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Numerous sources report that the United States spends more per capita on health care than other industrialized nations. In 2010, Medicare and Medicaid Services stated that medical-related expenditures exceeded 2.6 trillion dollars; however, indications are that these high expenditures are not improving health outcomes to the degree expected. What makes containing health care costs so difficult? What are the ethical issues of balancing cost with providing greater access to health care and improving quality?
This week, you will consider health care economics and how cost influences the decision-making process regarding coverage. You will also examine the trade-offs related to cost, quality, and access—three factors that drive the health care policy process.
Order an original nursing assignment on Health Care Economics and Financing
Analyze ethical and economic challenges related to policy decisions concerning health care in the United States
Assess the major reimbursement mechanisms for health care services in the United States
Analyze trade-offs related to cost, quality, and access
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.
Chapter 11, “Health Care Financing” (pp. 231–251)
This chapter attempts to unravel several of the complexities in America’s health care system, and it also provides an analysis of the health care/insurer/patient relationship and how hospitals are actually funded.
Chapter 12, “Health Care Costs and Value” (pp. 253–270)
Rising costs of health care and potential approaches to constraining growth in health care expenditures are examined in this chapter.
Chapter 10, “Health Workforce” (pp. 213–225)
This chapter looks at the nature of the supply and demand for health care professionals in the United States.
Milstead, J. A. (2016). Health policy and politics: A nurse’s guide (5th ed.). Burlington, MA: Jones and Bartlett Publishers.
Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 283-308)
This chapter breaks down the basic elements of economics as they relate to health care, explaining how consumer choice combined with limitations on what hospitals can supply affects the type of care given.
Reinhardt, U. E. (2010, Jan 20). State of the nation (a special report): Voices—A good start. The Wall Street Journal, p. R5.
Retrieved from the Walden Library databases.
This article describes how the U.S. health care reform bill seeks to obtain better value for the U.S. health care dollar by generating more research into cost-effective care.
Stein, R. (2010, November 8). Review of prostate cancer drugs Provenge renews medical cost-benefit debate. The Washington Post. Retrieved from http://www.washingtonpost.com/wp-dyn/content/article/2010/11/07/AR2010110705205.html
This article describes a federal review conducted to determine whether Medicare expenditures should be allocated to an expensive prostate cancer vaccine. The author details both sides of the debate on the issue.
Laureate Education (Producer). (2012c). Healthcare economics and financing. Baltimore, MD: Author.
Discussion: Financing of Health Care; health care economics and financing assignment
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 decisions.
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Read the case study “Economic Impact of States Declining Medicaid Expansion” on page 305 of the Milstead text.
Review the information in the Washington Post article “Review of Prostate Cancer Drugs Provenge Renews Medical Cost-Benefit Debate” 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 process.
Reflect on how the Washington Post example illustrates the tension between cost and care.