Healthcare in America: Whats Really Going On?

This page authored by Becca Arnold, San Diego Mesa college, San Diego, California, based on two eposides of NPRs This American Life.
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This material is replicated on a number of sites as part of the SERC Pedagogic Service Project


In this activity students listen to all or part of two NPR investigative shows on the healthcare system and then participate in one of a number of activities to explain what they have learned using economic terms. In this way, students have the opportunity to both learn about the current structure of healthcare in the US, and to conceptualize it from an economist's viewpoint.

Learning Goals

  • Students will understand the complexities of the healthcare system in the United States and the breadth of market failures throughout the system.
  • Students will learn the applied definitions of the following economic terms: Private Markets, Moral Hazard, Asymmetric Information. Supply, Demand, Market Failure, Government Failure, Industry Type, Perverse Incentives, Unintended Consequences

Context for Use

  • This activity is most useful in a Microeconomics Course (Principles level or higher); and given near the end of the semester to be sure all terms used have been covered.
  • This activity is suited for both on-campus and online courses.
  • The activity requires the use of a computer; and is best accomplished as a combination of homework followed by in-class discussion (for on-campus classes), or posting to the discussion board (for online classes).

Description and Teaching Materials

Healthcare is a topic that catches everyone's interest these days, including students; and it's complexity makes it an excellent subject to use in discussing the strengths and weaknesses of private markets. In 2009, at the height of the debate on the Affordable Healthcare Act, an NPR radio program called "This American Life" aired two episodes on the current healthcare system. Each show is divided into four "Acts"; each of which discusses a different economic aspect of healthcare today. Taken together they make excellent material for students to consider in terms of the economic concepts and theories they are learning in Principles of Microeconomics classes.

There are a number of activities that could be done with this lesson; both for on campus and online classes, that would give students practice in applying economic concepts to the current healthcare system. Below are instructions for three suggested activities; all of which use the shows: Episode 391 from October 9, 2009, and Episode 392 from October 16, 2009.

Two of the three suggested activities will ask students to identify the following terms in the show; the third will ask them to identify any economic term from their textbook.

Below are summary descriptions of the three activities. The attached student worksheets contain detailed descriptions.

Activity 1: Best Suited to On-Campus classes

Provide students with a list of the terms listed above. Divide them into eight groups; and assign each one an "Act" (there are two shows of four acts each). Students will first write the definition of the terms from their textbook glossary; then they will listen to their assigned Act and identify situations from the Act that could be described using the terms on their list (ask them to use at least three of the terms). They will write a summary of the act, incorporating the appropriate terms, and prepare a short presentation to the class of the Act . After each presentation, the class can discuss whether or not the terms were used correctly. Note: Be sure to have the audio available so you can re-listen to parts when advantageous to the discussion. It also is a good idea to listen to the introduction to each show together.

Student Worksheet Activity 1 (Microsoft Word 2007 (.docx) 14kB Jun8 13)

Activity 2. Best suited for online classes:

Give students the list of terms; and ask them to listen to the entire show (assign either More is Less or Someone Else's Money) with one of the terms in mind. The student will then post to the discussion board at least three examples of the term. Be sure they state what Act they are discussing, and why the term applies. Allow each term to be used only once, by dividing students into discussion groups of no more than eleven students (since their are eleven terms) and asking them to be sure to check all the posts before theirs so that they haven't repeated any terms. NOTE: This method of assigning unique terms become difficult if a student is working on a term but hasn't posted yet and another student then posts with the same term. I handle this possibility by letting students make an initial post letting other students know which term they are working on, and, in effect - "reserving" the term.

Student Worksheet Activity 2 (Microsoft Word 2007 (.docx) 14kB Jun8 13)

Activity 3. Suited for either online or on-Campus classes:

In this activity students are not provided a list of terms, but simply asked to discover appropriate terms from the textbook. Students listen to either Someone Else's Money or More is Less and write a one-page summary of show. The show will not usually use terms from the book, but in the summary, students should rephrase applicable content into economic terminology. Ask students to use at least three terms, from three different textbook chapters. Have them underline the terms so they can be can easily identified for grading.
Student Worksheet Activity 3 (Microsoft Word 2007 (.docx) 14kB Jun8 13)

Teaching Notes and Tips

As students work to apply concepts or terms to the "real-world" correctly, they can become very creative. Watch for these- they provides wonderful opportunities for discussion.

Also, please note that all of the above terms can be used in nearly all of the acts. However, the following lists those where they will be particularly obvious to the students.

More is Less
Act 1: Private Markets, Supply, Demand, Government Failure
Act 2: Private Markets, Unintended Consequences, Perverse Incentives, Government Failure
Act 3: Private Markets, Demand, Industry Type
Act 4: Market Failure; Government Failure

Someone Else's Money
Act 1: Demand, Industry Type, Asymmetric Information, Perverse Incentives
Act 2: Private Markets, Supply, Demand, Industry Type, Asymmetric Information
Act 3: Private Markets; Perverse Incentives, Moral Hazard
Act 4: Private Markets, Supply, Industry Type, Market Failure


Activity One: I assess this on a group-basis, and make it a fairly low part of the overall class grade - just a few points. I look mostly for effort.

Activities Two and Three: These are more formal assignments, and I assess this based on the appropriate use of the terminology.

References and Resources