Understanding and Improving the US Healthcare System

About the Course

This course provides students from a wide variety of backgrounds an asynchronous, engaging, practical, and interactive way to understand the US healthcare system and gain insight about how they can improve the system.  No specific pre-requisite knowledge is required for students in this course.

The course was originally developed following research published by Dr. Davis and his colleagues at University of Michigan and University of Pennsylvania, finding that medical students are far less confident about their health policy knowledge than their clinical preparation.  Based on his teaching for students in medical, public health, and public policy fields, Dr. Davis has developed this course content to be accessible and engaging for students from multiple different fields, including undergraduates, and for learners from the general public as well.

The course is designed to have a very favorable effort-to-learning ratio, with engaging instructional material and high-yield suggested readings.  Learning formats include didactic material (Unit 01), documentary-style archival material (Unit 02), in-depth expert interviews (Unit 03), simulation exercises (Unit 04), live online webinars to discuss group decision-making about health plan design (Unit 05), and an expert panel discussion (Unit 06).

The expected time commitment for students is approximately 1 hour of video viewing and 2 hours of reading and work time per week.  The course will last for 6 weeks.  

After completing this course, learners will:

  1. Understand the main players of the US healthcare system
  2. Be able to identify examples of synergistic versus conflicting actions of the main players in the healthcare system
  3. Expand their understanding of the history of healthcare reform in the United States, including the development and interaction of health insurance in the private sector and government programs in the public sector
  4. Understand the structure and function of benefits and cost-sharing in health insurance plans
  5. Be able to describe possible future directions of the US healthcare system
  6. Identify potential ways that they can improve the US healthcare system through their own actions

Optional resources will include online material from other sites, individual readings, recommended reference books, and crowd-sourced recommendations.

To optimize the learning experience for this course, all students should have dependable access to the Internet with video streaming capabilities. Some students may want the ability to utilize on-line video conferencing as well.

Work Expectations

This 6-week course includes multiple different formats of engagement, including videos, reading, on-line discussions, and sharing of decision-making regarding the design of benefits in simulated health plans.

Students should anticipate a light-to-moderate workload (approximately 2-3 hours/week) for the core course material, with the option to extend their work to additional hours at their discretion based on optional resources listed on the course website.

It will be extremely helpful to learners if they engage in activities that are required to earn a certificate of participation for this course.  These certificate activities are marked in each unit by the CERTIFICATE tag and include (in chronological order):

These specific certificate activities are designed to optimize involvement of the learners in the material.  They will also introduce learners to each other through sharing of ideas and perceptions in online discussion forums – thereby maximizing the ‘flipped classroom’ goal of the Coursera platform in which students gain additional benefits from the ways in which they interact with each other and explore topics in greater depth.  Plus:  if you complete these specific activities, you will receive the course certificate!

Course Syllabus

The course will begin by establishing a background familiarity with the 4 main players that serve as the core of the US healthcare system (patients, providers, payers, and public health).  Building on that background, the course will then set the context for the 4 main players by taking an in-depth look at how US presidents have viewed the healthcare system and attempted to reform it.  The course will subsequently address in greater depth the central role of payers – both private and public – in the US healthcare system, through a series of interviews with leading experts from economics, public health, health policy, and clinical care.  Halfway through the course, learners will then be introduced to the remarkable CHAT® simulation exercise, through which they will be engaged in decision-making about benefits in health plans.  Students will submit their own plan design, and will then be asked to develop a health plan for a community group, randomly assigned by the instructor.  By examining individuals’ choices for their groups in the live online webinar format, students will have the chance to engage each other and the instructor in real time regarding the challenges of plan design within a cost constraint.  To close the course, the instructor will facilitate a panel discussion of invited experts who will provide their insights about future directions for the healthcare system, and opportunities for its improvement.


There is no required text for this course.  Students are welcome to read the optional learning resources suggested; in general, there will be an emphasis on listing readings that are free to all readers in the material for each unit.  When listed readings are only available for a fee, they will be indicated as such with a FEE tag.  Dr. Davis has no financial relationships with any publisher and does not stand to gain from student purchase of any materials.

Course Format

Unit 1: The US Healthcare System – 4 Main Players

Unit 2: Mini-Documentaries – US Presidents and the History of US Healthcare Reform

Unit 3: In-Depth Interviews – Private and Public Payers in the US Healthcare System

Unit 4: Designing Benefits in a Health Plan – the CHAT® Simulation Exercise

Unit 5: Coursewide Discussions – Plan Benefits Design for Community Stakeholder Groups

Unit 6:  Looking Toward the Future of the US Healthcare System – an Expert Panel Discussion

Grading Policy

In order to receive a certificate documenting your participation in this course in October-November 2013, you must complete a series of activities as the course progresses. The activities are designed to ensure that you are engaged with major learning goals of the course. Although the activities will not be graded, they must be completed with meaningful content by the student (e.g., questions must be answered in the self-assessment) in order to get credit. These activities are all marked on the Syllabus page with the tag CERTIFICATE. The activities include (in chronological order):

Follow Us!

You can find all the course materials on the course website on Coursera.  Please follow us on Twitter, (@ushealthpolicy) and Like Us on Facebook ( We’ll make announcements and alert you to new resources through our Twitter feed and Facebook page. After all, this is an exciting and fast-paced time in the US healthcare system!