill-in-the-blank
Date Class Agenda Topics and Readings
# *Daily readings on relevant health issues in the media
are assumed as part of the weekly reading
Aug. 1 Introductions and TEXT: Shi and Singh, Chapter 1
Major characteristics of Review syllabus
US health care delivery Assign book club groups
Aug. 2 Foundation and history TEXT: Shi and Singh, Chapter 2 and 3
27 of US health care
Book Club: Starr (1982). Book One. Introduction
and Chapter One
Sept. 3 3 Foundation and history Book Club: Starr (1982). Chapter Two
of US health care
delivery and health
Sept. 4 Health care providers TEXT: Shi and Singh, Chapter 4, 5 and 6
10 and professionals and
Services Financing & Book Club: Starr (1982). Chapter Three
Group 1: Top News
Sept. 5 Medicare/Medicaid Readings:
Guest Lecturer: Phil http://www.kff.org/medicare/upload/7615-02.pdf
Group 2: Top News http://www.khi.org/resources/Other/1266-
DUE: Selection of who you intend to
Sept. 6 Outpatient services, TEXT: Shi and Singh, Chapter 7 and 8
24 primary care and
Book Club: Starr (1982). Chapter Four
Guest Lecturer: Tom
Bell, Executive Director
for the Kansas Hospital
Oct. 1 7 MID-TERM EXAM Take In-class exam
Oct. 8 8 Managed Care TEXT: Shi and Singh, Chapter 9
Book Club: Starr (1982). Chapters Five and Six
Group 3: Top News
Stories DUE: Interview questions and resume’
Oct. 15 FALL BREAK No class.
Oct. 22 9 Long term Care TEXT: Shi and Singh, Chapters 10
Guest Lecturer: Janet Book Club: Starr (1982). Book Two. Chapter
Williams, PhD (invited) One
President and CEO.
community works (home
care for brain injured
Oct. 29 10 Underserved populations TEXT: Shi and Singh, Chapter 11
Group 4: Top News
Stories Book Club: Starr (1982). Chapter Two
Guest lecturer: Phil
Nov. 5 11 Cost, access, and quality TEXT: Shi and Singh, Chapter 12
Group 5: Top News Book Club: Starr (1982). Chapter Three
Nov. 12 Health Policy TEXT: Shi and Singh, Chapter 13
Group 6: Top News
Stories Book Club: Starr (1982). Chapters Four and Five
Nov. 13 Future of health services TEXT: Shi and Singh, Chapter 14
Guest Lecturer: State KansasCountyHealthRankings2009.pdf
Senator Jim Barnett, MD
DUE: TURN IN FINAL PAPER
Nov. THANKSGIVING No Class.
Dec. 3 14 High performance health Reading:
Dec. 15 FINAL EXAM Take In-Class Exam
MHSA Writing Guidelines
1. Use 12point font, with one-inch margins on all sides. For each course, the
instructor will indicate whether single-spacing or double-spacing is
acceptable. A title page is appropriate for research papers and other
2. Know your objective, and state it early in your writing. In addition, your
paper (or each portion of an assignment) should conclude with a summary
that ties together its various parts.
3. Organize your thoughts and your research before you begin writing.
4. Use headings and subheadings, if the length of what you are writing is a full
page or more.
5. Do not leave headings or subheadings hanging at the bottom of a page.
6. Make your formatting attractive and readable. You may use lists/bullet points
7. Use page numbers on each assignment you submit. Begin pagination on the
8. Use short sentences and paragraphs. Do not write one-sentence paragraphs.
9. Do not use contractions. For example, use “cannot” instead of “can’t” and
“do not” instead of “don’t.”
10. A sentence should never begin with a figure, even when there are figures in
the rest of the sentence. Either spell out the first number or reframe the
11. When using percentages in the text of your work, use a numeral and write out
“percent, for example, “47 percent.” Use the percent sign (%) in table and
12. When using an abbreviation or acronym (HMO, PPO, AHA, CEO) write the
complete name or phrase the first time you use it, followed by the
abbreviation or acronym in parenthesis. Subsequent references may use the
abbreviation or acronym.
13. Do not being a sentence with an abbreviation or an acronym.
14. Put sentences in the active voice (“I did it;” “They did it”) instead of the
passive voice (“It was done.”)
15. Use the first person (“I” or “we”) rather than third person (“the author”) to
describe what you yourself did. Do not use second person (‘you”) in
16. Write in your own voice; be natural. Use simple language. Avoid jargon and
“fancy language.” Omit needless words. Do not use a phrase when a word
will do, a sentence when a phrase will do, or a paragraph when a sentence
17. Avoid use of slang and “informal” language.
18. Avoid language that might be interpreted as denigrating to ethnic, racial,
gender, or other groups. Be particularly careful in dealing with gender, where
long-established customs, such as the use of certain pronouns (“he” for
physician; “she” for nurse) can imply gender-based discrimination. Use of
plural pronouns or reframing the sentence usually helps.
19. Always use proper grammar and correct spelling.
20. Be consistent in your use of grammar rules (e.g., use of a comma before a
conjunction in a list, verb usage and tense in a list of bullet points, use of
numbers and numerals).
21. Edit and proofread carefully. Review your writing carefully for readability,
clarity, spelling, grammar, and typographical errors. You writing should flow
smoothly and coherently.
22. Provide appropriate citations in an accepted format. Provide references for all
concepts, thoughts, ideas, quotations, etc., from other sources (e.g., books,
journal articles, personal interview). Identify direct quotations properly.
23. Acquire a collection of references on writing that can help you. In addition to
a good dictionary and thesaurus, here are a few suggestions:
o Alred, Brusaw & Oliu. The Business Writer’s Handbook
o Munter. Guide to Managerial Communication: Effective Business
Writing and Speaking
o Shertzer. The Elements of Grammar
o Strunk & White. The Elements of Style
o Walsh. Plain English Handbook
o American Psychological Association. Publication Manual, 5th