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Discussion1 ( 200 words)
You have just developed a GPS unit that can be worn on a
necklace, wristband or belt. The unit is designed to aid in
locating missing children, individuals with dementia, or those
who are developmentally disabled. Who your target audience(s)
are and what approach will you use with them.
Discussion2 ( 200 words)
Duluth Trading Company Ads
COLLAPSE
Top of Form
The Duluth Trading Company began in 1989 with the creation
of a work belt for carpenters and "handy" men (and now
women). It has since expanded into clothing and a focus on
underwear and work clothes. A new series of attention grabbing
ads has been released this year bringing more visibility to the
company.
Watch the ads - both those aimed at men and at women -
featured on the page linked below (copy and paste into your
browser).
Discuss how effective this advertising campaign is to today's
audience.
What segment of the market is Duluth targeting?
Do you think this ad campaign will be effective for that
segment?
Would this same ad campaign work in another country such as
Saudi Arabia, Korea or China? Why or why not?
https://www.youtube.com/user/DuluthTrading
Case 5.1(answer following questions, 300 words)
Case 6.1(answer following questions, 300 words)
Bottom of Form
Malpractice Reform in Illinois
COLLAPSE
Top of Form
Client:
The client is the Illinois Health and Hospital Association
(IHA). They seek to “To advocate for and support hospitals and
health systems as they serve their patients and
communities” (Illinois Health and Hospital Association, 2016).
The IHA has a strong interest in malpractice reform. They
maintain a page on their website for medical liability (Illinois
Health and Hospital Association, 2016).
Problem Statement:
What can be done to reduce malpractice premium costs in the
State of Illinois?
Kingdon Analysis:
Problem stream:
The problem is real - Malpractice issues in Illinois are
particularly problematic. Illinois is ranked as having the fourth
highest tort costs in the country and the fifth most draconian
tort laws according to The Pacific Research Institute (Luke,
Illinois, NY among Usual Tort Suspects in PRI Study, 2008).
Illinois is also in the top five states in terms of malpractice
insurance costs (Kiernan, 2016’s Best & Worst States for
Doctors, 2016).
Politics Stream
Stakeholders:
1) Patients - the consumers of health care - Individuals who are
scheduled for or are receiving healthcare services. There are a
variety of associations and organizations that advocate for
patients. For example, Propublica is committed to “expose
abuses of power and betrayals of the public trust by
government, business, and other institutions, using the moral
force of investigative journalism to spur reform through the
sustained spotlighting of wrongdoing” (Propublica, 2016). Their
journalistic interest extends to healthcare including medical
malpractice. They are particularly interested in changes in the
malpractice environment that will decrease medical
errors (Pierce & Allen, 2015)
2) Providers - physicians, nurses, allied health professionals and
other personnel who deliver health care services to patients. The
United States’ largest advocacy group for physicians is the
American Medical Association. They advocate for noneconomic
damages limitations, reduction of premiums, health courts and
safe harbors (American Medical Association, 2016). The AMA
is also dedicated to reducing medical errors (American Medical
Association, 2003).
3) Legislators - individuals who make laws. In Illinois, the
Committee of the Whole in the House considered tort reform
last year (Levin &Perconti, 2015).
4) Government executives - individuals who work in the
executive branch of government at various jurisdictional levels
who enforce and execute laws. An example of an association
that represents government executives is the National Governors
Association (NGA). The NGA is the bipartisan association of
U.S. state governors. They state that “through NGA, governors
share best practices, speak with a collective voice on national
policy and develop innovative solutions that improve state
government and support the principles of federalism” (National
Governors Association, 2016). The NGA is committed to
containing medical malpractice costs by reforming tort law,
decreasing premiums, ensuring physician tax credits, reducing
medical errors, and improving reporting (National Governors
Association, 2005).
5) Judges – an elected or appointed individual who considers
and renders decisions about cases in a court of law. A
representative of judges in Illinois is the Illinois Judges
Association (IJA). The IJA “supports judicial excellence and
professional development and judicial education, fosters public
confidence in an independent judiciary, works to preserve the
independence of the judiciary by educating the public and
students, and promotes a diverse judiciary that administers
justice in a fair and impartial court system” (Illinois Judges
Association, 2016).
6) Trial Lawyers - a lawyer who tries cases in a court of law.
The Illinois Trial Lawyers Association (ITLA) represents
plaintiffs’ attorneys in Illinois. Their mission is “to ensure all
citizens get equal footing in the courtroom, even when taking on
the most powerful interests. We see to it that those who harm
consumers, other individuals, or even their own employees, are
held accountable” (Illinois Trial Lawyers Association, 2015).
The ITLA takes a strong position against medical malpractice
reform (Illinois Trial Lawyers Association, 2010).
7) Insurance Companies - companies that provide insurance to
individuals and employers to pay for medical care expenses for
those individuals and their families or employees respectively.
America’s Health Insurance Plans (AHIP) organization is the
leading trade association representing the health insurance
community in the United States. “AHIP advocates for public
policies that expand access to affordable health care coverage to
all Americans through a competitive marketplace that fosters
choice, quality, and innovation” (America’s Health Insurance
Plans, 2016).
8) Government Payers - the Center for Medicare and Medicaid
services and state-run Medicaid programs that pay for medical
expenses for their constituents.
