NURS 6050 week 3 Discussion: Financing of Health Care Essay

NURS 6050 week 3 Discussion: Financing of Health Care Essay

Discussion: Financing of Health Care

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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? NURS 6050 week 3 Discussion: Financing of Health Care Essay. 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.

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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. NURS 6050 week 3 Discussion: Financing of Health Care Essay.

To prepare:

  • Read the following case study, “Hard Economic and Finance Choices in US Healthcare” (Milstead):
    • Case Study 1: Hard Economic and Finance Choices in US HealthcareApplied 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 ‘will of the people’ about how to use scarce resources for the good of a nation. NURS 6050 week 3 Discussion: Financing of Health Care Essay.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 NURS 6050 week 3 Discussion: Financing of Health Care Essay. 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 Provenge™. 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 “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. NURS 6050 week 3 Discussion: Financing of Health Care Essay.
  • 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 outside resources. NURS 6050 week 3 Discussion: Financing of Health Care Essay.

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 format.
  • Share an insight from having read your colleagues’ 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. NURS 6050 week 3 Discussion: Financing of Health Care Essay.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Reference:

National Health Expenditures 2010 Highlights, Centers for Medicare & Medicaid Services (n.d.). Retrieved from https://www.cms.gov/NationalHealthExpendData/downloads/highlights.pdf

 

Main post:

The dynamics of this discussion puts us in the middle of a debate, in which I can see merit in both side of this coin. The “vaccine” treatment of advanced prostate cancer, with a price tag of $93,000, and has shown to extend patient lives about four months (Stein, 2010). Quite a hefty amount for a treatment to extend life for such a short period of time on the dime of the tax payer, some might think. NURS 6050 week 3 Discussion: Financing of Health Care Essay. Much of this debate is because the cost of Provenge, which was approved by the FDA was disclosed prior to approval and Medicare usually covers cancer drugs approved by the FDA. However in this case the price was disclosed and as Milstead stated, “By law, MedPAC is not allowed to use price or cost of any treatment in the decision-making process” (Milstead, 2016). Some felt that is the cost was not included that the debate for this drug wouldn’t exist. Another concern is that denial of this drug by Medicare would discourage pharmaceutical companies from developing cancer drugs (Stein, 2010).

Ethically, as health care providers we want the best and most effective treatment for our patients as possible. However, we must also consider that the some $1 billion that could be potentially spend on patients with “advanced” prostate cancer, might be able to be put to better use than the extension of life for several months. The United States leads the world in healthcare spending, yet we are not leading the world in any of the positive health aspects, (i.e. infant mortality, life expectancy, death rate, etc.) (Holtz, 2016) NURS 6050 week 3 Discussion: Financing of Health Care Essay. This type of health care spending may not be beneficial for the greater population. According to Milstead, studies continue to show that there is no correlation between increased spending on health care spending on health care in the United States and the reduction in population morality (Milstead, 2016). Because of this tension between cost and care can be greatly strained, we must face the question of “does this cost of $93,000 for a treatment 100,000 times over, worth causing more deficits in health than there currently is?” and “are we not following of commitment of nonmaleficence to ‘do no harm’ by denying a patient those extra moments of life”.

References:

Holtz, C. (2016). Global Health Care Issues and Policies . Burlington, MA: Jones & Bartlett.

Milstead, J. (2016). Health Policy and Politics: A nurse’s guide. Burlington, MA: Jones & Bartlett Learning.

Stein, R. (2010, November 8). Review of prostate cancer drug Provenge renews medical cost-benefit debate. Retrieved from The Washington Post: http://www.washingtonpost.com/wp-dyn/content/article/2010/11/07/AR2010110705205.html

NURS 6050 week 3 Discussion: Financing of Health Care Essay

 

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