Syllabus for HSCI 305 Canadian Health Care System

1. Syllabus for HSCI 305 Canadian Health Care System

2. Contact Information • Instructor: John Calvert • Office: Blusson Hall, Room 10512 • Phone: 778 782-8163- • email: jrc@sfu.ca • Office hours: Mon 10:00 – 12:00 & by appointment

3. CourseDescription The course will challenge assumptions, provoke thinking, and deepen your understanding of Canada’s single payer universal health care system. We’ll look at the history of the system, the values engrained in it, the politics, the financing, the delivery, the strengths, the limitations, and the threats. We’ll compare and contrast Canada’s health care system to other countries, including the US, UK, Cuba, Europe & Australia

4. Overall Goal The goal of the course is to deepen and broaden your understanding of the Canadian health care system. In addition, it should provide you with the analytical tools to evaluate the strengths and weaknesses of various health policy options that Canada now faces Health care policy is constantly changing, so other topics may be added during the course to take advantage of contemporary issues.

5. Course Objectives Describe the historical evolution of the Canadian health care system Describe the structure of the Canadian health care system and the roles & responsibilities of the federal, provincial, and territorial governments Describe the financing of health care in Canada and elsewhere Describe how health care is delivered in Canada and elsewhere Analyze major positions in current health care policy debates in Canada and critically evaluate arguments for and against these positions

6. The Context of the Course The course deals primarily with Canada’s health care system: its evolution, organization, funding and current challenges But there are wider issues associated with the ‘social and economic determinants of health’ Arguably these are as important in influencing an individual’s health status as medical interventions or drug therapy So I want to note that what we are dealing with is really a subset of the broader issue of health promotion and health protection

7. Rationale for the Course • Having said that, the health care system is critical to most of us at different stages of our lives • The debates about how we address our health care needs are profoundly important to all of us • They are also the subject of intense political argument and political controversy

8. Issues in Health Care System • How do we define our health care system? • What do we include in the concept of health care? • What role should governments play in providing health programs and services? • What level of government should provide health services? Why? • What types of services should government provide? • What role should markets play in health care? – how expensive should they be? • How do we ensure that policies are based on evidence and not merely prejudice or the interests of different organized groups?

9. How Did We Get Here? • Exactly how did our public health care system get established? • What were the constitutional, social, economic and political forces that shaped its development? • What did we actually get? • What did we not get? • Why is our system so different from that of the US? • How does it compare with other countries?

10. Current Issues in Health Care • Can we continue to afford our public system as it is currently organized? Is this sustainable? • Does it matter if the delivery of certain health services is done publicly or privately? • Is there a larger role for private health insurance? If so what is it? If not, why not? • What are the causes & the solutions to wait lists? • Do we have a constitutional right to health care? • If so what role should the courts play?

11. Content of the Course • We can’t answer all these questions in one survey course about the Canadian health system • But we can touch on a few of the most important of these issues • And we can engage in a debate about some of the solutions that may be needed to address ongoing issues and problems • And some of the “solutions” that we should not be adopting as well

12. Health and Politics • The health care system we currently have is not just a reflection of the application of evidence or technical expertise to solve health care problems • Rather it reflects the broader political compromises that took place throughout the last century • And it reflects the political forces currently at play • Health is political because so much of the debate about our health care system hinges on the role government chooses to play – or chooses not to play • I have included a short reading by (READ) Clare Bambrawhich addresses some of these points

13. Teaching Format One 3-hour class each week including (but not limited to) lectures, discussion, in-class exercises, and films. You are welcome to eat and/or drink during class. Breaks will be taken periodically Napping is strongly discouraged. Please put cell phones to sleep during class, and please don’t text message, facebook (disguised as note-taking), or otherwise communicate with the outside world during class. And don’t surf the internet, play games on your computer or check your emails

14. Overview of assignments, exams, other activities The course will consist of writing assignments, literature reviews, heavy reading, group discussion, debates, lectures, presentations, and exams, If you struggle with any of these learning techniques, please come see me and we’ll develop strategies to support your success. Members of the class should respect different opinions and values. On time attendance is mandatory. Students must sign the attendance record confirming presence in class to ensure 5% credit (absences permitted only with instructor’s permission).

16. Required Text Armstrong, H., and Armstrong P. Health Care Halifax: Fernwood Publishing, 2008, ISBN 978-1-55266-246-5 A collection of journal and other articles which have been posted on WebCT These are arranged for each week in separate folders One folder has the assigned readings A second folder has additional optional readings dealing with the theme of the week

17. Other Background Material • I have posted the complete first volume of the Royal Commission on Health Services (Hall Commission) in a separate folder • ***USEFUL FOR ESSAYS** • I have posted almost all of the background papers commissioned by the Romanow Royal Commission on Health Care in a separate folder • These should be helpful in preparing your term paper and also enable you to follow up on areas of the course you find of interest • I have also posted some articles on good writing style which I encourage you to read