9) Hospitals -facilities that provide surgical and medical
therapies to patients. As noted above the Illinois Health and
Hospital Association (IHA) is an example of an association that
represents the interests of hospitals. The IHA seeks to “To
advocate for and support hospitals and health systems as they
serve their patients and communities” (Illinois Health and
Hospital Association, 2016). The IHA has a keen interest in
malpractice reform. They maintain a page on their website for
medical liability (Illinois Health and Hospital Association,
2016).
10) Associations and organizations - various groups that
advocate for their constituents points of view in
the healthcare space.
The Illinois legislature has tried to address the problem but has
been blocked by the courts. The IHA filed an amicus brief
regarding the courts consideration of the 2005
cap (Nodzenski, Galland, Hatton, & Mudron, 2005). Despite
this, the court overturned the cap on constitutional grounds. In
fact, the Illinois Supreme Court has struck down $500,000
noneconomic malpractice case award limitations passed by the
Legislature on three different occasions. The Court has done
this even after recognizing that eight states have sustained caps
in the face of legal challenges, and 19 states have a successfully
adopted damage caps. The courts principal argument is that caps
are unconstitutional based on separation of power
arguments (Clayton, Hansen, & Placher, 2010).
Policy Stream – Reaction to a crisis
1) Tort reform - mitigate awards with other fund sources such as
health insurance, assign financial liability in proportion to fault
rather than in proportion to capacity, eliminate or restrict
punitive damages, end lump-sum payments, and cap
noneconomic damages at $250,000. The impact of tort reform is
controversial. Some authors maintain that, at least in some
states, it has been highly successful. In other cases, it appears
that tort reform initiatives like noneconomic damages caps have
not worked in isolation. Amongst the stakeholder groups, trial
attorneys and possibly injured patients would be financially
disadvantaged. The predicted effect of tort reform, in particular,
damage limitations, without provisions for premium limitation
on the other stakeholders is variable. From a political feasibility
point of view tort reform in Illinois seems to face a very steep
hill to climb – i.e. a consistent and firm resistance of the
Supreme Court to allow the legislature to pass noneconomic
damage limitations.
2) Medical error reduction - incentivize quality improvement
and quality assurance programs, facilitate device and
medication error reduction strategies (for example,
with barcoding), require algorithms of care utilization and
evidence-based standards of practice, reward the penalty free
reporting of medical errors, address provider impairment
(substance abuse and sleep deprivation), and promote
information transparency, accessibility, communication, and
accuracy with information technology. Medical error reduction
benefits all stakeholders except for trial attorneys. The only
caveats have to do with concerns over “big brother” oversight
and the sweat equity and financial costs of increased
documentation
3) Develop expert medical panels and/or health courts. Instead
of lay persons struggling with difficult to understand medical
complexities malpractice cases would be adjudicated by expert
panels or judges. Panels and health courts are considered
alternative mechanisms for dispute resolution. Trial lawyers and
some injured patients could expect less remuneration. The other
stakeholders would benefit but only if such a system worked
and if it was politically feasible. Both of these caveats are
raised as substantial concerns by multiple authors.
4) Do not address the medical malpractice environment in
Illinois – the medical malpractice situation in Illinois is very
unfavorable. The current emphasis on quality and on saving
money in the US healthcare environment, and the current
Illinois Governor’s desire to overhaul the malpractice system
make doing nothing politically inexpedient.
Window of opportunity:
A window of opportunity may now exist in Illinois for
malpractice reform because of the new governor. Bruce
Vincent Rauner is the new Governor of Illinois. Mr. Rauner is a
wealthy self-made businessman who was elected governor of
Illinois on November 4, 2014 (Sanguinetti, 2015). He has a
strong pro-business platform that includes tort reform (Geiger
& Hellmann, 2015). However, it should be noted that
Mr.Rauner’s tort reform efforts, including those that have to do
with malpractice, have faced considerable resistance from the
Democrats in the Illinois House of Representatives (Hinz,
2016). Overall, the malpractice issues higher on the public
agenda than it was prior to Mr. Rauner’selection.
Bibliography
America’s Health Insurance Plans. (2016). About. Retrieved
June 14, 2016, from America’s Health Insurance
Plans:https://www.ahip.org/about-us/
American Medical Association. (2003, December). Opinion
8.121 - Ethical Responsibility to Study and Prevent Error and
Harm. Retrieved June 14, 2016, from American Medical
Association: http://www.ama-assn.org/ama/pub/physician-
resources/medical-ethics/code-medical-ethics/opinion8121.page
American Medical Association. (2016). Medical Liability
Reform. Retrieved June 14, 2016, from American Medical
Association:http://www.ama-
assn.org/ama/pub/advocacy/topics/medical-liability-reform.page
Clayton, R. R., Hansen, M. D., & Placher, J. A. (2010). What
Every Litigator Needs to Know About the Illinois Supreme
Court’s Rejection of Damage Caps. IDC Quarterly, 20(4), 46 –
49.
