Position Paper 1    Fall 2017


Health care spending and financing in the US (or anywhere) can be compartmentalized into a defined number of service types or categories. For each category, the sources of funds to cover those categories can also be compartmentalized.


The largest categories are hospitals, physicians and clinics, prescription drugs, and administration.  Other categories include home health, nursing care, medical equipment, dental, other professional services and more. The relative contribution that each category makes to overall spending in any given year, or over time, gives a sense for how the organization of health care delivery is evolving.


Similarly, the source of funds to cover any one of these categories evolves over time. Insurance is now (but was not always) the dominant category, composed of multiple public [Medicare, Medicare, State Children’s Health Insurance Program (SCHIP) Veterans Administration, Department of Defense, Indian Health Service], and private sources. Out of pocket expenditures by the consumer (which dropped dramatically as a share of total expenditures over 5 decades) are now trending upward.


The major purpose of this exercise is to select one, and only one, sector of health care service of interest to you, and explore trends in funding magnitude and source of funds, over decades. A key point is to connect trends in funding in that sector with the sources of funds for that sector. For example, suppose you’re interested in pharmaceutical spending.  As you will, the annual percentage of total healthcare spending on pharmaceuticals has varied markedly over decades. Similarly, the sources of funds to cover that spending have also evolved – in other words, the fraction annually contributed by Medicare, Medicaid, private insurance, out of pocket, and other sources continues to change.


An excellent source of information is the Kaiser family foundation site ( The health spending explorer (see URL below) provides longitudinal data on health care spending by category. The health system tracker (URL below) provides data on access, spending, and quality.




In addition to the Kaiser family foundation site, you should identify at least two other sources that provide information on your topic. For many if not most topics, there are reputable sources that typically come down on both sides (politically) of issues related to health spending. The New York Times and The Wall Street Journal are obvious examples. Bloomberg is a very comprehensive source, along with many other online sites.

Assignment Guidelines


This assignment involves an analysis of quantitative data. The submission should clearly capture the quantitative nature of the material. That is best done with a combination of narratives, graphs, tables, and other illustrations.


Your submission should consist of the following sections:

  • Synopsis/abstract of your submission. This should be one short paragraph.
  • Introduction and background. Clearly state the one service area you are investigating, why it is of interest to you, and any background information that sets the stage for your analysis.
  • Methodology: Describe the methodology you used to do your analysis. At a minimum, this will outline (very succinctly) your use of the spending explorer and the complimentary sources you searched.


  • Data: This is the main substance of the assignment. Your analysis should include past spending trends as well as projections for the trajectory of future spending. Graphs or tables (excel or other formats are fine) and most explanatory, especially when coupled with narratives describing the material shown. Data should be organized under sub-headings, with narrative explanations of your findings. Figures and tables should have legends, and be cited in the text. Downloading/copying figures and tables directly from the spending explorer is appropriate, but 100% credit will require graphs, tables and/or narratives from other source material.


  • Summary and Conclusion: Summarize your findings and interpret them in the context of your introduction and background section.


The length of the submission depends primarily on the extent to which graphs, tables and other supplemental material are used. The narrative portion alone should be between 2 and 3 pages.

Evaluation Criteria and Grading Rubric


The grading of this assignment will be based on three criteria: analysis (40%), interpretation (40%), and mechanics (20%). In each aspect, you should follow the assignment instructions closely. The grading rubric is as follows.


Criterion 100% Credit 80% Credit 50% Credit or less
Complete analysis of trends in magnitude and sources of funding for one service area based on the health care explorer site, and additional supporting data from at least two other sources, with graphs and tables to illustrate findings. Complete analysis of trends in magnitude and sources of funding for one service area, with minimal supporting data from other sources limited use graphs and tables to illustrate findings. Incomplete analysis of trends in magnitude and sources of funding for one service area, with no additional supporting data from other sources.
Goes beyond material on health care spending explorer to explain and interpret changes over time. Gives cogent summary of trends in magnitude and source of funds, with some level of interpretation. Response limited to describing trends, without additional interpretation.



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