Ezekiel J. Emanuel

All Courses

• BIOE5650 - 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, and concern what are called micro-allocation decisions. But trade-offs also need to be made at the meso- and macro-level. Budgets of public payers of healthcare, such as governments, and of private ones, such as health plans, are limited: they cannot cover all drugs and services that appear beneficial to patients or physicians. So what services should they provide? Is there a core set of benefits that everyone should be entitled to? If so, by what process should we determine these? How can we make fair decisions, if we know from the outset than not all needs can be met? Using the cases of organs for transplantation, the rationing for vaccines in a flu pandemic, and 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 allocation decisions, including cost-effectiveness analysis, age-based rationing and accountability for reasonableness.

• BIOE5720 - 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.

• BIOE5750 - Health Care Reform

  This course provides students with a rigorous understanding of the current American health care system and how it is likely to evolve over the next decade. The course will focus on six 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 including the Affordable Care Act (ACA); 4) analysis of current policies regarding provider payment, technology, and electronic health records and how various sectors (e.g. public health and hospitals) are evolving in the current system; 5) drug pricing and potential strategies for reform, and 6) future megatrends in American health care system. Throughout the course, lessons will integrate basic health economics, history, health policy, and politics to elucidate key principles for understanding the health care system. The course will also examine at least one other country’s health system for comparison. The course will end with a consideration of the long-term outlook for the structure of the US health system and potential reform. Numerous expert guest speakers will give their perspectives throughout the semester.

• BIOE5900 - Ethics in Mental Healthcare

  Mental healthcare—which includes, but is not limited to, psychiatry, psychology, and clinical social work—is an especially ethically fraught subdiscipline of the larger medical enterprise. Issues range from garden-variety problems related to informed consent, patient capacity, and clinical professionalism to novel issues related to involuntary treatment, research on mentally ill persons, questions about free will and nosological categories. This course will present a survey of these ethical issues by first introducing foundational concepts from ethical theory and the philosophy of psychiatry and mind. Students will be expected to become conversant in several bioethical approaches and methods and be able to use them to critically examine both historical and contemporary questions in mental healthcare and research.

• HCIN6000 - American Health Care System

  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.

• HCIN6150 - 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.

• HCIN6170 - Leading Change in Health Care

  There has been no shortage of recommendations from executives, consultants, and self-declared experts on how to improve health care. But the success rate for implementation has been low, and health care systems still struggle with problems of quality, cost, and access--not to mention high employee turnover and provider burnout. However, across the country, there have been pockets of success in improving care delivery. A number of best practices show promise, including open access scheduling, care coordination and standardization, performance measurement and feedback, the expansion of palliative care, community health worker programs, and the integration of behavioral care. Through lectures, case studies presented by multiple expert faculty, and interviews with leaders in the field, you will examine these transformative practices, and the leadership techniques that have led to their success. You will identify organizations that are primed for transformation, potential directions for leading transformation, and ways to direct change within your organization.

• HCMG2500 - Health Care Reform

  This course provides students with a rigorous understanding of the current American health care system and how it is likely to evolve over the next decade. The course will focus on six 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 including the Affordable Care Act (ACA); 4) analysis of current policies regarding provider payment, technology, and electronic health records and how various sectors (e.g. public health and hospitals) are evolving in the current system; 5) drug pricing and potential strategies for reform, and 6) future megatrends in American health care system. Throughout the course, lessons will integrate basic health economics, history, health policy, and politics to elucidate key principles for understanding the health care system. The course will also examine at least one other country’s health system for comparison. The course will end with a consideration of the long-term outlook for the structure of the US health system and potential reform. Numerous expert guest speakers will give their perspectives throughout the semester.