Geiger, K., & Hellmann, J. (2015, May
12). Madigan sends Rauner message on tort reform. Retrieved
June 14, 2016, from Chicago
Tribune:http://www.chicagotribune.com/ct-illinois-madigan-
rauner-tort-reform-met-0513-20150512-story.html
Hinz, G. (2016, January 27). State of the State - Rauner offers
softer tone, but same hard line. Retrieved June 14, 2016,
from Crain's Chicago
business: http://www.chicagobusiness.com/article/20160127/BL
OGS02/160129832/rauner-offers-softer-tone-but-same-hard-line
Illinois Health and Hospital Association. (2016). About IHA.
Retrieved June 10, 2016, from IHA
today: http://www.ihatoday.org/about-iha.aspx
Illinois Health and Hospital Association. (2016). Medical
liability. Retrieved June 10, 2016, from IHA
today:http://www.ihatoday.org/Health-Care-Issues/Medical-
Liability.aspx
Illinois Judges Association. (2016). About. Retrieved June 14,
2016, from Illinois Judges Association: https://ija.org/about-
ija.html
Illinois Trial Lawyers Association. (2010). The Whole Truth
About Medical Malpractice and Insurance. Retrieved June 14,
2016, from Illinois Trial Lawyers
Association: https://www.iltla.com/WebsiteDocs/TheWholeTrut
hAboutMedicalMalpractice_Feb2010.pdf
Illinois Trial Lawyers Association. (2015). Our Mission.
Retrieved June 14, 2016, from Illinois Trial Lawyers
Association:https://www.iltla.com/about-itla/our_mission/
Kiernan, J. S. (2016). 2016’s Best & Worst States for Doctors.
Retrieved June 14, 2016, from Wallet
Hub: https://wallethub.com/edu/best-and-worst-states-for-
doctors/11376/
Kiernan, J. S. (2016). 2016’s Best & Worst States for Doctors.
Retrieved May 28, 2016, from Wallet
Hub: https://wallethub.com/edu/best-and-worst-states-for-
doctors/11376/
Levin, & Perconti. (2015, June 23). Illinois Hearing Highlights
Problems with Tort Reform. Retrieved June 14, 2016, from
Illinois Medical
Malpractice Blog: http://medicalmalpractice.levinperconti.com/
2015/06/illinois_hearing_highlights_pr.html
Luke, R. (2008, March 11). Illinois, NY Among Usual Tort
Suspects in PRI Study. Retrieved June 14, 2016, from Pacific
Research
Institute:http://www.pacificresearch.org/article/illinois-ny-
among-usual-tort-suspects-in-pri-study/
Luke, R. (2008, March 11). ILLINOIS, NY AMONG USUAL
TORT SUSPECTS IN PRI STUDY. Retrieved May 28, 2016,
from Pacific Research
Institute: http://www.pacificresearch.org/article/illinois-ny-
among-usual-tort-suspects-in-pri-study/
National Governors Association. (2005, June 30). Containing
Medical Malpractice Costs: Recent State Actions. Retrieved
June 14, 2016, from National Governors
Association: http://www.nga.org/cms/home/nga-center-for-best-
practices/center-publications/page-health-publications/col2-
content/main-content-list/containing-medical-malpractice-
c.html
National Governors Association. (2016). About - Mission
Statement. Retrieved June 14, 2016, from National Governors
Association:http://www.nga.org/cms/about
Nodzenski, T. J., Galland, G. F., Hatton, M. R., & Mudron, M.
D. (2005). Amicus Curiae Brief of the Illinois Hospital
Association, American Hospital Association, Illinois Catholic
Health Association and Illinois Rural Health Association in
Support of Defendent – Appellant GottliebMemorial Hospital.
Retrieved June 10, 2016, from IHA
Today: http://www.ihatoday.org/uploadDocs/1/lebron.pdf
Pierce, O., & Allen, M. (2015, December 31). How Denmark
Dumped Medical Malpractice and Improved Patient Safety.
Retrieved June 14, 2016,
from Propublica: https://www.propublica.org/article/how-
denmark-dumped-medical-malpractice-and-improved-patient-
safety
Propublica. (2016). About Us. Retrieved June 14, 2016,
from Propublica: https://www.propublica.org/about/
Sanguinetti, E. (2015). About Bruce. Retrieved June 14, 2016,
from Bruce Rauner: http://brucerauner.com/about/
Yee, M. (2014, March 31). Illinois's Cap for Medical
Malpractice Damages. Retrieved June 14, 2016, from Legal
Match:http://www.legalmatch.com/law-library/article/illinoiss-
cap-for-medical-malpractice-damages.html
Bottom of Form
· Assignment Description
Policy Analysis and Commentary
For this assignment, you will be required to write a brief
commentary to a journal of your choice discussing the pros and
cons of a particular health policy issue of interest to you and
offering a recommendation based on your research and analysis
about the particular issue. Choose a topic that will push you to
take strong positions. Select a topic that you CARE about.
Consider both intervention and prevention programs. Your
analysis should be accurate, timely, meaningful, and have an
impact factor. Ask the questions: 1) why should the person
reading this actually care about this issue?, 2) is a realistic
solution suggested?
The format will vary depending on the journal you decide to
submit the commentary to. In general the final document will
include a description of the problem, some statements about
different solution options that can be used to address the
problem, and a recommendation drawing on evidence that exists
in the literature related to your issue for the best way to solve
the problem.
