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 CONTENTS: OCTOBER 12, 1998 HOME | Analyzing Editorial Cartoons | Building Web Skills | Cover Analysis | Focus Lesson: A Collision Between Money and Medicine | Standards Watch | Take A Stand | Teacher Tip | Time Weekly Quiz | Vocabulary in Context | Worksheet: In Search of Heroes | Worksheet: Writing About Science PAGE 2 FOCUS LESSON: A COLLISION BETWEEN MONEY AND MEDICINE PAGES 54-101 A Week in the Life of a Hospital Curriculum Standard: Science, Technology and Society As a result of the revolution in how medicine gets paid for, American hospitals have reached a point of crisis. To understand this crisis, TIME sent a team of writers to a large research hospital in North Carolina. Their reports, gathered over the course of a week-long visit, raise many of the thorny issues-economic, medical and ethical-that are being debated in communities around the nation today. Preparing to Read Ask students: If you were admitted to a prominent research hospital with a life-threatening disease, how would you want decisions about your care to be made? Should your type of insurance or ability to pay affect whether you are treated there? Should the cost of care and procedures determine what and how much therapy or treatment you receive? Comprehension and Analysis
Ethics, Costs and Modern Medicine1. In small groups, assign students to read together one of the pieces from the cover package, listed below. After reading, students should discuss their piece and define, as appropriate, the ethical question, medical issue or policy dilemma suggested by the piece: "I'll Be His Mom for a While" Page 58* What issue or issues does the piece raise? * Does the incident or information in this piece reflect well or badly on Duke University Medical Center? 2. Dramatize the issue. Have students work together to conceive of a way to present the issue their group identified to the rest of the class. Some possibilities: a dramatized reading of lines from the article, a debate, an Oprah-like "talk show," a scripted dialogue, an improvisation from an opening scenario, a roundtable discussion. 3. After all groups have made their presentations, return to the question discussed in "Before Reading." At Duke University Medical Center, what are the realities of how treatment decisions are made and paid for? Do students feel confident or concerned about health care today as represented by Duke?
The Business of Health Care1. As in the first lesson, assign students in groups to read together one of the pieces listed below. What is the cost or management issue raised by each article? More Science... And Much More Money Page 682. Chart the consequences of market forces on medicine. Make a two-column chart. On the left, using your article as a source, note any benefits for medicine that result from business pressures on the health field On the right, record any detriments to good care resulting from market competition and rising costs. Application and Investigation 1. Marketing Medicine. As reported in "The Doctor Is Out-Shooting A Commercial," hospitals are discovering they have to compete for patients-and advertise for them. Devise an ad campaign (print, radio or TV) for one of the following: a small community hospital; a large medical center like Duke; a group primary-care practice; an HMO. What do people want in their health care? What do they fear? 2. Ideal Care? Imagine what a hospital would be like if it were able to operate without any financial worries. How would such a hospital work? Describe its research and teaching programs, its treatment of hospitalized patients, its emergency services, its community programs. Are there any potential dangers in an absence of financial pressures? 3. Costs and ethics. From the pages of the cover story, identify a difficult medical decision made by either a doctor or patient. What was the reasoning behind the decision? What factors entered into it: cost, quality of life, efficacy of treatment? Construct an argument in favor of a different choice. Now conclude: what decision would you have made? What are the principles or influencing factors behind your choice? Examine the financial outlook of a publicly traded health company by charting the price of its stock at http://quote.yahoo.com. Choose one of the companies listed below and use the "symbol lookup" command to identify its "ticker symbol." Then use this symbol to obtain quotes on the company's stock prices. What was the company's most recent closing price? What range of prices did it cover over the past year? Next, look at graphs of the company's performance for periods of one day, five days, three months and one year. What trends do you see in the company's overall performance over these periods? What information in the "Recent News" section of the Website helps explain these trends? Companies to examine: HealthSouth; Nationwide Health Properties, Inc.; Oxford Health Plans; PhyCor Inc.
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