• HCMG8500 - Health Care Reform

  This course provides students with a rigorous understanding of the current American health care system and how it is likely to evolve over the next decade. The course will focus on six 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 including the Affordable Care Act (ACA); 4) analysis of current policies regarding provider payment, technology, and electronic health records and how various sectors (e.g. public health and hospitals) are evolving in the current system; 5) drug pricing and potential strategies for reform, and 6) future megatrends in American health care system. Throughout the course, lessons will integrate basic health economics, history, health policy, and politics to elucidate key principles for understanding the health care system. The course will also examine at least one other country’s health system for comparison. The course will end with a consideration of the long-term outlook for the structure of the US health system and potential reform. Numerous expert guest speakers will give their perspectives throughout the semester.

• HCMG8900 - Advanced Study Project

  HCMG 8900-001: This course examines issues related to the Services Sector of the health care industry. For those interested in management, investing, or banking in 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 are 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 buy out 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 8410. Health Care Management MBA majors only

• HCMG8990 - Independent Study

  Arranged with members of the Faculty of the Health Care Systems Department. For further information contact the Department office, Room 204, Colonial Penn Center, 3641 Locust Walk, 898-6861.

• PHIL1180 - Franklin and His World

  Benjamin Franklin was a preternaturally talented Renaissance man. He was a world-famous scientist whose insights into electricity are still relevant today; a leading citizen and civic leader; a first-class printer who helped define and expand the world of letters; a preeminent journalist, essayist, and aphorist; a skilled politician and diplomat. His tremendous legacy of political, cultural, scientific and civic organizations continues to influence his city and his country. His Autobiography is an essential feature of the American literary canon. But Benjamin Franklin's life also raises deep and disturbing questions for students. He owned slaves and profited from the sale of enslaved persons. He copied and reworked many of his most famous phrases. His sexual habits and behavior are incompatible with the character of the "Me Too" era. He broke promises, circulating - knowing they would become public- personal letters of great political import, which he had pledged to keep private. Through examining Franklin's life, we will consider weighty questions in history, citizenship, ethics, and science. This course will explore the life and ethos of Benjamin Franklin. We will study the history of the 18th century, including the American Revolution, the details of Franklin's life and accomplishments, and six major ethical issues he confronted. Over the course, students will follow Franklin's own advice for establishing order in life. Students will keep a detailed moral diary modeled on Franklin's. For a 5-day period, students will emulate the diet he had as a young and low-paid-adult. The course will encourage students to critically examine the 18th Century, the "great man" theory, and the ability to make moral evaluation of people living in other times. They will critically examine the relevance of the life of a world historical figure for how to lead their own civically engaged, ethical life.

• PSCI3991 - Selected Topics

  Consult department for detailed descriptions. More than one course may be taken in a given semester. Recent titles have included: Sustainable Environmental Policy & Global Politics; Shakespeare and Political Theory.

Knowledge at Wharton

• A Return to ‘Normal’: How Long Will the Pandemic Last?, Knowledge at Wharton - 7/14/2020
• Tackling Tough Decisions in End-of-life Scenarios, Knowledge at Wharton - 2/9/2015
• Hospital Advertising: Good Business, or Time to Pull the Plug?, Knowledge at Wharton - 9/24/2014
• Do MOOCs Upend Traditional Business Education?, Knowledge at Wharton - 6/3/2014
• Ezekiel Emanuel on ‘Reinventing American Health Care’, Knowledge at Wharton - 3/11/2014
• Marketing Health Exchanges: Can Paul Bunyan and the Red Sox Help?, Knowledge at Wharton - 10/9/2013
• Medical Innovation: When Do the Costs Outweigh the Benefits?, Knowledge at Wharton - 10/2/2013

Wharton Stories

• Faculty Insights: How to Lead and Work Through a Pandemic, Wharton Stories - 03/26/2020
• A New Real-Time Course Responds to Coronavirus Outbreak, Wharton Stories - 03/23/2020
• Lessons This Healthcare Management Student Took Away from a Trip to Ethiopia, Wharton Stories - 06/12/2019
• Student Builds Friendships and Expands Career at Wharton San Francisco, Wharton Stories - 05/31/2016