The practice of medicine isn’t what it used to be. Not only do doctors have to care for patients, they also need to understand and function in the world of managed care, Medicare, and long-term care—among a plethora of other issues that affect how physicians actually do their jobs in today’s complex medical environment. Being a doctor these days involves interacting with patients who may not only have problems with their health but problems with their health insurance—or lack thereof—as well.

That’s where the Department of Health Care Policy comes in. For more than 20 years, HCP has been addressing issues in the economics of health care, quality of health care, access to care, disparities in care, and other thorny questions facing the US health care system. Recognizing the importance of these social science issues to the practice of medicine today, Harvard Medical School requires tomorrow’s physicians—HMS students—to take an HCP course on health care policy, taught by HCP Associate Professor Haiden A. Huskamp, PhD, and Ridley Watts Professor Barbara J. McNeil, MD, PhD, head of the Department of Health Care Policy. The course, Introduction to Health Policy (HC750.0), had been an elective, but since 2007 has been a requirement. Currently a fall semester course for second-year students, Introduction to Health Policy will be moving in the 2009–10 academic year to the January term for first-year students.

Addressing important issues confronting physicians in the 21st century
The course introduces students to the key features of the current US health care delivery and financing system and to analytic concepts these potential physicians will need to understand in order to evaluate current health policy issues. Faculty from throughout Harvard University lead discussions on specific health care policy topics, including recent changes in the health care market, physician payment arrangements, factors affecting quality of care, how other countries organize and finance their health care systems, and approaches to expanding insurance coverage in the United States. Class sessions include a variety of formats, including lectures, case study discussions in small groups, and debates.

Beginning with an overview of the US health care system, the sessions cover:

• private insurance in the United States
• Medicare, Medicaid, and the uninsured
• the politics of health care
• the economics of insurance
• changing systems of care to prevent medical errors
• how health care providers are organized and paid
• how high-quality care is defined and measured
• different ways the United States could organize and finance its health care system
• lessons the United States can learn from other developed countries
• the Massachusetts health care reform experiment
• consumerism in health care
• drug/device policy and regulation

Case discussions are led by a range of experts in the field, including Glenn D. Steele, Jr., MD, president and CEO of Geisinger Health System in Pennsylvania, and Jon Kingsdale, PhD, executive director of Commonwealth Connector, an independent state agency that helps Massachusetts residents find health care coverage under the state’s 2006 health care law.

By popular demand, this year’s course includes changes from last year’s inaugural required course. “We’ve expanded the number of discussion sessions from four to eight,” says Huskamp, “and reduced the number of students in each small group from 15 to 10.” The new format seems to be working. “The class is very well taught, clear, and interesting,” says one participant, second-year student Leslie Irvine, MD 2010. “Because the course is taught by an economist, it provides an excellent analytical framework for us to use when thinking about health care policies and economics in the United States. And since many other lectures are taught by physicians still in practice, the course is helping us, as future physicians, better understand our role within the larger system so that we can advocate for our patients, plan our own future professional careers, and help design policy reforms based on sound clinical and economic principles.”

For Huskamp, teaching this course is a pleasure. “I really enjoy working with the medical students and helping them see the importance of health policy for their future practice,” she says. “I think it’s good for them learn this material before they get to the third year and work closely with patients who will be directly affected by many of the issues we discuss in class. The background on the health care system and the theoretical concepts we discuss can also help students become better informed about the health care debate and better able to influence it.”