Challenge Questions (7 – 10 pages) This is an estimate. Be sure to answer questions fully.

Module 1 Overview and System Performance

Each question is to be answered separately. Be sure to identify the question you are answering. Answers are to be double spaced, 12 point font and 1” margins.

1. What is the real and perceived performance of the U.S. healthcare system? Please elaborate on the views expressed by Khazan. Are these views different among patients, providers, payers, employers and policymakers? Please identify all critical stakeholders and criteria they may use to evaluate health system performance.
2. Is healthcare a right?Should the government play a key role in aiding the uninsured or should market forces reign supreme?While your opinion is highly valued, you must justify your answers based on readings and outside sources.
3. Please explain 3 key indicators of health system performance. The indicators are cost, quality and access. How do they interrelate? E.g. Can you have higher quality and lower cost?
4. In the Triple Aim, Berwick and colleagues identify a path forward to a more effective health system that shifts the burden from provider organizations to the political arena. Briefly describe the “triple” aim. What are the preconditions necessary and what should the focus become to meet the triple aim. How can health policy achieve the goal of achieving the triple aim? What is added in the quadruple aim compared to the triple aim? Why is this important?
5. In Porter’s article on strategies that fix healthcare he is predicting that the health system will become value based. What does he mean by that? Briefly describe the value agenda and the 6 strategies needed to achieve a value-driven system? What is the role of health policy in achieving the aims described by Porter? (e.g. how is the ACA driving change?)

In answering these questions you should reflect on how you are achieving the following learning objectives and competencies:

#	LEARNING OBJECTIVE	MPH Foundational Knowledge	MPH Foundational Competencies
1	Identify the components of an effective healthcare system and the organization of the U.S. healthcare system including the roles of public and private health systems.	1. Explain public health history, philosophy and values.	5. Compare the organization, structure and function of health care, public health and regulatory systems across national and international settings 22. Apply systems thinking to a public health issue.
2	Evaluate the performance of the US Healthcare System and its ability to meet the Triple Aim in comparison with OECD countries	10, Explain the social, political and economic determinants of health and how they contribute to population health and health inequities ;	22. Apply systems thinking tools to a public health issue

Assignment Details

Externalities are costs or benefits that are caused by producing or consuming a good but that are not included in the market price for the good. They are simply the unintended side effects of market activities. Externalities can be positive or negative. One example of a positive externality might be when beekeepers provide a means of pollination for fruit growers. Air, water, and noise pollution are examples of negative externalities.

Please answer the following questions to describe an instance in which you, an acquaintance, or family member has experienced an externality. Please use economic concepts, and use references in your main contribution.

1. How did it affect you (or your acquaintance or family member?) Please explain.
2. What were the effects? Please explain.
3. Did you (or your acquaintance or family member) experience increased or decreased health or quality of life? Please explain.
4. If you choose to write about a negative externality such as pollution, what do you think is the best way to reduce pollution? Please explain.
5. If you choose to write about a positive externality, what is the economic problem that positive externalities create? How would you resolve that? Please explain.