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Study Group on The Global Interface of Medicine, Business and Government--Fall, 2011
Moderator:  Timothy Christian, MD, MPA, Senior Fellow at M-RCBG

Syllabus
Objective:  This study group explores the complex interface of medicine, business, and government.   These entities, while often studied separately, are closely intertwined. This group is an effort to capture the full context. We will explore some of the assumptions about global health care in relation to governments and business, why we make them, and how they hinder progress.  Participants are encouraged to think of solutions that may not reflect the current reality, but may offer a new direction for action.
Articles from the literature will be used as a fulcrum for discussion but study group conversations will go beyond the published word. Published sources provided here offer basic background necessary to engage fully in the conversation.  No prior knowledge of the health-care system in the US or globally is required.  This group will help you understand the basic concepts of these fields.  Eventually, participants may identify an area of personal interest and develop specific solutions to the issues that are at its core.
There will be guest participants for some of the sessions to provide expertise and experience.  This is an excellent opportunity to challenge your and their assumptions and acquire a different perspective on sectors you may be less familiar with such as the insurance and pharmaceutical industries.  The group will meet every other Thursday starting on Sept 8th  from 3-4pm.  Walk-ins are always welcome.

Schedule
As an overview for the study group, these three papers can be used as reference and form the backbone of the seminar. 

  1. Weisbrod BA.  The Health Care Quadrilemma: An Essay on Technological Change, Insurance, Quality of Care and Cost Containment.  Journal of Economic Literature Vol. XXIX (June 1991), pp. 523-552.
  2. Fernandez B.  Health Insurance:  A Primer.  CRS Report for Congress, Feb 2005.
  3. Anderson AJ.  Global Pharmaceutical Patent Law in Developing Countries- Amending TRIPS to Promote Access for All2006.

Session 1:  The four key questions at the interface:  Cases-The US Anthrax attacks and TRIPS, The curious case of the drug eluting coronary stent

Readings:

  1. Godwin M, Prescription Panic:  How the Anthrax Scare Challenged Drug Patents.
  2. Shih C, Berliner E. Diffusion Of New Technology And Payment Policies:  Coronary Stents. 
  3. Fleck LH. The Costs of Caring: Who Pays? Who Profits? Who Panders?  Hastings Center Report, The / May-June, 2006.

Session 2: Health Insurance

Readings:

  1. Baicker K, Chandra A.  Myths And Misconceptions About U.S. Health Insurance.   [Health Affairs 27, no. 6 (2008): w533–w543.
  2. McArdle M. Why I Oppose National Health Care.  The Atlantic, no. 7: 2009.
  3. Diamond GA, Kaul S.  Cost, Effectiveness, and Cost-Effectiveness.  Circulation: Cardiovascular Quality and Outcomes. 2009; 2: 49-54.
  4. Pauly MV, et al. Private Health Insurance In Developing Countries.  Health Aff March 2006 vol. 25 no. 2: 369-379.
  5. Ensor T, Sen PD.  Strategies for Developing Health Insurance in Bangladesh.  Ministry of Health, Bangladesh, 2000.

Session 3:  The Global Pharmaceutical Industry

Readings:

  1. Ismail M.  Drug Lobby Second to None:  How the Pharmaceutical Industry Gets its Way in Washington.  Pushing Prescriptions, The Center for Public Integrity 8/3/2011.
  2. The Economist.  Quagmire to Goldmine?  The Rapid Growth in Developing Countries Prompts a Rethink by Drugs Companies.
  3. Angell M.  The Truth About the Drug Companies.  NY Times Review of Books.  July 15, 2004.
  4. Pharmaceutical Pricing Policies in a Global Market.  OECD 9/24/2008.
  5. Cohn J.  Politics. Profits and Pharma: Dangerous Prescription
  6. Ortiz C.  Global Healthcare on the Ground: Roche Takes on Illnesses in LDCs. Phamtec May 2, 2011.