The analysis must represent the interests of a specific client
(special interest group executive director, government official,
CEO, etc.) and your reading audience. The solution must be
realistic. The issue (problem) must be worthy of being placed
high on the public agenda. Your objective is to present a
problem and then you will offer several alternative choices for
addressing the problem after researching solution options. Your
goal is to come up with one preferred option through the
process of policy analysis. After presentation of the
alternatives, you will suggest a final recommendation.
There is no need to reinvent the wheel to develop your section
for policy options... rely on research. Borrow (cite original
source) language from current policy. Read the mission
statement of "your client". Find historical precedents. Locate
policies in the pipeline and adopt relevant language for your
proposal (citing resources, of course). “Real world” policy
proposals, pending and accepted legislation, and official plans
illustrate what could be accomplished. Generate a list of
legislation (if present) that passed and bills that died. Look for
already developed guidelines, regulations, or programs. Look
for new and developing alternatives currently in the
“pipeline”:identify policies in the pipeline (proposed, rejected,
accepted in other geographic areas). Consider areas for
compromise. Consider the possible consequences of action as
well as the possible consequences of inaction. Remember that
“do nothing” can be an alternative.
Think about your policy options and the positive and negative
aspects of each option according to criteria (cost, legal
issues, political feasibility, etc.) that your client would specify
as important. Dollars won't fix a problem ... but lack of dollars
can limit opportunity to fix a problem. Seeing the $$$
distribution indicates public priorities and placement on the
public agenda. Generally, you will find that funding and
awareness activities will increase if the subject rises on the
public agenda ... not the other way around. Money (by itself) is
NOT a solution. Increasing awareness (by itself) is NOT a
solution. The solution (policy) must help to resolve the issue
(problem).
The Final Product component of the Policy Proposal Project is
an individual effort. Your PPP Final Product will evolve while
you work independently on your concept. Change elements
(and wording) as you see a need for modification. The policy
proposal will be refined and modified through scheduled Step
assignments as the semester progresses. Policy creation is a
process. It requires time. Expect to research, revise, rethink,
compromise, and revise some more when preparing a policy
proposal. Rather than be concerned about your grade be
inspired to excellence. It takes a few times to revise a
publication-ready manuscript.
Adhering to all of the journal’s requirements for authors is
required. Try and keep references limited to recent journals.
The length of your final manuscript will vary but your final
product is to be 8 - 13 pages or a minimum of 1000 words
should be submitted for the final assignment unless the journal
you select requires less words for commentaries. If you need to
go over 13 pages, that is all right but make sure that the extra
pages are justified. Please do not go over 15 pages. You
decide on how much information (and how many pages) to
devote to each section. Focus on necessary content. You would
be surprised at how much you can cut out and how you can
tighten and solidify your writing. And remember, don't lose
sight of your client and the actual problem statement.
Acceptance for publication to the journal is not a requirement.
A main goal of this assignment is to provide the experience of
writing for a journal. Acceptance of your manuscript for
publication is a bonus. Follow up and revise your work if the
journal asks you to resubmit the article. If you need help with a
revision after the end of the semester, the professor will be
available to provide feedback. Please let me know when you
are published.
· Post a best effort, rough draft version to the DB.
REVISE: Expect detailed feedback and suggestions for
modifications because this process requires multiple revisions
as you refine your thinking.
· The PPP Step assignments are supposed to reflect a
progressive learning process.
· Do not expect "correct" on the first attempts.
PARTICIPATION: Peer comments are required. You can
expect detailed feedback and suggestions for modifications.
· The PPP Step assignments are intended to be a learning
process and I am looking for a good faith effort. Learn from
each other as changes are made on the subsequent PPP Step
assignments. I hope you gain insights BECAUSE of the need
for revisions and corrections. Review each others work and my
comments on the PPP Step assignments. Ongoing revisions,
modifications, and changes are encouraged. Look for new
posts to the most recent Step assignments. Add your thoughts
... and expect to see my thoughts.
"The only thing" that you want to post is what you are asked to
complete: client, revised problem statement, a few stakeholders,
and your journal selection.
Answer the following questions for PPP Step 2:
1. Modify and revise (if necessary): Who is your client?
2. Improve the wording (as needed) of your problem statement.
3. Identify some of the key stakeholders whose positions and
concerns must be understood before a well-informed decision
can be made. Consider the politics and who has the power.
Be specific and list 4 to 6 significant stakeholders (individuals,
interest groups, etc.).
· Note: The List of Stakeholders should contain at least one
descriptive sentence for each of those stakeholders.
4. Select a peer-reviewed journal.
· Name the journal and provide a very brief description of its
purpose.
· Include a brief summary of the selected journal's basic
requirements for publication (word length, format, etc.). Also,
include the citation style required by the journal and a link to
the citation style if the journal has it’s own approach to
citations.
· Include a link to the Author's Guide.
· STEP 5 Refined Concept: Abstract
You must write an Abstract. This must be a concise summary
statement and it should be included in your Final manuscript.
The summary statement must describe all important
components. This is a "road map" telling the reader what to
expect.
The Abstract should state the purpose or objective of your
writing, the main results, and your major conclusion.
Your Abstract should not be more than two or three paragraphs.
