Dilemma-Advocacy for Whom?
Estimated Time of Completion: 2 days
To investigate why some doctors feel torn between patients and insurance
To explore managed care and its implications for patient health
To understand the changes that have occurred within the health insurance
field and the impact on the consumer's ability to afford health
activity addresses the following national content standards as established
by McREL at http://www.mcrel.org/standards-benchmarks/standardslib/health.html:
Knows factors that influence personal selection of health care resources,
products, and services
Knows local, state, federal, and private agencies that protect and/or
inform the consumer (e.g. FDA, EPA, OSHA, local prosecutor's office)
Understands the cost and accessibility of a variety of health-care
services(e.g. Health insurance coverage)
Technology Standards found at http://cnets.iste.org/912pro.htm
Routinely and efficiently use online information resources to meet
needs for collaboration, research, publications, communications,
Select and apply technology tools for research, information
analysis, problem-solving, and decision-making in content learning
Economics Standards found at http://www.mcrel.org/standards-benchmarks/standards/econ/S6.html:
Understands that because citizens, government employees, and elected
officials do not always directly bear the costs of their political
decisions, sometimes policies have costs that outweigh their benefits
Understands that most federal tax revenue comes from personal income
and payroll taxes, and these taxes are used to fund social security
payments, the costs of national defense, medical expenditures, and
interest payments on the national debt
Understands that most state and local government revenues come from
sales taxes, grants from the federal government, personal income
taxes, and property taxes, and are used to fund education, public
welfare, road constructions and repair, and public safety
Understands that government can use subsidies to help correct for
insufficient output, use taxes to help correct for excessive output,
or can regulate output directly to correct for over- or under-production
or consumption of a product
Understands that governments provide an alternative method to markets
for supplying goods and services when it appears that the benefits
to society of doing so outweigh the costs to society but that not
all individuals will bear the same costs or share the same benefits
of these policies
Understands that incentives exist for political leaders to implement
policies (e.g., price controls, barriers to trade) that disperse
costs widely over large groups of people and benefit relatively
small, politically powerful groups of people.
Understands that few incentives exist for political leaders to implement
policies that entail immediate costs and deferred benefits, even
though these types of programs may be more economically effective
Recommended Web Sites
particular attention to the section # 14 and these four Web sites:
Health Care Crisis
Doctor Solomon's Dilemma
"Many Doctors Bend Rules to Help Patients"
The High Price of Health
Video: "Healthcare Crisis - Who's at Risk?"
Computers with Internet access
Ask students if they had to be admitted to the hospital tonight,
who would be in charge of their care? Who would decide their course
of treatment? Probably most will answer-the doctor.
Tell them they'll be seeing a video today in which one doctor and
several patients feel differently.
Further explain that they'll be writing an essay about the statement
Dr. Napoli makes about no longer being a patient's advocate and
why the doctor might not feel he's responsible for patient care.
(Link to quote by Dr. Napoli under the Introduction : http://www.pbs.org/healthcarecrisis/)
Try to examine why Dr. Napoli might feel that way.
Ask if anyone knows the meaning of the term "advocate."
Tell students to pay particular attention to Dr. Napoli's statements
and the individual patients' accounts of problems they've encountered.
Explain that they are required to use quotes, define examples of
problems related to managed care, and use specific references within
the video to support their position.
Ask students to organize their note taking into sections:
Definition of managed care
Specific examples of families and doctors problems
Definition of managed care
Capitation definition and its role
View the video "Healthcare Crisis: Who's At Risk?"
Students have one day to further research the essay (see Web sites
listed above) and begin writing. The essay could be completed as
a homework assignment.
essays may be assessed using the rubric provided.
(Link to this Rubric, in .pdf format)
Dilemma: Advocacy for Whom?
1. Explanation of Managed Care 10
2. Explain capitation and its effect 10
3. Quotes: * Patients 10 * Doctors 10
4. Specific examples of problems
* doctors 25 * patients 25
5. Sentence structure, grammar, spellingcorrect 10
A doctor who is part of an insurance network, an insurance agent,
a third party administrator and/or an administrator from a managed
care company might be excellent choices for class speakers. They
could speak individually or as part of a panel using questions the
class would prepare in advance.
Those particular speakers could also be part of an audience as various
students read their essays. The speakers would be asked give their
reactions from their perspectives.
Students might also be required to interview at least one person
involved in the managed care networking system as part of their