Ezekiel J. Emanuel

Ezekiel J. Emanuel
  • Diane v.S. Levy and Robert M. Levy University Professor
  • Professor of Health Care Management
  • Professor of Medical Ethics and Health Policy in the Perelman School of Medicine

Contact Information

  • office Address:

    122 College Hall
    Philadelphia, PA

Overview

Ezekiel J. Emanuel is Vice Provost for Global Initiatives and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania. From January 2009 to January 2011, he served as special advisor for health policy to the director of the White House Office of Management and Budget. Since 1997 he was chair of the Department of Bioethics at The Clinical Center of the National Institutes of Health and a breast oncologist. Dr. Emanuel received his M.D. from Harvard Medical School and his Ph.D. in political philosophy from Harvard University. After completing his internship and residency in internal medicine at Boston’s Beth Israel Hospital and his oncology fellowship at the Dana-Farber Cancer Institute, he joined the faculty at the Dana-Farber Cancer Institute. He has since been a visiting professor at the University of Pittsburgh School of Medicine, UCLA, the Brin Professor at Johns Hopkins Medical School, and the Kovitz Professor at Stanford Medical School and visiting professor at New York University Law School. Dr. Emanuel has written and edited 9 books and over 200 scientific articles. He is currently a columnist for the New York Times.

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Research

Teaching

Current Courses

  • BIOE575 - Health Care Reform

    This course will provide students a broad overview of the current U.S. healthcare system. The course will focus on the challenges facing the health care system, an in-depth understanding of the Affordable Care Act, and its potential impact upon health care access, delivery, cost, and quality. The U.S. health care system is the worlds largest, most technologically advanced, most expensive, with uneven quality, and an unsustainable cost structure. This multi-disciplinary course will explore the history and structure of the current American health care system and the impact of the Affordable Care Act. How did the United States get here? The course will examine the history of and problems with employment-based health insurance, the challenges surrounding access, cost and quality, and the medical malpractice conundrum. As the Affordable Care Act is implemented over the next decade, the U.S. will witness tremendous changes that will shape the American health care system for the next 50 years of more. The course will examine potential reforms, including those offered by liberals and conservatives and information that can be extracted from health care systems in other developed countries. The second half of the course will explore key facets of the Affordable Care Act, including improving access to care and health insurance exchanges, improving quality and constraining costs through health care delivery system reforms, realigning capacity through changes in workforce and medical education, and potential impact on biomedical and other innovation. The course will also examine the political context and process of passing major legislation in general and health care legislation in particular, including constitutional arguments surrounding the Affordable Care Act. Throughout lessons will integrate the disciplines of health economics, health and social policy, law and political science to elucidate key principles.

    BIOE575401 ( Syllabus )

  • HCIN600 - American Health Care Sys

    This course surveys the historical development of the American health care system from the turn of the Twentieth Century to the present. We examine the logic, economics, and implementation of the system's basic structural components from insurance, to hospitals, to models for compensating physicians and nurses. We review many attempts at reform, and discuss why they failed. We analyze in detail the passage of the Affordable Care Act, the Supreme Court's rulings, and its provisions on access, cost control, quality, workforce, and financing. And we begin to consider some of the directions in which the American health care system may evolve next.

    HCIN600001

    HCIN600002

  • HCMG250 - Health Care Reform

    This course provides students with a rigorous understanding of the American health care system. The course will focus on five topics: 1) the developement of the current health care system; 2) challenges of health care costs, quality, and access; 3) lessons of previous attempts to reform the system and enactment of the Affordable Care Act (ACA); 4) the impact of the ACA on the financing, organization, delivery, and outcomes of the health care system; and 5) probable future evolution of the American health care system. Throughout the course, lessons will integrate health economics, health policy, and politics to elucidate key principles for understanding the health care system. The course will end with a consideration of the long-term outlook for health reform in the United States, including recent pushes for "Medicare for All." Students unable to sign up for the course who want to be placed on a waitlist should email Aaron Glickman at aarongl@pennmedicine.upenn.edu

    HCMG250401 ( Syllabus )

  • HCMG850 - Health Care Reform

    This course provides students with a rigorous understanding of the American health care system. The course will focus on five topics: 1) the development of the current health care system; 2) challenges of health care costs, quality, and access; 3) lessons of previous attempts to reform the system and enactment of the Affordable Care Act (ACA); 4) the impact of the ACA on the financing, organization, delivery, and outcomes of the health care system; and 5) probable future evolution of the American health care system. Throughout the course, lessons will integrate health economics, health policy, and politics to elucidate key principles for understanding the health care system. The course will end with a consideration of the long-term outlook for health reform in the United States, including recent pushes for "Medicare for All."