Word count must meet the requirements of your selected
journal. (Include the journal limitations on your assignment
document.) However, if not specified in the Author's Guide,
word count should be no less than 100 words and no more than
300 words.
An Abstract must be able to stand alone. Avoid citations and
need for references. Avoid abbreviations.
PARTICIPATION:
Provide each other meaningful and helpful feedback. Suggest
content and/or editorial revisions for improvements. Provide
questions or constructive feedback on your classmates'
presentations.

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  • 1. Discussion1 ( 200 words) You have just developed a GPS unit that can be worn on a necklace, wristband or belt. The unit is designed to aid in locating missing children, individuals with dementia, or those who are developmentally disabled. Who your target audience(s) are and what approach will you use with them. Discussion2 ( 200 words) Duluth Trading Company Ads COLLAPSE Top of Form The Duluth Trading Company began in 1989 with the creation of a work belt for carpenters and "handy" men (and now women). It has since expanded into clothing and a focus on underwear and work clothes. A new series of attention grabbing ads has been released this year bringing more visibility to the company. Watch the ads - both those aimed at men and at women - featured on the page linked below (copy and paste into your browser). Discuss how effective this advertising campaign is to today's audience. What segment of the market is Duluth targeting? Do you think this ad campaign will be effective for that segment? Would this same ad campaign work in another country such as Saudi Arabia, Korea or China? Why or why not? https://www.youtube.com/user/DuluthTrading Case 5.1(answer following questions, 300 words)
  • 2. Case 6.1(answer following questions, 300 words) Bottom of Form Malpractice Reform in Illinois COLLAPSE Top of Form Client: The client is the Illinois Health and Hospital Association (IHA). They seek to “To advocate for and support hospitals and health systems as they serve their patients and communities” (Illinois Health and Hospital Association, 2016). The IHA has a strong interest in malpractice reform. They maintain a page on their website for medical liability (Illinois Health and Hospital Association, 2016). Problem Statement: What can be done to reduce malpractice premium costs in the State of Illinois? Kingdon Analysis: Problem stream: The problem is real - Malpractice issues in Illinois are particularly problematic. Illinois is ranked as having the fourth highest tort costs in the country and the fifth most draconian tort laws according to The Pacific Research Institute (Luke, Illinois, NY among Usual Tort Suspects in PRI Study, 2008). Illinois is also in the top five states in terms of malpractice insurance costs (Kiernan, 2016’s Best & Worst States for Doctors, 2016).
  • 3. Politics Stream Stakeholders: 1) Patients - the consumers of health care - Individuals who are scheduled for or are receiving healthcare services. There are a variety of associations and organizations that advocate for patients. For example, Propublica is committed to “expose abuses of power and betrayals of the public trust by government, business, and other institutions, using the moral force of investigative journalism to spur reform through the sustained spotlighting of wrongdoing” (Propublica, 2016). Their journalistic interest extends to healthcare including medical malpractice. They are particularly interested in changes in the malpractice environment that will decrease medical errors (Pierce & Allen, 2015) 2) Providers - physicians, nurses, allied health professionals and other personnel who deliver health care services to patients. The United States’ largest advocacy group for physicians is the American Medical Association. They advocate for noneconomic damages limitations, reduction of premiums, health courts and safe harbors (American Medical Association, 2016). The AMA is also dedicated to reducing medical errors (American Medical Association, 2003). 3) Legislators - individuals who make laws. In Illinois, the Committee of the Whole in the House considered tort reform last year (Levin &Perconti, 2015). 4) Government executives - individuals who work in the executive branch of government at various jurisdictional levels who enforce and execute laws. An example of an association that represents government executives is the National Governors Association (NGA). The NGA is the bipartisan association of U.S. state governors. They state that “through NGA, governors share best practices, speak with a collective voice on national policy and develop innovative solutions that improve state government and support the principles of federalism” (National Governors Association, 2016). The NGA is committed to containing medical malpractice costs by reforming tort law,
  • 4. decreasing premiums, ensuring physician tax credits, reducing medical errors, and improving reporting (National Governors Association, 2005). 5) Judges – an elected or appointed individual who considers and renders decisions about cases in a court of law. A representative of judges in Illinois is the Illinois Judges Association (IJA). The IJA “supports judicial excellence and professional development and judicial education, fosters public confidence in an independent judiciary, works to preserve the independence of the judiciary by educating the public and students, and promotes a diverse judiciary that administers justice in a fair and impartial court system” (Illinois Judges Association, 2016). 6) Trial Lawyers - a lawyer who tries cases in a court of law. The Illinois Trial Lawyers Association (ITLA) represents plaintiffs’ attorneys in Illinois. Their mission is “to ensure all citizens get equal footing in the courtroom, even when taking on the most powerful interests. We see to it that those who harm consumers, other individuals, or even their own employees, are held accountable” (Illinois Trial Lawyers Association, 2015). The ITLA takes a strong position against medical malpractice reform (Illinois Trial Lawyers Association, 2010). 7) Insurance Companies - companies that provide insurance to individuals and employers to pay for medical care expenses for those individuals and their families or employees respectively. America’s Health Insurance Plans (AHIP) organization is the leading trade association representing the health insurance community in the United States. “AHIP advocates for public policies that expand access to affordable health care coverage to all Americans through a competitive marketplace that fosters choice, quality, and innovation” (America’s Health Insurance Plans, 2016). 8) Government Payers - the Center for Medicare and Medicaid services and state-run Medicaid programs that pay for medical expenses for their constituents. 9) Hospitals -facilities that provide surgical and medical
