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Lecture 01 – HLST 2020

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Health Studies
HLST 2020
Kenneth Lam

Kimberly Yap September 12, 2013 Lecture 01 – HLST 2020 Professor: Kenneth Lam TA: Cameron McKenzie [email protected] 1. Neo-Institutional Approach -Jenkins defines public policy as a process. -Public health care expenditures -Priority-setting (e.g. what gets covered by public funds) -Interrelated decisions -Highlights the role that history plays in defining institutions and government components and how they implement policy 2. Path Dependency -Characteristics -No blank slate -Policy feedback -Hide disagreements -Punctuated equilibrium -Short bursts -Long periods of stability -Predictive value? The three “I’s” Ideas, Interests and Institutions -Policy decisions are based on a combination of -Systematic structures of political institutions -Interplay of interests and ideas -History matters -Directions of cause and effect is not unidirectional -If analyzed too narrowly, will become shortsighted Ideas: Definition and Characteristics -“Any notions or thoughts” (Pearsall, 2001) that influence the desired states those individuals, organizations, and groups seek to obtain -Can be driven by: -Ideologies -Paradigms -Dominant ideas Ideas and Ideologies Kimberly Yap September 12, 2013 -Generalized assumptions -Most comprehensive and overarching category -Embodies a set of political beliefs -Lens (internally coherent) -Influence, interpretation, and variation -Examples: -Neoliberalism -Social solidarity *Liberalism takes many meanings- Focus on promoting rights of individuals and the role of government. Supports a greater role for private sector and freedom to each individual (free market ideology). Ideas and Paradigms -“General set of assumptions, questions and methods that structure a field of inquiry at any given time” -Ideas are driven by paradigms (theories/ideas widely entrenched -Ideology more abstract -Paradigms, general sects of assumptions, questions, and methods of inquiry of any given time (testing of time). Term originated from fiscal science time. Market Model vs. Government Model -Linked to ideology -Market model -Greater role for private sector/minimal role for government -Improves quality, accessibility and efficiency/ -Health care is a good market -Incentive to do well -Intermediate position -Private payment with public sector intervening -Co-payments and/or user fees -Inferior system performance Medical Model vs. Holistic Model -Dominant health paradigm was the medical model -Absence of sickness -Pathology of the body -Episodic acute care -Treatment -Reflection in Canada health act -Comprehensiveness principle *Drug coverage and care is one of the biggest expenditures in health care in Canada Kimberly Yap September 12, 2013 Shift to a more Holistic Approach -Alma Ata Declaration of 1978 -Incorporates the treatment of disease -Reco
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