    HCMG850401 ( Syllabus )

Past Courses

  • BIOE282 - PROFESSIONAL ETHICS

    Professionals - in business, medicine, law, and politics - face myriad ethical dilemmas in their daily work life that challenge, and sometimes conflict with, the moral commitments that guide their everyday life. This course systematically examines the ethical dimensions of these four professional roles, asking questions such as: Are there limits to what we should sell? How far should competitors go to "win"? Who should get ventilators in a flu pandemic? Is it morally permissible for physicians to assist in suicide? Should lawyers represent terrorists or child killers? How far does attorney-client privilege go? Is it morally justifiable to torture enemy combatants? Should politicians lie?

  • BIOE565 - RATIONING

    You have one liver but three patients awaiting a liver transplant. Who should get the liver? What criteria should be used to select the recipient? Is it fair to give it to an alcoholic? These are some of the questions that arise in the context of rationing and allocating scarce health care resources among particular individuals, what is called micro-allocation decisions. There are also macro-allocation decisions that focus on how health care systems distributes resources across populations. Using the cases of organs for transplantation, the rationing for vaccines in a flu pandemic, and oncology drug shortages, the course will critically examine alternative theories for allocating scarce resources among individuals. Using both the need to establish priorities for global health aid and to define an essential benefit package for health insurance, the course will critically examine diverse theories for macro-allocation from cost-effectiveness analysis to age-based rationing to accountability for reasonableness.

  • BIOE572 - GLOBAL BIOETHICS

    According to the WHO, around 30 million people with HIV/AIDS should receive anti-retroviral treatment. But only 10 million do. Drugs containing tenofovir--the standard of care in developed countries are expensive. Stavudine-based treatments are much cheaper but have worse side-effects. Is it ethical to use stavudine-based rather than tenofovir-based treatments in sub-Saharan Africa? Smoking rates have decreased drastically in most developed countries. But they are increasing in many developing countries. Established public health measures are not implemented, and the tobacco industry pursues a range of marketing activities that would be unacceptable in developed countries. As a consequence, global deaths from smoking are expected to increase to 1bn by the end of the 21st century, with 80% of deaths in developing countries. Is industry s behavior immoral or normal in a global market? ARDS is a disease of premature newborns. Is it ethical to test a new ARDS drug in Bolivia if the drug--if proven to be effective-- will be very expensive and accessible only to the richest people in Bolivia and other developing countries? An overarching question that these different cases raise is whether there are universal ethical standards that should apply to all people, or whether regional variations should be acceptable. Universalists typically argue that there must be no double standards, and that people should be treated the same regardless of where they live. Pragmatists raise concerns about moral imperialism, neo-colonialism, or insufficient respect for cultural or other differences. Increasing globalization fuels debates about which of competing sets of moral standards is the right one. Looking at a range of diverse cases including healthcare research, health policy, flu pandemics, family planning, smoking and obesity policy, and genetically modified crops, this course explores controversies in the cross winds of market forces, politics and ethics, and examines the roles and responsibilities of key actors and international policy guidance.

