Week 3 discussion
Financing of Health Care
With coinciding concerns about health care costs and the
imperative to improve quality of care, health care providers and others face
difficult decisions in the effort to achieve an appropriate balance. Such
decisions often are addressed in the policy arena. How do policymakers evaluate
which health care services should be financed through government programs? How
do ethics-related questions and other considerations play into this evaluation
process? Is it possible to contain costs and provide accessible, high-quality
care to all, or is the tension between cost and care inherent in the U.S.
health care delivery system? These questions are central to health care
financing decisions in the United States.
For this Discussion, you will focus on the policy
decision-making process that determines what types of care are covered by
public and private insurers and the ethical aspects of such financial
Read the following case study, â€œHard Economic and Finance
Choices in US Healthcareâ€ (Milstead):
Case Study 1: Hard Economic and Finance Choices in US
Applied economics is all about managing scarce resources.
Economics is an amoral field of study: it is neither moral nor immoral.
Morality and values are determined by individuals at the personal level and by
group consensus or majority opinion at the national level. State and federal
governments determine the â€˜will of the peopleâ€™ about how to use scarce
resources for the good of a nation.
The U.S. health care system is an exemplar of scarcity:
primary care physicians, substance abuse treatment centers, trauma centers,
registered nurses, and the money to pay for goods and services. Finance is all
about how to pay for goods and services. The Medicare Payment Advisory
Commission (MedPAC) is appointed by the Executive branch of the federal
government to make decisions about what the Medicare program will and will not pay
for. In this role, MedPAC makes decisions about medications, procedures and
treatments. Examples of MedPAC decisions include coverage for left ventricular
assistive devices as a destination therapy, coverage for bariatric surgery, and
in 2010, coverage of the drug Provengeâ„¢. By law, MedPAC is not allowed to use
price or cost of any treatment in its decision-making processes.
Review the information in the Washington Post article
â€œReview of Prostate Cancer Drugs Provenge Renews Medical Cost-Benefit Debateâ€ in
the Learning Resources.
Consider how policy decisions currently are made about what
will and will not be paid for and what changes, if any, could improve the
Reflect on how the Washington Post example illustrates the
tension between cost and care.
By Day 3
Post your analysis and assessment of the ethical and
economic challenges related to policy decisions such as those presented in the
Washington Post article. How does this type of situation contribute to the
tension between cost and care? Substantiate your response with at least two
By Day 6
Respond to at least two of your colleagues on two different
days in one or more of the following ways:
Ask a probing question, substantiated with additional
background information, evidence, or research using an in-text citation in APA
Share an insight from having read your colleaguesâ€™ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleaguesâ€™ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
National Health Expenditures 2010 Highlights, Centers for
Medicare & Medicaid Services (n.d.). Retrieved from
Milstead, J. A. (2013). Health policy and politics: A
nurse’s guide (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers.
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