Session 4:  Medicine and International Trade-TRIPS and essential medicines for developing countries

Readings:

  1. Patent Protection versus Public Health.  Lancet Volume 358, Issue 9293, Page 1563, 10 November 2001.
  2. Harper DE.  EU CUSTOMS BLOCKADE OF INDIA’S GENERIC MEDICINES:CLAIMS OF COUNTERFEITING TAKE ADVANTAGE OF A LOOPHOLE IN TRIPS.  The student appeal law journal 2011.
  3. WTO Press Release.  INTELLECTUAL PROPERTY: TRIPS AND PUBLIC HEALTH. Council approves LDC decision with additional waiver. 2002.
  4. Bate R.  Local Pharmaceutical Production in Developing Countries Campaign for Fighting Diseases discussion paper no. 1, 2008.
  5. Pharmaceutical Price Controls Abroad: An Unfair Trade Policy. US Senate, Republican Policy Committee. 2003.
  6. Trade & Pharmaceutical Policy Update. Forum on Democracy & Trade, Special 301 Report. 2011.

Session 5  Medical Innovation:  Who Pays?  

Readings:

  1. Appleby J.  The Case of CT angiography:  How Americans View and Embrace New Technology.   Health Affairs 2008; 27:  1515-1521.
  2. Dickson M. The Cost of New Drug Discovery and Development.  Discovery Medicine 2009.
  3. Big Trouble for Big Pharma,  Why Big Pharma Urgently Needs a New Business Model.  Economist, Dec 4, 2003.
  4. Chesbrough H.  Pharmaceutical Innovation Hits the Wall: How Open Innovation Can Help.  Forbes April 25, 2011.
  5. Platzer, M. Patient Capital:  How Venture Capital Investment Drives Revolutionary Medical Innovation.  National Venture Capital Association.
  6. Glennerster, Kremer and Williams.  Creating Markets for Vaccines.  Innovations, Winter 2006.

Session 6:  Health-care Delivery Systems

Readings:

  1. Estes J, Pell M. Lobbyists Swarm Capitol to Influence Health Reform.  Iwatch Feb 24, 2010.
  2. Tina Rosenberg. Villages Without Doctors.  NY Times Feb 14, 2011.
  3. Larson, Sven R. Lessons from Sweden’s Universal Health System:  Tales from the Health-care Crypt.  Journal of American Physicians and Surgeons Volume 13 Number 1 Spring 2008: 21-22.
  4. Sood N, Grayboes R, Baron J, Miller T.  Does Healthcare Reform Help U.S. Business?  Council on Foreign Relations 2011.
  5. Kaiser Foundation.  Summary of the New Health Care Reform Act (PPACA).
  6. Fortner, Paula. Mobile Phones Drive Health IT Innovation. iHealthBeat Features August 10, 2009.
  7. Brownlee, Shannon. Bad Science and Breast Cancer. Discover Magazine August 1, 2002.

Session 7:  Medical Devices

Readings:

  1. Voelker R.  FDA Ponders Regulation and Innovation.  JAMA, April 20, 2011—Vol 305, No. 15.
  2. Brian Garriock Firth, Liesl M. Cooper, and Steve Fearn.  The Appropriate Role Of Cost-Effectiveness In Determining Device Coverage: A Case Study Of Drug-Eluting Stents.  Health Affairs 27, no. 6 (2008): 1577–1586; 10.1377/hlthaff.27.6.1577.
  3. Timmerman L. Is the U.S. Losing its Medical Device Innovation Mojo? PwC Report Says Yes.  X Economy 1/20/11.
  4. Miller JA. Money for mischief: USAID and Pathfinder Tag-team Women in the Developing World.  Population Research Institute.
  5. Schoonmaker, Michele. Comparison of the Drug and Device Approval Process. 2005.
  6. World Health Organization. Medical Device Regulations: Global Overview and Guiding Principles. 2003

Session 8:  Solutions
During this session, members of the study group are invited to offer potential solutions to issues they have identified as important during the semester.  Presentation is optional and those not presenting are encouraged to attend to provide feedback.