18. Class Discussions

19. Guest Speakers • I intend to invite speakers knowledgeable about specific health policy areas • You should ask questions & take notes • We will discuss their presentations at the next class • Presentations may be the subject of exam questions • Speakers are not for ‘entertainment’ but are part of the class curriculum

20. Grading • Assignments are graded as follows (instructor reserves the right to change percentages when introducing assignments): • Assignment 1 10% • Assignment 2: 10% • Mid Term Take Home Exam: 20% • Term Paper (Essay) 25% • Final Exam 30% • Participation (including in-class work 5%

21. Grading Letter Grade % Range SFU Grade Point A+ 90-100 4.33 A 85-89 4.00 A- 80-84 3.67 B+ 77-79 3.33 B 73-76 3.00 B- 70-72 2.67 C+ 67-69 2.33 C 63-66 2.00 C- 60-62 1.67 D 50-59 1.00 F 0-49 0.00

22. Due Dates and Absences Late work causes problems for both of us. I will collect assignments at the beginning of class If you hand it in at the end of class, it’s late. If your work is late, you lose 5 percentage points per day. For example, if your assignment would ordinarily merit a score of 92%, but you handed it in after the start of class on the due date, you’ll receive 87%. If it is handed in the day after it was due, you’ll receive 82%. The late penalty includes weekends and holidays.

23. Attendance

24. Sign the Attendance Sheet • Your participation grade of 5% is based on your attendance in class • You will lose one percentage point for every class you miss • So make sure you sign the attendance sheet at the beginning of every class!

25. Illnesses or Emergencies • If you are sick and unable to complete your work, a medical certificate from a health care professional may be requested at the instructor’s discretion. • If you need or want to observe a holy day, please send me an email describing your situation. If the holy day falls on the day an assignment is due, it must be turned in the day before. • If you are struggling in class, come see me. Don’t delay. I’ll help you develop strategies for success.

27. Academic Integrity Don’t cheat. Ever. Even by accident. It’s that simple. Use proper citation in your writing. There is no shame in direct quotation, or in paraphrasing, so long as you attribute to the original source of your ideas and words. The goal is to learn, not just to get a good grade. When in doubt, cite your source. If you struggle with writing, I’ll help you learn to be a better writer. Becoming a good writer will serve you forever in your career.

28. Read the Syllabus • I have not gone over all the details of the Syllabus, and particularly the discussion of how to write your term paper • But you should read this carefully as it will assist you in developing your proposal and in structuring the essay itself • If you have not written a term paper before, please ask for help and Tarya or I will do our best to assist you • Much of this advice also applies to your two other written assignments

29. 1st Assignment • “Should medically necessary physician and hospital care be a right or a privilege?” (Maximum 5 pages, double spaced. This is worth 10% of your grade.) • I do not expect this to be a detailed research paper, but rather a paper that sets out what you think about this issue. Take some time to think about the question and do your best to explain the reasons for your answer • This question is one that you may want to look at again at the end of the class to see if your perspective has changed • THISASSIGNMENT 1 IS DUE CLASS 3

30. How the Course is Organized • Class 1 - Introduction and administrative issues • Class 2 - Constitutional Framework, History and Development of Medicare - Note: This is the May 24th holiday so no class. But you will have to study the assigned readings for the week • Class 3 - Hall Commission, Lalonde Report, The Canada Health, Romanow Commission • Class 4 - US Health Care System. Film: TBA • Class 5 - Public or Private Financing, Hall Commission on Insurance • Class 6 - Public or Private Delivery of Health Services

31. How the Course is Organized • Class 7 – Role of Provinces in delivering and regulating health care services • Class 8 - Human Resources, Labour Relations • Class 9 - Pharmaceutical Issues • Class 10 - Trade Agreements & Health: TRIPS/ NAFTA/Political Economy • Class 11 - Wait Lists, Courts Legal Challenges and Role of Evidence • Class 12 – BC Day – Future of Medicare, Current Issues International Perspectives. Note: you will be responsible for the readings assigned for this week • Class 13 - Final Exam – In Class August 9th

32. Current Health Policy Issues • I will start every class with a very brief discussion of current health issues • I may also send you emails containing short articles on issues relevant to the course • You should try to monitor current policy developments be able to participate in the discussions knowledgeably • This is also an opportunity to ask me about issues of interest to you

33. Contacting Me • The best way to contact me is by email • I am in and out of my office at various meetings so the phone should be your second choice • You must put HSCI-305 on every email to me (I am also teaching another health science course so I need to know which course you are in.) • Also make sure you put your name on the email – I won’t recognize you if all I see is your email address. • I will try to return emails within 2 days, with the exception of the Olympics

34. Your Questions • Please ask me anything you want to know about the course • Ask me about any concerns you may have about its organization and focus • Or anything else you need to know

35. My Questions? How many students are in 2nd year? In 3rd year? In 4th year? How many students are majoring in health sciences? How many are in social sciences (politics, sociology, history, economics How many are in traditional sciences (biology, chemistry etc.)