Assumed Student Prior Knowledge
It is assumed that students know that health insurance exists in the United States to aid individuals with the costs of health care.
1. An anticipatory set for this lesson could include bringing in empty prescription bottles of typical medications that students might have taken such as penicillin, asthma medication, or prescription anti-inflammatory drugs. Place the bottles on a table where the students can see them and have students guess the actual cost of the drugs without health insurance, if it is a generic drug and what it would cost with health insurance such as an HMO. (Costs can often be determined from prescription receipts, insurance statements or salespeople, or a pharmacist. Or use the comparison Emory University gives its employees.
Or hand out a copy of an actual bill from a common surgery. Show students the difference in actual costs and costs covered by several health care plans. Lead into the next activity with the students thinking about the following essential questions: "Why are health care costs rising?" "How are different professions, people and industries affected by the cost of health care in the United States?"
2. Working in Think/Pair/Share partnerships, have students use the Health Association of America Web site to reference their Consumer Guide to Health Insurance. (Alternatively, the guide could be downloaded in advance and a copy made for each partnership.) Have students work with their partners to complete the 'What is Health Insurance?' concept map (PDF). This activity will help students acquire the necessary background information about different types of health care, as well as important health care vocabulary.
3. After completing the concept map, have students work with their partners to complete the K-W-L chart related to "The Rising Costs of Health Care." (PDF)
4. Have groups share out the concept maps and K-W-L charts. The students at this point should have a basic understanding of health insurance and have drawn on prior knowledge related to the rise in health care costs by completing the K-W-L chart. You may wish to also briefly discuss additional background information on the need for medical research, improved technology, high costs of malpractice insurance, and the stringent regulations of the Food and Drug Administration.
5. Using the Internet or printed handouts, have students individually read the "As Goes Maine" transcript from the May 17, 2002 'NOW with Bill Moyers' broadcast. This reading could be potentially assigned for homework. (Alternatively, the video could be shown in class. Programs can be taped off-air and used in the classroom for one year, or purchased from ShopPBS.
6. After reading the transcript or watching the video, have students brainstorm answers to the question "Who is affected by the rise in health care costs?" Use the worksheet titled, "The Rising Costs of Health Care - Who is Affected and How" (PDF) to capture their thinking. Encourage them to come at the question from as many perspectives as possible. For example, what impact does it have on their families, families on welfare, families in high socio-economic areas, health care businesses and professionals such as hospitals and physicians, pharmaceutical companies, senior citizens, those using managed care plans, on Medicaid, etc. Once they have identified the section of the worksheet addressing "WHO", have them complete the section focusing on "HOW".
7. Review some of the lists with the class. Ideally, students have accurately identified some of the differences in how rising health care costs affect people without health insurance, small businesses, health care professionals etc.
8. Set up new Think/Pair/Share partnerships and assign each set of partners one role to take on such as doctor, nurse, lawyer, low socio-economic family, middle socio-economic family, high socio-economic family, a hospital CEO, a small business owner, a CEO of a large corporation, a health insurance agent, a nurse, pharmaceutical company worker, a pharmacist, senior citizen, and President Bush.
9. Distribute the Role Play worksheet and challenge students to reread (or re-watch) the "As Goes Maine" story through the eyes of their assigned role and answer the questions on the worksheet. The group that is representing President Bush should also read President Bush's Health Care Plan. Guide students to really delve into their role and focus in-depth on the details of how health care costs truly affect their lives, from their paychecks, to their budgets, to accessing the health care system.
10. Have each set of partners share how the person they represent is affected by rising health care costs and their three possible solutions to controlling costs. List the possible solutions and discuss how other roles would be impacted if the solutions were implemented.
11. As a culminating activity, have students choose one of the roles shared (doesn't have to be their original role) and write a persuasive letter to a newspaper editor, public official or organization proposing ways to control health care costs in the U.S. They are to recommend solutions that directly impact the perspective they chose. For example, a student may choose to write through the eyes of a small business owner who is struggling to provide health care benefits to his or her employees. The letter would include ideas for how small business owners could offer affordable benefits packages to their employees, possibly including ideas for the U.S. government or the public at large. Letters can then be sent out to actual agencies, legislators etc.
12. Have students revisit their K-W-L chart and work with their K-W-L partner to complete the learned section of the chart.
- A rubric can be used for Think/Pair/Share partner work. A sample Think/Pair/Share rubric is provided.
- Assess the clarity and completeness of student responses on the concept map and K-W-L chart.
- Assess the persuasive letter for content, conventions, style and readability.
- Assess student presentations to the class for quality and content.
1. Adapting the questions from the Role Play worksheet, students can interview health care professionals such as a pharmacist, doctor, nurse, hospital spokesperson, small business owner, large corporation benefits officer, etc.
2. Invite a health care worker into the classroom and have him or her explain how his or her job has changed over the last several years due to the rise in health care costs.
3. Enhance your multiple perspectives discussion by looking at the following Web resources:
- The text of a speech from an executive of the Merck pharmaceutical company entitled, "Meeting the Challenge of Pharmaceutical Innovation in an Environment of Rising R&D Costs," presented November 30, 2001. It addresses the question of why prescription drugs cost so much.
- An article from the American Medical Association related to fees charged by physicians. Includes statements such as: Reimbursements increased 5.2% last year, while the overall increase in health care costs was 6.6%.
- A 1997 University of Michigan study that cites the demand for and use of emerging medical technologies as an important cause of the rising costs of health care for HMO's.
- Using the U.S. Healthcare: Healthcare Resource Map
Have students visit the Department of Health Web site for the state in which they live. Ask students to research the estimated percentage of people in their state without health insurance and have them come up with reasons why that is happening in their state.
Employee Health Benefits Survey
Results of the Employee Health Benefits Surveys conducted by the Henry J. Kaiser Foundation. The 2002 survey finds workers are paying more and getting less for their health coverage and that premiums are up 12.7% since 2001. The Kaiser Foundation site also includes links to the surveys conducted 1998-2001, insurance trends, health facts, and much more.
Health Care Crisis: Who is at Risk?
This companion site to a PBS program features a wealth of information in the areas of health care, long term care, the uninsured, Medicare, Medicaid, managed care, patients, providers etc.
A June 22, 1998 transcript from THE NEWSHOUR WITH JIM LEHRER examining medical inflation for managed care recipients.
HMOs facing rising health care costs
A 1997 University of Michigan study cites the demand for and use of emerging medical technologies as an important cause of the rising costs of health care for HMO's.
Meeting the Challenge of Pharmaceutical Innovation
in an Environment of Rising R&D Costs
The text of a speech from an executive from the Merck pharmaceutical company entitled, "Meeting the Challenge of Pharmaceutical Innovation in an Environment of Rising R&D Costs," presented November 30, 2001.
Physicians seeing higher fees as health care costs rise
An article from the American Medical Association related to higher fees for physicians.
About the Author
Donna DeTommaso-Kleinert is an elementary physical education teacher at Hatfield Elementary School in the North Penn School District Lansdale, Pa. She has participated on the writing team for the Pennsylvania State Health and Physical Education Standards and coordinates and presents the new teacher induction program. She has been in the teaching profession for 20 years with experiences in elementary and secondary health and physical education and also as a learning coordinator of all the special area curricula. Presently she is enrolled in a curriculum and instruction program in the Department of Kinesiology at Temple University. Her proudest accomplishments have come from motherhood and marriage.