Building upon the lessons below, learners will also critique assigned articles, participate in discussion boards, compose a comprehensive essay on the subject “How shall my nation better prepare against pandemic threats?” and participate in a comprehensive healthcare improvement simulation.



Week 1: The Paradox and Historical Perspectives


The “Spend More, Get Less” paradox

Capitalism, public health, American exceptionalism, imbalance of  spending

The rise of “organized” medicine and opposition to a national health care system

Contrasts in US health care and social services systems


Week 2:  Front Line Insights


US health care system bears the brunt of an inadequate social services sector

Front line healthcare personnel are stretched past the limits

Need for more holistic care widely known and acknowledged


Week 3: Learning from Abroad and Home Grown Innovations


Models for more effective health care systems

The definition of health differs in the US and Scandinavia

Rationing of health care is part of both the US and Scandinavian systems

American creativity in health care technology, organization and financing

Front line models of inventive, integrated health care


Week 4: An American Way Forward and Continuing the Discourse


Lessons from neighborhood/ community health centers and HMOs

Collectively addressing social determinants of health requires a paradigm shift

American individualism, concepts of health, and massive financial investments


Week 5: Health Care Access in America and the Formal-Informal Hybrid Health Care System and Access to Care in Jackson Homes


Health disparities abound due to race, income, language, etc.

Health care “safety net”, emergency rooms, resources outside formal healthcare

Formal-informal hybrid health care system

Health care resources available to Jackson Homes

Obstacles to overcome

Heterogeneity in access to care


Week 6: Sick, Poor and without Care and On the Poor Side of Things


The emergence of a hybrid system

Family, friends and the underground economy

Hybrid systems exist because of the formal system


 Week 7: The Doctor Is In


Intense role conflict for caregivers due to inadequate resources

Risks of violating usual norms, rules and practices

Reasons for using (or not) informal assistance to needy patients


Week 8: After the Affordable Care Act and Conclusion


ACA related improvements  and deficiencies for the marginalized

Persistence of the hybrid health care system

Cultural humility essential to understanding the hybrid system