(1) Many public health students consider a career in medicine, nursing, pharmacy, or similar profession that requires training beyond a Bachelor’s degree. A well-founded understanding of that career can help students choose one that is well-suited to their skills and interests and can help them build the necessary credentials to be successful. Students should thoughtfully investigate a specific health profession and create an articulate description that communicates a realistic appraisal of the profession’s role in the health care system, the most important challenges the profession faces with regard to that role, and the profession’s future manpower needs.
Specifically, students should consider:
a. The educational requirements relevant to the profession such as the type of degree, the minimum requirements needed to enroll in a training program, and the qualifications of successful applicants.
b. The role and function of the health professional in the workforce with a description of what tasks and services providers undertake and in what types of settings.
c. Anticipated trends in the workforce including the number of professionals needed to meet future demand, potential employers, career satisfaction, and starting salaries.
Required reading:
There is no required reading for this question; however, students must incorporate information from at least 2 PubMed references instead of the usual 1.
(2) Health care spending in the United States continues to rise faster than inflation. Health spending now exceeds $10,000 per person and comprises 18% of gross domestic product (GDP). Future projections suggest that Americans, on average, are growing older and are at greater risk of developing expensive to treat chronic diseases like diabetes, heart disease, and cancer. Many have argued that spending more on clinical preventive services would not only reduce the number of Americans who will develop these conditions but will also save money. Others have criticized this for being overly optimistic.
Specifically, students should:
a. Construct an argument supporting or opposing greater funding for clinical prevention programs targeting individuals who smoke, are sedentary, or are overweight? In answering this question, students should:
i. Differentiate between cost-effective and cost-saving programs.
ii. Explain whether clinical prevention programs targeting individuals are likely to save consumers and/or taxpayers money in the long-term.
iii. Describe how policy-makers should use the concept of “value” to decide whether or not to fund clinical prevention programs.
Required Reading:
Cohen JT, Neumann PJ, Weinstein MC. Does Preventive Care Save Money? Health Economics and the Presidential Candidates. NEJM. 2008; 358 (7):661-663.
Goetzel RZ. Do Prevention or Treatment Services Save Money? The Wrong Debate. Heatlh Affairs. 2009; 28 (1):37-41.
Recommended Reading:
Goldman DP, Cutler D, Rowe JW, Michaud PC, Sullivan J, Peneva D, Olshansky SJ. Substantial Health and Economic Returns from Delayed Aging May Warrant A New Focus for Medical Research. Health Affairs. 2013; 32 (10):1698-1705.
(3) Health behaviors like smoking, exercise and weight have been shown to be important determinants of health. To encourage individuals to engage in healthy behaviors or avoid unhealthy ones, policy makers have been experimenting with various rewards and punishments. Recently, the National Health Service (NHS) in the United Kingdom instituted a policy that delayed or denied elective surgery for beneficiaries who smoked or were obese. Choosing either smoking or obesity as a core example, construct an argument supporting or opposing the NHS policy.
Specifically, students should:
a. Differentiate between policies that incentivize, coerce, or punish.
b. Provide an example when the government would be ethically permitted to use one of these approaches to address a public health problem.
c. Guesstimate the magnitude of impact the NHS policy might have on changing individual health behaviors and/or reducing NHS health spending.