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2017 Bishop Lecture featuring Norman Daniels, PhD

Tue, April 25, 2017, 11:15am
Location: 
Great Lakes Room, Palmer Commons, 100 Washtenaw Ave, Ann Arbor, MI 48109

The 2017 Bishop Lecture in Bioethics was presented by Norman Daniels, PhD, Mary B Saltonstall Professor and Professor of Ethics and Population Health in the Department of Global Health and Population at Harvard School of Public Health. Dr. Daniels presented a talk entitled, "Universal Access vs. Universal Coverage: Two models of what we should aim for." The Bishop Lecture served as the keynote address during the CBSSM Research Colloquium.

Abstract: We contrast two models of health care insurance, the Universal Coverage model underlying the Affordable Care Act and the Universal Access model underlying the (now withdrawn) American Health Care Act. Our goal is to evaluate the strongest argument for the Universal Access model. That model suggests that if people have real choices about health care insurance, some will buy it and some will not, and no one should be mandated to buy it. We argue that the Universal Access model presupposes that people can afford insurance, and that means subsidizing it for millions of people as the Universal Coverage model underlying the ACA does. These costs aside, the strongest argument for the Universal Access model is that giving people true choice may make the population level of well-being higher. Some people will have other priorities that they prefer to pursue, especially if they can free ride by enjoying the benefits of a system that provides health care without their contributing to it. If the additional costs that third parties have to pay as a result of the increase in real choice are significant, then the strongest argument for Universal access fails: the benefits of choosing not to be insured are outweighed by the imposed costs on others from these choices.

Norman Daniels, PhD is Mary B. Saltonstall Professor of Population Ethics and Professor of Ethics and Population Health in the Department of Global Health and Population at the Harvard School of Public Health. Formerly chair of the Philosophy Department at Tufts University, his most recent books include Just Health: Meeting Health Needs Fairly (Cambridge, 2008); Setting Limits Fairly: Learning to Share Resources for Health, 2nd edition, (Oxford, 2008); From Chance to Choice: Genetics and Justice (2000); Is Inequality Bad for Our Health? (2000); and Identified versus Statistical Lives (Oxford 2015). He has published 200 peer-reviewed articles and as many book chapters, editorials, and book reviews. His research is on justice and health policy, including priority setting in health systems, fairness and health systems reform, health inequalities, and intergenerational justice. A member of the IOM, a Fellow of the Hastings Center, and formerly on the ethics advisory boards of the CDC and the CIHR, he directs the Ethics concentration of the Health Policy PhD at Harvard and recently won the Everett Mendelsohn Award for mentoring graduate students.

  • Click here for the video recording of the 2017 Bishop Lecture.

Ken Langa, MD, PhD

Faculty

Dr. Langa is the Cyrus Sturgis Professor in the Department of Internal Medicine and Institute for Social Research, a Research Scientist in the Veterans Affairs Center for Clinical Management Research, and an Associate Director of the Institute of Gerontology, all at the University of Michigan. He is also Associate Director of the Health and Retirement Study (HRS), a National Institute on Aging funded longitudinal study of 20,000 adults in the United States ( http://hrsonline.isr.umich.edu ).

Last Name: 
Langa

Funded by National Institutes of Health; Nationatal Institute on Aging

Funding Years: 2012-2017

A cornerstone of the nation’s social science research infrastructure, the Panel Study of Income Dynamics (PSID) is a longitudinal survey of a nationally representative sample of U.S. families. Begun in 1968, 36 waves of data have now been collected on PSID families and their descendents. Its long-term measures of economic and social well-being have spurred researchers and policy makers to attend to the fundamental dynamism inherent in social and behavioral processes. This project collects, processes, and disseminates three modules in the 2013 and 2015 waves of the PSID:
1.Health module: Including 15 minutes of survey questions on health status, health behaviors, health insurance coverage & health care costs. Linkages to the National Death Index and Medicare will be extended;
2.Wealth module: Including 10 minutes of survey questions on wealth, active savings, and pensions. Linkage to Social Security earnings and benefits records for active sample and decedents will be undertaken for the first time, and a new module to minimize errors in reports of wealth changes will be developed and implemented; and
3.Well-being module with related psychosocial measures: A mixed-mode (web/mail out) questionnaire to collect content from both respondents and spouses about their well-being and related psychosocial measures (e.g., personality, intelligence), with an experiment to identify (and allow researchers to adjust for if necessary) mode effects.

PI(s): Robert Schoeni

Co-I(s): Mick Couper, Vicki Freedman, Katherine McGonagle

Thomas Valley, MD

Faculty

Tom Valley is an Assistant Professor in the Division of Pulmonary and Critical Care Medicine in the Department of Internal Medicine at the University of Michigan. He received his undergraduate degrees in history and chemistry from Emory University, and his medical degree from the University of Miami. He completed his internal medicine residency and chief residency at the University of Texas-Southwestern/Parkland Memorial Hospital.

Last Name: 
Valley

Caitlin Weber has been presented the 2009 Laurie Kittl Luzynski Administrative Professional Award. This award honors a staff member in the Department of Internal Medicine who has particular commitment to continuing education and to wellness awareness, in addition to a positive attitude and team spirit. The Division of Hematology/Oncology at the University of Michigan presents the award annually in memory of a highly respected staff member in their unit. Weber, who was the Administrative Assistant for CBSSM, was nominated by CBSSM staff.

Adam Marks, MD

Faculty

Dr. Marks is associate director of the adult Palliative and Supportive Care Clinic at the East Ann Arbor Health and Geriatrics Center, as well as the Adult Palliative Care medical director at Arbor Hospice. He received his medical degree and masters of public health from the Wisconsin School of Medicine and Public Health in Madison, Wisconsin. He completed his combined internal medicine-pediatrics residency at the University of Michigan, where he also completed his fellowship training in palliative care.

Last Name: 
Marks

Julie Wright Nunes, MD, MPH

Faculty

Julie Wright Nunes is an Assistant Professor at the University of Michigan Department of Internal Medicine. Her research interests include Chronic Kidney Disease (CKD) and its prevention and also the development of methods and tools to help facilitate and optimize provider-directed CKD patient education.

Last Name: 
Wright Nunes

Along with Ted A. Skolarus, M.D., M.P.H., CBSSM Co-Director, Angela Fagerlin authored a Viewpoint article titled "Rethinking Patient-Physician Communication of Biopsy Results -- The Waiting Game." In the article, they conclude, "Telemedicine approaches can potentially relieve much of the anxiety associated with in-person consultations while delivering bad news in a timely, compassionate, and patient-centered manner."

Jeff Kullgren's editorial "Injecting Facts Into the Heated Debates Over Medicaid Expansion" was recently published in the Annals of Internal Medicine. In this editorial, Dr. Kullgren reviews Wherry and Miller's study on the effects of ACA on coverage, access, utilization, and health. 

Wherry LR, Miller S. Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions. A quasi-experimental study. Ann Intern Med 2016

Link to IHPI article.

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