Health and Healing in America

Our workshop generated some terrific questions and I added a few of my own. Here are some topics to study; the exam’s questions will be based on this list, as well as the glossary wiki and people wiki terms.

Describe a pre-modern theory of disease

Be prepared to contrast/compare diagnosis or treatment in early America vs. in our own time

Benjamin Rush: quack or hero?

What is Foucault’s conception of “the gaze”and why is it a useful concept for historians of medicine?

How (and when) did Johns Hopkins, or the Flexner Report, or European models influence American medical education?

What was “Listerism” and why was it resisted by the American medical establishment?

Is vaccination a Constitutional use of the police power given to states? Discuss this question, using relevant legislation or court cases.

Medical researchers in the early to mid 20th century were on the forefront of scientific discovery, yet positioned themselves firmly against nationalized health care. Can you explain why physician organizations were on the one hand, futuristic in their work and on the other hand, so resistant to certain kinds of change?

Characterize treatment or the patient experience and outcomes at Willard; the institution was an example of why, exactly? I.e., place those experiences in wider context (medical, social, legal or other).

What is Paul Farmer’s contribution to the ethical dimensions of medicine and health care? Would you consider him he a modern Hippocrates, why or why not?

Provide a case study of the role of race in medicine or health care in America (possibilities: transfusions/blood banking, epidemics, “white man’s burden”)

What loopholes does the Affordable Care Act (aka Obamacare) close? Where, according to its critics, does the legislation fall short (or, conversely, go too far)?

During this unit, we’ll work at understanding our tremendously complex American health care system: its origins, current reform efforts, issues for debate, consequences, and possible future.

Wed 4/17 – View Michael Moore’s film Sicko. Response Paper #3 due.

Mon 4/22 – How Did We Get Here? Reading: Stevens, “History and Health Policy in the US” (PDF on Blackboard)

In-class link: “Why is American Health Care So Ridiculously Expensive?” (The Atlantic 3/27/13)

Wed 4/24 – Costs: Economic, Social and Ethical. Reading and Listening: Farmer, “Pathologies of Power” (PDF on Blackboard) and LISTEN to and take notes on this October 2009 hour-long episode of the NPR program This American Life

Links we watched in class:
MRI Costs (Washington Post WonkTalk, March 2013)
Health Care System Overview (Khan Academy)
Journalist Steven Brill talks about his Time cover story on Medical Bills (March 2013)

Mon 4/29 – Health Care Reform, Law & Policy. Start by browsing this site: Healthcare.gov

Then read these:
Health Care Reform – Top 10 Pros/Cons on Procon.org
“The Case for Universal Health Care in the United States,” AMSA (American Medical Student Association), 2008
Robert A. Levy, “The Case Against President Obama’s Health Care Reform: A Primer for Nonlawyers,” Cato Institute White Paper, 2011 (12-page downloadable PDF)
“Fighting to Control the Word ‘Obamacare’” NYT 25 March 2012
“The ABCs of the Health Care Law and its Future,” NYT 2 April 2012

Note: there quite a number of polemical websites, you might want to look at a few, keeping in mind none of these are official or scholarly sources –

Obamacarefacts.com
Obamacareprosandcons.org
therepealpledge.com
HeritageFoundation.org’s content on Obamacare
CommonHealth: Reform and Reality (WBUR.org)
NYT: Multimedia content on the Affordable Care Act and the Supreme Court

Wed 5/1 – The HC Debate in Microcosm. See the “Debate” tab at the top of the course website. Prepare for the debate by taking, and supporting with evidence, a position in the health care debate. Due in class: Your Position Paper

Mon 5/6 – Wrap Up Day and Exam Prep. We will complete the Glossary in or before class, and work on developing the format for the final together.

Mon 5/13 – Final Exam 12:30 pm. Due at the final: Your Course Reflection Paper (prompt TBA)

Throughout the third unit of this course we’ve been reading and discussing health care and medicine in the period 1890-1950. For Response Paper #3, due Wed 4/17, choose one of these prompts and craft a 3-4 page paper drawing on our class discussions and course readings in this unit: Willrich Pox, Rutkow Seeking the Cure Chapters 8-10, and Penney & Stastny The Lives They Left Behind.
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Over the next few weeks we’ll be exploring aspects of health care in the twentieth century: the post-Flexner, vaccine-and-antibiotic era in which a gigantic industry of health care began to flourish – and during which the medical profession’s opposition to centralized health care emerged with a vengeance.

For Wednesday, April 3rd – your Disease Report papers are due, but also: please bring Rutkow’s book and be ready to talk about chapters 8 and 9.

Relevant links:

A (hilariously campy) British government 1964 film looking back on the 1940s discovery of penicillin

See Jack Gibbon’s heart-lung machine in action (BBC Four)

Hear Ronald Reagan in his 10 minute LP recording from the AMA’s “Operation Coffee Cup” 1961 lobbying effort (never mind the images, just listen to the recording)

Listen to the 1948 “Truth or Consequences” episode introducing the original “Jimmy” of the Jimmy Fund

Next week we’ll read a short, but gripping, historical and medical detective book delving into the abandoned suitcases of inmates (is that the right word?) at a big New York mental hospital in the 1920s-1950s. I think you’ll really enjoy reading it and considering its thought-provoking depiction of care for the mentally ill. Read chapters 1-6 of The Lives They Left Behind for Monday, April 8th and Chapters 7-Epilogue for Wednesday, April 10th. I’ll then hand out a prompt for the third response paper, due on Wed 4/17.

Summing up your #1 takeaway from Michael Willrich, Pox: An American History:

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