Vision Science 84, Section 1

Current Topics in US Healthcare (1 unit, P/NP)

Professor Kenneth Polse
Thursday 11:00-1:00, 491 Minor Hall, Class number: 40658

Problems associated with affordability, accessibility and quality of health care in the US began to escalate in the late 1980s.  Over the past twenty-five years both Republican and Democratic administrations have attempted to address these problems, but without success. In 2008, President Obama was elected on a mandate to change the health care system in a way that would provide affordable and accessible care to all Americans. After considerable debate, controversy and compromise, the Patient Protection and Affordable Health Care Act of 2010 (ACA) was signed into law by President Obama on March 23, 2010. The ACA (often referred to as Obamacare) was the most significant health care legislation passed since the Medicare Act of 1964. Since its inception, Republicans have attempted at least fifty times to repeal the law. In addition to Congressional efforts to repeal the ACA, its constitutionality has been challenged twice and upheld by the US Supreme Court. Even though the ACA’s constitutionality has been upheld and a majority of US citizens would like to maintain Obamacare (with some modifications) the Republicans were determined to repeal and replace the ACA. Although it appeared likely that President Trump and the Republican controlled Congress would repeal the ACA, it did not happen. However, using executive action, President Trump can make substantial changes to the present law. Therefore, the future remains uncertain as to what US Health Care will offer to the millions of individuals and families who currently have coverage under the ACA.

To begin to understand what repeal, replace, or simply modify the ACA will mean, we first will examine health care prior to Obamacare since there is some probability that many of the pre-ACA health care delivery paradigms may again become the law. Secondly, we will discuss some of the more important strengths and weaknesses of Obamacare, which will help us understand what changes are urgently needed to strengthen Obamacare. Finally, we will explore health care in other developed countries, which will provide considerable insight in the health care systems for nations that consider health care a right and not a privilege.

Typically, the class will review an article, news story, media presentation, or editorial that will serve as the beginning for class discussion/debate. Two to three times during the course, students will give a short presentation on a specific topic, followed by class discussions. Some of the topics will include single-payer vs. third-party medical coverage, factors driving up the cost of medical care, possible strategies to control medical costs, the role of insurance companies, and how pharmacological and device manufacturers contribute to high medical costs.

Instructor Bio

From 1972-2003 Professor Polse served as faculty member, Clinic Director, and Associate Dean in the School of Optometry, University of California, Berkeley (UCB). Recently retired, Dr. Polse is currently Professor of Graduate Studies at UCB. His research developed from years of clinical experience, convincing him that it is the clinician's astute observations that often drive the research agenda. He also believes that discovery and clinical implementation require close collaborative efforts between basic and clinical scientists, a principle that has guided his research career. Some of Professor Polse's professional services and honors include President, International Society for Contact Lens Research; memberships on the AOA Council on Research and the National Advisory Eye Council (NIH); a Senior Fulbright Fellowship; AAO Garland Clay Award; AAO Max Shapero Lecture; BCLA Principal Keynote Speaker; UCB Sarver Endowed Chair; and Montague Ruben Medal. Since 1974, Professor Polse has had many students, residents, and post-doctoral fellows participate in his laboratory. He has received continuous research support from NIH and Industry for thirty years, resulting in many successful studies (including two NIH-sponsored randomized clinical trials) and over 140 papers published in peer-reviewed journals.

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Students interested in pursuing a career in health care delivery (e.g., physician, nurse, etc.), heath care planning/administration, or simply just interested in the impact of current heath care on society should find most of the topics covered of interest.