  • BIOE575 - HEALTH CARE REFORM

    This course will provide students a broad overview of the current U.S. healthcare system. The course will focus on the challenges facing the health care system, an in-depth understanding of the Affordable Care Act, and its potential impact upon health care access, delivery, cost, and quality. The U.S. health care system is the worlds largest, most technologically advanced, most expensive, with uneven quality, and an unsustainable cost structure. This multi-disciplinary course will explore the history and structure of the current American health care system and the impact of the Affordable Care Act. How did the United States get here? The course will examine the history of and problems with employment-based health insurance, the challenges surrounding access, cost and quality, and the medical malpractice conundrum. As the Affordable Care Act is implemented over the next decade, the U.S. will witness tremendous changes that will shape the American health care system for the next 50 years of more. The course will examine potential reforms, including those offered by liberals and conservatives and information that can be extracted from health care systems in other developed countries. The second half of the course will explore key facets of the Affordable Care Act, including improving access to care and health insurance exchanges, improving quality and constraining costs through health care delivery system reforms, realigning capacity through changes in workforce and medical education, and potential impact on biomedical and other innovation. The course will also examine the political context and process of passing major legislation in general and health care legislation in particular, including constitutional arguments surrounding the Affordable Care Act. Throughout lessons will integrate the disciplines of health economics, health and social policy, law and political science to elucidate key principles.

  • BIOE590 - PHIL'AL TOPICS IN BIOE

    This set of courses provides a philosophical perspective on bioethical topics and issues. This can include courses that integrate ethical theory with concern for particular applications of theory or conceptual issues in medicine, health care, and the life sciences. Past courses have included Philosophy of Death and Dying, Genetics and Ethics, Philosophy of Medicine, Pragmatic Bioethics, and Feminism and Bioethics. This is a topics course - for information on the topics currently being offered, please go to the course listing on the Bioethics website: http://www.med.upenn.edu/mbe.

  • HCIN600 - AMERICAN HEALTH CARE SYS

    This course surveys the historical development of the American health care system from the turn of the Twentieth Century to the present. We examine the logic, economics, and implementation of the system's basic structural components from insurance, to hospitals, to models for compensating physicians and nurses. We review many attempts at reform, and discuss why they failed. We analyze in detail the passage of the Affordable Care Act, the Supreme Court's rulings, and its provisions on access, cost control, quality, workforce, and financing. And we begin to consider some of the directions in which the American health care system may evolve next.

  • HCIN615 - POLICYMAKING

    How is health policy developed, decided, and executed? We are cognizant of legislation in its final, enacted form--but what precedes it, and how is it shaped? This course will take students from the offices of policymakers to the floor of the House and Senate, to the offices of physicians and providers. The course will examine what foundational elements are necessary to pass any piece of legislation and the process through which a law comes to fruition. Key health care legislation--Medicare, "Clinton Care," CHIP, and the ACA--will all be examined through the lens of policy development. Upon completing the course, students will be able to define the specific decisions, actions, and agendas in order to, ultimately, propel health care policymaking.

  • HCIN617 - TRANSFORMING HEALTH CARE

    Transformation of Health Care in the Real World A number of best practices show promise in improving care, including open access scheduling, care coordinators, physician extenders, medical homes, and connected technologies. But two forces keep these best practices from spreading and from having the transformative results they are capable of delivering. First, health care is complex and a best practice that works well for hip replacement might not be right for the management of a chronic condition. Second, implementation in the real world is more than identifying a best practice and declaring it as the new standard for care delivery. An organization has to first understand the new practice and how it should be applied to a new setting, involving both technical solutions and changes to management systems. Finally, a successful transformation requires a change in providers' mindsets and behaviors. The purpose of this course is to teach participants about successful transformative practices in various parts of the health care system, enabling them to lead initiatives to transform their own medical organization. Students will hear from practitioners what works, learn from academics why the practice works and what are alternatives, and discuss with practitioners how the practice was rolled out. Topics will include scheduling, care delivery A number of best practices show promise in improving care, including open access scheduling, care coordinators, physician extenders, medical homes, and connected technologies. But there are two forces that keep these best practices from spreading and from having the transformative results they are capable of delivering. First, health care is complex and a best practice that works well for hip replacement might not be right for the management of a chronic condition. Second, implementation in the real world is more than identifying a best practice and declaring it as the new standard for care delivery. An organization has to first understand the new practice and how it should be applied to a new setting, involving both technical solutions and changes to management systems. Finally, a successful transformation requires a change in providers' mindsets and behaviors. The purpose of this course is to teach participants about successful transformative practices in various parts of the health care system, enabling them to lead initiatives to transform their own medical organization. Students will hear from practitioners what works, learn from academics why the practice works and what are alternatives, and discuss with practitioners how the practice was rolled out. Topics will include scheduling and appointment management, welcoming the patient, care delivery in the process flow paradigm, care delivery with more complex patients, discharge and follow-up, and financial viability.