  • 5. therapies to patients. As noted above the Illinois Health and Hospital Association (IHA) is an example of an association that represents the interests of hospitals. The IHA seeks to “To advocate for and support hospitals and health systems as they serve their patients and communities” (Illinois Health and Hospital Association, 2016). The IHA has a keen interest in malpractice reform. They maintain a page on their website for medical liability (Illinois Health and Hospital Association, 2016). 10) Associations and organizations - various groups that advocate for their constituents points of view in the healthcare space. The Illinois legislature has tried to address the problem but has been blocked by the courts. The IHA filed an amicus brief regarding the courts consideration of the 2005 cap (Nodzenski, Galland, Hatton, & Mudron, 2005). Despite this, the court overturned the cap on constitutional grounds. In fact, the Illinois Supreme Court has struck down $500,000 noneconomic malpractice case award limitations passed by the Legislature on three different occasions. The Court has done this even after recognizing that eight states have sustained caps in the face of legal challenges, and 19 states have a successfully adopted damage caps. The courts principal argument is that caps are unconstitutional based on separation of power arguments (Clayton, Hansen, & Placher, 2010). Policy Stream – Reaction to a crisis 1) Tort reform - mitigate awards with other fund sources such as health insurance, assign financial liability in proportion to fault rather than in proportion to capacity, eliminate or restrict punitive damages, end lump-sum payments, and cap noneconomic damages at $250,000. The impact of tort reform is controversial. Some authors maintain that, at least in some states, it has been highly successful. In other cases, it appears that tort reform initiatives like noneconomic damages caps have not worked in isolation. Amongst the stakeholder groups, trial attorneys and possibly injured patients would be financially
  • 6. disadvantaged. The predicted effect of tort reform, in particular, damage limitations, without provisions for premium limitation on the other stakeholders is variable. From a political feasibility point of view tort reform in Illinois seems to face a very steep hill to climb – i.e. a consistent and firm resistance of the Supreme Court to allow the legislature to pass noneconomic damage limitations. 2) Medical error reduction - incentivize quality improvement and quality assurance programs, facilitate device and medication error reduction strategies (for example, with barcoding), require algorithms of care utilization and evidence-based standards of practice, reward the penalty free reporting of medical errors, address provider impairment (substance abuse and sleep deprivation), and promote information transparency, accessibility, communication, and accuracy with information technology. Medical error reduction benefits all stakeholders except for trial attorneys. The only caveats have to do with concerns over “big brother” oversight and the sweat equity and financial costs of increased documentation 3) Develop expert medical panels and/or health courts. Instead of lay persons struggling with difficult to understand medical complexities malpractice cases would be adjudicated by expert panels or judges. Panels and health courts are considered alternative mechanisms for dispute resolution. Trial lawyers and some injured patients could expect less remuneration. The other stakeholders would benefit but only if such a system worked and if it was politically feasible. Both of these caveats are raised as substantial concerns by multiple authors. 4) Do not address the medical malpractice environment in Illinois – the medical malpractice situation in Illinois is very unfavorable. The current emphasis on quality and on saving money in the US healthcare environment, and the current Illinois Governor’s desire to overhaul the malpractice system make doing nothing politically inexpedient. Window of opportunity:
  • 7. A window of opportunity may now exist in Illinois for malpractice reform because of the new governor. Bruce Vincent Rauner is the new Governor of Illinois. Mr. Rauner is a wealthy self-made businessman who was elected governor of Illinois on November 4, 2014 (Sanguinetti, 2015). He has a strong pro-business platform that includes tort reform (Geiger & Hellmann, 2015). However, it should be noted that Mr.Rauner’s tort reform efforts, including those that have to do with malpractice, have faced considerable resistance from the Democrats in the Illinois House of Representatives (Hinz, 2016). Overall, the malpractice issues higher on the public agenda than it was prior to Mr. Rauner’selection. Bibliography America’s Health Insurance Plans. (2016). About. Retrieved June 14, 2016, from America’s Health Insurance Plans:https://www.ahip.org/about-us/ American Medical Association. (2003, December). Opinion 8.121 - Ethical Responsibility to Study and Prevent Error and Harm. Retrieved June 14, 2016, from American Medical Association: http://www.ama-assn.org/ama/pub/physician- resources/medical-ethics/code-medical-ethics/opinion8121.page American Medical Association. (2016). Medical Liability Reform. Retrieved June 14, 2016, from American Medical Association:http://www.ama- assn.org/ama/pub/advocacy/topics/medical-liability-reform.page Clayton, R. R., Hansen, M. D., & Placher, J. A. (2010). What Every Litigator Needs to Know About the Illinois Supreme Court’s Rejection of Damage Caps. IDC Quarterly, 20(4), 46 – 49. Geiger, K., & Hellmann, J. (2015, May 12). Madigan sends Rauner message on tort reform. Retrieved June 14, 2016, from Chicago Tribune:http://www.chicagotribune.com/ct-illinois-madigan- rauner-tort-reform-met-0513-20150512-story.html Hinz, G. (2016, January 27). State of the State - Rauner offers softer tone, but same hard line. Retrieved June 14, 2016,
