So, welcome to our Specialization Overview of the healthcare marketplace, Coursera course. What we're going to do to walk through this specialization is talk to you about the four courses in capstone experience that lay ahead. So best way to probably dive into this thing is to use a landscape picture of the entire healthcare marketplace. And this actually is going to be emphasized quite a bit for the first course which is actually called the healthcare marketplace. It's an overview of all these different constituencies that you see. This is taking somewhat of a US focus. But it also pretty much applies to most other countries in terms of a government role and where different actors, whether they be physicians, hospitals, insurers, all come together. What's interesting about this graphic is that Congress plays a key role. And it's, in the US, very important because Congress basically creates, if you will, the funds and the appropriations for much of the public health system, and Medicare, and Medicaid, and major pieces to operate. Some of the big obvious players when you look at that map are the insurers with their sort of sand-colored building that's sort of there to the left. And then the physicians and hospitals over to the right of them, there's very obvious roles in terms of what they're engaged in. The medical technology firm, which could be pharma and medical devices, is off to the top. Big business is mentioned there as well. This is emphasized a lot in course one, because what makes the US system unique is that much of the health insurance system that finances the US health economy comes from large employers, and so they play a critical role. Federal government up there in that lovely blue building plays a role in the whole space in terms of administrating many of the government programs, including Department of Defense programs and Veteran's Affairs. And then, probably the most critical thing on the rings, you don't have a system unless you actually have patients that are getting care. And patients come to you in all shapes and sizes and walks of life, whether they're coming from Main Street or they're high income individuals, and we kind of emphasize those issues as well. So course one really talks about the dynamic of all of these actors that are in play. Some of their history over the last 100 years, a common theme is their monopoly rights, which define a lot of what makes the US health economy unique. And then ultimately, you end course one with a sense of a market sizing idea for either concept or innovation in the space that involves a different actors that you've seen. Then we get to course two, and course two focuses on the physicians and the hospitals. So, physicians and hospitals are really the core of what you would think of for any major healthcare market per se. And we start with them because they really set the tone for most of the market. Without essentially physicians and hospitals, we really don't have much of a system to talk about. Physicians play a key role crafting new medical technologies, innovations. Many times, they're entrepreneurs, not just caregivers. They also exercise a tremendous amount of monopoly rights. The hospitals function as their workshop, and we talk about that in course two. What's great about course two is that it's being led by a physician who focuses on healthcare innovation and how the fusion of the physician trade and the hospital trade come together to create really unique healthcare delivery opportunities. Then we move over to course three. Now course three is actually being taught by someone who works in the medical technology space and mainly the pharmaceutical space. And what the emphasis there is going to be on medical devices, say like implantable cardiac defibrillators, literally bringing you back to live, like a CPR machine essentially in your chest. Talk about pharmaceuticals, which is well known, and also biotechnology for advanced personalized medicine in genetics that are really fine tuned just to you. And many of the coming and actually emerging cures for cancer for different site-specific cancers come from that biotechnology space. So in course three, what we emphasize is what makes essentially the manufacturing side of whether a device or pharmaceutical so unique, the regulatory issues that go on with the Food and Drug Administration in the U.S. and other regulatory agencies around the world. Also recognizing that the medical technology market is truly a global market where really the U.S. is only maybe 30 or 40% of that market, and the rest of the developed and developing world occupies the rest of that space. We talk about how these technologies get reimbursed. Very few of the very high tech procedures are ever paid for by cash. They require to be reimbursement is the key word from different insurance companies whether they be public insurance companies, like a Medicare, or private insurance company like a Blue Cross Blue Shield. And then we go to class four, and class four is kind of interesting. I know we have the picture here of the insurers, you're like, what, is it a course on insurers? Well, no, actually, course four is called Medical Technology Evaluation and Market Research. And the reason why that matters is that the insurers really make the determination on whether a major technology is going to get paid or not. And they're really public insurers as well as private insurers. Many times actually private insurers subcontract out their work to the public insurers. So for example, Medicare, which is the largest public insurance program for the elderly and disabled in the United States, most of it operates through private insurance companies for its administration. And so in medical technology evaluation, we talk about cost effectiveness analysis. We talk about comparative effectiveness. We talk about the criteria that are used not just in the U.S but also globally to get a medical technology reimbursed by one of these insurers, and without that reimbursement really, you can't go to market. So, one of the skills that people learn in course four is really getting a much more in depth understanding of what the reimbursement strategy will be, as well as competitive analysis of what products. Otherwise, we're in that space. Then we wrap the entire specialization with a capstone experience. And a lot of the other actors that we talked about in that landscape now all come into play. So our capstone experience focuses on this idea of having a valuation of an innovation. This is something that we're very proud of at the University of Minnesota, that we work with our students to learn how to do. It's where you take a new idea, it could be a medical technology, it could be a different process for delivering care. And we look at it from the perspective of an investor in saying, is this ready to go to market? And the reason why we have so many different actors there, whether it's Congress sort of sitting over in terms of the Medicare program or Main Street USA or different folks of income. Is that, to a certain extent, you have to have green lights across the board for almost all of these technologies that are in place. For an investor to shell out millions of dollars to take a promising technology, which could be a cure for cancer, and give it to the market. We've actually looked at situations where, literally, cures for cancer are not invested in. Because there just isn't enough green lights across the board to go forward. So that sort of blue modern building at the bottom there, that's Medicare, essentially they have to agree to pay for the technology. The courts are involved as well because the courts govern most of the law in terms of intellectual property restrictions. Intellectual property, if you don't have that locked down, if your patents and copyrights, you might as well stop now. The large employers are also involved because they actually set their own terms and agreements for whether the technology will be allowed to come to market or not. And then finally, the voice of the consumer and just Main Street, will they even buy it? Is it actually in their right price point to go? And even for folks that are in the 1% at the top right there in that 99% category, maybe it's something that they're going to pay cash for. But it's gotta really cure what's going on if it's going to be that unique market. So in the capstone experience, people write a report that basically is their investor document. And we find that that is one of the strongest ways that someone can introduce themselves to the market for a career change once they complete this specialization in the healthcare marketplace. [SOUND]