  • HCMG250 - HEALTH CARE REFORM

    This course provides students with a rigorous understanding of the American health care system. The course will focus on five topics: 1) the developement of the current health care system; 2) challenges of health care costs, quality, and access; 3) lessons of previous attempts to reform the system and enactment of the Affordable Care Act (ACA); 4) the impact of the ACA on the financing, organization, delivery, and outcomes of the health care system; and 5) probable future evolution of the American health care system. Throughout the course, lessons will integrate health economics, health policy, and politics to elucidate key principles for understanding the health care system. The course will end with a consideration of the long-term outlook for health reform in the United States, including recent pushes for "Medicare for All." Students unable to sign up for the course who want to be placed on a waitlist should email Aaron Glickman at aarongl@pennmedicine.upenn.edu

  • HCMG850 - HEALTH CARE REFORM

    This course provides students with a rigorous understanding of the American health care system. The course will focus on five topics: 1) the development of the current health care system; 2) challenges of health care costs, quality, and access; 3) lessons of previous attempts to reform the system and enactment of the Affordable Care Act (ACA); 4) the impact of the ACA on the financing, organization, delivery, and outcomes of the health care system; and 5) probable future evolution of the American health care system. Throughout the course, lessons will integrate health economics, health policy, and politics to elucidate key principles for understanding the health care system. The course will end with a consideration of the long-term outlook for health reform in the United States, including recent pushes for "Medicare for All."

  • HCMG890 - ADVANCED STUDY PROJECT

    HCMG 890-001: This course examines issues related to the Services Sector of thehealth care industry. For those interested in management, investing, or bankingto the health care industry, the services sector will likely be the largest and most dynamic sector within all of health care. We will study key management issues related to a number of different health care services businesses with a focus on common challenges related to reimbursement, regulatory, margin, growth, and competitive issues. We will look at a number of different businesses and subsectors that may have been unfamiliar to students prior to taking the course. We will make extensive use of outside speakers, many of whom will be true industry leaders within different sectors of the health care services industry. Speakers will address the current management issues they face in running their businesses as well as discuss the career decisions and leadership styles that enables them to reach the top of their profession. Students will be asked to develop a plan to both buyout and manage a specific health care services business of their choosing and will present their final plans to a panel of leading Health Care Private Equity investors who will evaluate their analysis. Prerequisites: HCMG 841. Health Care Management MBA majors only Senior healthcare executives and policy leaders will be engaged as guest speakers.

  • PSCI282 - PROFESSIONAL ETHICS

    Professionals - in business, medicine, law, and politics - face myriad ethical dilemmas in their daily work life that challenge, and sometimes conflict with, the moral commitments that guide their everyday life. This course systematically examines the ethical dimensions of these four professional roles, asking questions such as: Are there limits to what we should sell? How far should competitors go to "win"? Who should get ventilators in a flu pandemic? Is it morally permissible for physicians to assist in suicide? Should lawyers represent terrorists or child killers? How far does attorney-client privilege go? Is it morally justifiable to torture enemy combatants? Should politicians lie?

In the News

Activity

Latest Research

Amol S. Navathe, Joshua M. Liao, Sarah E. Dykstra, Erkuan Wang, Zoe M. Lyon, Yash Shah, Joseph Martinez, Dylan Small, Rachel M. Werner, Claire Dinh, Xinshuo Ma, Ezekiel J. Emanuel (2018), Association of Hospital Participation in a Medicare Bundled Payment Program With Volume and Case Mix of Lower Extremity Joint Replacement Episodes, Journal of the American Medical Association, 320 (9), pp. 901-910.
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In the News

Twelve Innovative Ideas for Fixing American Health Care

In his new book, Obamacare advisor and Penn professor Ezekiel Emanuel looks at innovative solutions for the health care crisis.

Knowledge @ Wharton - 2017/06/22
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