  • 8. from Crain's Chicago business: http://www.chicagobusiness.com/article/20160127/BL OGS02/160129832/rauner-offers-softer-tone-but-same-hard-line Illinois Health and Hospital Association. (2016). About IHA. Retrieved June 10, 2016, from IHA today: http://www.ihatoday.org/about-iha.aspx Illinois Health and Hospital Association. (2016). Medical liability. Retrieved June 10, 2016, from IHA today:http://www.ihatoday.org/Health-Care-Issues/Medical- Liability.aspx Illinois Judges Association. (2016). About. Retrieved June 14, 2016, from Illinois Judges Association: https://ija.org/about- ija.html Illinois Trial Lawyers Association. (2010). The Whole Truth About Medical Malpractice and Insurance. Retrieved June 14, 2016, from Illinois Trial Lawyers Association: https://www.iltla.com/WebsiteDocs/TheWholeTrut hAboutMedicalMalpractice_Feb2010.pdf Illinois Trial Lawyers Association. (2015). Our Mission. Retrieved June 14, 2016, from Illinois Trial Lawyers Association:https://www.iltla.com/about-itla/our_mission/ Kiernan, J. S. (2016). 2016’s Best & Worst States for Doctors. Retrieved June 14, 2016, from Wallet Hub: https://wallethub.com/edu/best-and-worst-states-for- doctors/11376/ Kiernan, J. S. (2016). 2016’s Best & Worst States for Doctors. Retrieved May 28, 2016, from Wallet Hub: https://wallethub.com/edu/best-and-worst-states-for- doctors/11376/ Levin, & Perconti. (2015, June 23). Illinois Hearing Highlights Problems with Tort Reform. Retrieved June 14, 2016, from Illinois Medical Malpractice Blog: http://medicalmalpractice.levinperconti.com/ 2015/06/illinois_hearing_highlights_pr.html Luke, R. (2008, March 11). Illinois, NY Among Usual Tort Suspects in PRI Study. Retrieved June 14, 2016, from Pacific
  • 9. Research Institute:http://www.pacificresearch.org/article/illinois-ny- among-usual-tort-suspects-in-pri-study/ Luke, R. (2008, March 11). ILLINOIS, NY AMONG USUAL TORT SUSPECTS IN PRI STUDY. Retrieved May 28, 2016, from Pacific Research Institute: http://www.pacificresearch.org/article/illinois-ny- among-usual-tort-suspects-in-pri-study/ National Governors Association. (2005, June 30). Containing Medical Malpractice Costs: Recent State Actions. Retrieved June 14, 2016, from National Governors Association: http://www.nga.org/cms/home/nga-center-for-best- practices/center-publications/page-health-publications/col2- content/main-content-list/containing-medical-malpractice- c.html National Governors Association. (2016). About - Mission Statement. Retrieved June 14, 2016, from National Governors Association:http://www.nga.org/cms/about Nodzenski, T. J., Galland, G. F., Hatton, M. R., & Mudron, M. D. (2005). Amicus Curiae Brief of the Illinois Hospital Association, American Hospital Association, Illinois Catholic Health Association and Illinois Rural Health Association in Support of Defendent – Appellant GottliebMemorial Hospital. Retrieved June 10, 2016, from IHA Today: http://www.ihatoday.org/uploadDocs/1/lebron.pdf Pierce, O., & Allen, M. (2015, December 31). How Denmark Dumped Medical Malpractice and Improved Patient Safety. Retrieved June 14, 2016, from Propublica: https://www.propublica.org/article/how- denmark-dumped-medical-malpractice-and-improved-patient- safety Propublica. (2016). About Us. Retrieved June 14, 2016, from Propublica: https://www.propublica.org/about/ Sanguinetti, E. (2015). About Bruce. Retrieved June 14, 2016, from Bruce Rauner: http://brucerauner.com/about/ Yee, M. (2014, March 31). Illinois's Cap for Medical
  • 10. Malpractice Damages. Retrieved June 14, 2016, from Legal Match:http://www.legalmatch.com/law-library/article/illinoiss- cap-for-medical-malpractice-damages.html Bottom of Form · Assignment Description Policy Analysis and Commentary For this assignment, you will be required to write a brief commentary to a journal of your choice discussing the pros and cons of a particular health policy issue of interest to you and offering a recommendation based on your research and analysis about the particular issue. Choose a topic that will push you to take strong positions. Select a topic that you CARE about. Consider both intervention and prevention programs. Your analysis should be accurate, timely, meaningful, and have an impact factor. Ask the questions: 1) why should the person reading this actually care about this issue?, 2) is a realistic solution suggested? The format will vary depending on the journal you decide to submit the commentary to. In general the final document will include a description of the problem, some statements about different solution options that can be used to address the problem, and a recommendation drawing on evidence that exists in the literature related to your issue for the best way to solve the problem. The analysis must represent the interests of a specific client (special interest group executive director, government official, CEO, etc.) and your reading audience. The solution must be realistic. The issue (problem) must be worthy of being placed high on the public agenda. Your objective is to present a problem and then you will offer several alternative choices for addressing the problem after researching solution options. Your goal is to come up with one preferred option through the process of policy analysis. After presentation of the alternatives, you will suggest a final recommendation.
  • 11. There is no need to reinvent the wheel to develop your section for policy options... rely on research. Borrow (cite original source) language from current policy. Read the mission statement of "your client". Find historical precedents. Locate policies in the pipeline and adopt relevant language for your proposal (citing resources, of course). “Real world” policy proposals, pending and accepted legislation, and official plans illustrate what could be accomplished. Generate a list of legislation (if present) that passed and bills that died. Look for already developed guidelines, regulations, or programs. Look for new and developing alternatives currently in the “pipeline”:identify policies in the pipeline (proposed, rejected, accepted in other geographic areas). Consider areas for compromise. Consider the possible consequences of action as well as the possible consequences of inaction. Remember that “do nothing” can be an alternative. Think about your policy options and the positive and negative aspects of each option according to criteria (cost, legal issues, political feasibility, etc.) that your client would specify as important. Dollars won't fix a problem ... but lack of dollars can limit opportunity to fix a problem. Seeing the $$$ distribution indicates public priorities and placement on the public agenda. Generally, you will find that funding and awareness activities will increase if the subject rises on the public agenda ... not the other way around. Money (by itself) is NOT a solution. Increasing awareness (by itself) is NOT a solution. The solution (policy) must help to resolve the issue (problem). The Final Product component of the Policy Proposal Project is an individual effort. Your PPP Final Product will evolve while you work independently on your concept. Change elements (and wording) as you see a need for modification. The policy proposal will be refined and modified through scheduled Step assignments as the semester progresses. Policy creation is a process. It requires time. Expect to research, revise, rethink, compromise, and revise some more when preparing a policy
  • 12. proposal. Rather than be concerned about your grade be inspired to excellence. It takes a few times to revise a publication-ready manuscript. Adhering to all of the journal’s requirements for authors is required. Try and keep references limited to recent journals. The length of your final manuscript will vary but your final product is to be 8 - 13 pages or a minimum of 1000 words should be submitted for the final assignment unless the journal you select requires less words for commentaries. If you need to go over 13 pages, that is all right but make sure that the extra pages are justified. Please do not go over 15 pages. You decide on how much information (and how many pages) to devote to each section. Focus on necessary content. You would be surprised at how much you can cut out and how you can tighten and solidify your writing. And remember, don't lose sight of your client and the actual problem statement. Acceptance for publication to the journal is not a requirement. A main goal of this assignment is to provide the experience of writing for a journal. Acceptance of your manuscript for publication is a bonus. Follow up and revise your work if the journal asks you to resubmit the article. If you need help with a revision after the end of the semester, the professor will be available to provide feedback. Please let me know when you are published. · Post a best effort, rough draft version to the DB. REVISE: Expect detailed feedback and suggestions for modifications because this process requires multiple revisions as you refine your thinking. · The PPP Step assignments are supposed to reflect a progressive learning process. · Do not expect "correct" on the first attempts. PARTICIPATION: Peer comments are required. You can expect detailed feedback and suggestions for modifications. · The PPP Step assignments are intended to be a learning
  • 13. process and I am looking for a good faith effort. Learn from each other as changes are made on the subsequent PPP Step assignments. I hope you gain insights BECAUSE of the need for revisions and corrections. Review each others work and my comments on the PPP Step assignments. Ongoing revisions, modifications, and changes are encouraged. Look for new posts to the most recent Step assignments. Add your thoughts ... and expect to see my thoughts. "The only thing" that you want to post is what you are asked to complete: client, revised problem statement, a few stakeholders, and your journal selection. Answer the following questions for PPP Step 2: 1. Modify and revise (if necessary): Who is your client? 2. Improve the wording (as needed) of your problem statement. 3. Identify some of the key stakeholders whose positions and concerns must be understood before a well-informed decision can be made. Consider the politics and who has the power. Be specific and list 4 to 6 significant stakeholders (individuals, interest groups, etc.). · Note: The List of Stakeholders should contain at least one descriptive sentence for each of those stakeholders. 4. Select a peer-reviewed journal. · Name the journal and provide a very brief description of its purpose. · Include a brief summary of the selected journal's basic requirements for publication (word length, format, etc.). Also, include the citation style required by the journal and a link to the citation style if the journal has it’s own approach to citations. · Include a link to the Author's Guide. · STEP 5 Refined Concept: Abstract You must write an Abstract. This must be a concise summary statement and it should be included in your Final manuscript. The summary statement must describe all important components. This is a "road map" telling the reader what to
  • 14. expect. The Abstract should state the purpose or objective of your writing, the main results, and your major conclusion. Your Abstract should not be more than two or three paragraphs. Word count must meet the requirements of your selected journal. (Include the journal limitations on your assignment document.) However, if not specified in the Author's Guide, word count should be no less than 100 words and no more than 300 words. An Abstract must be able to stand alone. Avoid citations and need for references. Avoid abbreviations. PARTICIPATION: Provide each other meaningful and helpful feedback. Suggest content and/or editorial revisions for improvements. Provide questions or constructive feedback on your classmates' presentations.