U.S. healthcare system’s financing and delivery of services

    Who Should Pay?

    This week you have been examining the U.S.

    healthcare system’s financing and delivery of services.

    Consider the issue highlighted in the article “Cancer

    Drugs Offer Hope, but at a Huge Expense.”Given that

    we have limited resources, what is the best use of our

    healthcare dollars? Should expensive treatments be

    provided to everyone who would benefit from them? If

    so, who should bear the costs, for instance, should it be

    third-party insurance, Medicare, Medicaid, or the

    individuals themselves paying out-of-pocket? There are

    other important facets to this issue. Should resources

    be used to provide basic services to the greatest

    number of people, such as through immunization?

    Should the drugs be rationed in any way, to keep costs

    down?

    Prepare for this Discussion by reflecting on these and

    other questions that may have come to mind as you

    read the article. In your posting you will need to take a

    position about who should pay, and defend it. In

    support of your position, be sure to refer to relevant

    policies you have been learning about this week

    regarding financing and delivery of healthcare services

    in this country.
    Post by Day 4 the following information: (Reminder:

    Your initial response must be made in a single posting.)
    • State your position about who should

    receive the kind of high-cost cancer drugs described in

    the article, and how those drugs should be paid for.

    Make sure to justify your position.
    • Based on your readings this week, are

    there current U.S. healthcare policies that address this

    issue? Explain where they stand on this issue.

    Application: Core Policy Analysis- 2 pages

    For this Application, which you will begin this week

    and complete by the end of next week, you are asked

    to analyze a core policy about health or healthcare.

    Examples might include policies on scope of practice

    for healthcare practitioners or on health insurance for

    children. After selecting your policy, locate resources to

    help you understand the specifics of it, including how its

    programs are organized and financed, how the services

    are delivered, and, generally, how well the policy has

    been implemented to date.
    Make sure to select a policy on which you can focus in

    some detail. If you choose to analyze the policy on

    insurance for poor children, for example, you will soon

    discover that this policy differs from state to state, so

    you might wish to focus primarily on your state’s policy.

    Search Walden Library’s databases to find an article

    explaining the background on this policy—the journal

    Health Affairs, for example, frequently publishes

    summaries on initiatives in child health insurance.
    In addition, learn about the pros and cons of this policy

    by locating opinion statements issued by state or

    national organizations, such as the American Hospital

    Association (AHA) or American Medical Association

    (AMA). Many of these organizations have Web sites in

    which they not only explain their perspective or opinion

    on a policy but also have legislative sections with

    commentary on policy proposals currently under

    consideration in government.
    To analyze this core policy, it is important that you

    gather this breadth of information. In your paper, you

    must cite the following:
    • At least two articles, Web sites, or other

    credible and neutral sources providing analysis of this

    core policy; at least one of these sources must be a

    peer-reviewed article.
    • At least two opinion statements from

    stakeholders regarding the policy. To find these,

    consider who the stakeholders would be. AMA, for

    example, has an important stake in whether or not

    children are covered by insurance or not, and would be

    a good source for such a statement. Look also for

    opinion papers from other professional or special-

    interest organizations. These might be on Web sites or

    in journals. At least one of these statements should be

    from a stakeholder Web site.
    After reviewing these materials, write a two to three

    page paper in which you address the following:
    1. Summarize the policy and its main goals.

    Describe its implications on organization, financing, and

    delivery of healthcare services in the U.S.
    2. Discuss why you think this policy was

    introduced and any challenges it has faced. For

    example, has it faced major challenges in being funded

    or implemented?
    3. Summarize the opinions you have read.

    Based on this and your own understanding of the issue,

    do you think the policy needs to be changed

    significantly in order to meet its goals?
    4. Include an APA bibliography (in addition to

    the body of the two to three page paper), with a

    minimum of the four references, as described above.
    Note: This paper is due by Day 7 of Week 4. See the

    Week 4 Application Assignment area for submission

    instructions.

    4A- 1 page

    The documentary film Salud provides an international

    perspective on one of the most pressing of social

    issues—access to healthcare.

    What did this film show about the Cuban system that

    helps shed light on the U.S. healthcare system? Prepare

    for this Discussion by recalling Cuba’s healthcare

    access and funding policies and comparing and

    contrasting them with those of the U.S.

    Post by Day 4 the following information: (Reminder:

    Your initial response must be made in a single posting.)
    • Compare and contrast the Cuban

    healthcare system, as seen in the film Salud, with the

    U.S. system, particularly in terms of quality and access.


    • In light of this film and your other Learning

    Resources this week, state your own views on the

    strengths and weaknesses of U.S. policies on

    healthcare. What would you change in the U.S.

    system? Are there pieces in the Cuban healthcare

    system that you think the U.S. should adapt?

    5A- one page
    In your media and other Learning Resources this week,

    you discovered some of the ways in which community

    health assessment and strategic planning are conducted.

    You heard Dr. Guerra describe the ways in which San

    Antonio benefitted from using one particular

    assessment process, MAPP. But each community

    presents its own unique assessment challenges and

    opportunities.

    For this Discussion, you will investigate how another

    organization conducts assessments. Begin by finding

    out whatever you can through Web searching about

    your local or state health department’s approach to

    assessment and strategic planning. Find out also if there

    are initiatives at the state level to coordinate health

    assessments from the various communities in the state.

    If so, are there tools and forms available to do that?

    (See the Iowa state Web site as an

    example:http://www.idph.state.ia.us/chnahip/Guide.asp

    x.)

    Then locate and interview someone who has been

    involved in community health assessment and strategic

    planning at either a local or state level. To find a person

    to interview, contact your local health department.

    Depending on the size of the department, you may wish

    to ask to interview the director or else ask to be

    referred to someone who has participated in

    assessment and strategic planning. If you prefer, you

    could instead call your state health department; each

    state should have personnel who deal with coordinating

    strategic plans from individual counties, and one of

    these individuals might be a good person to interview.

    Your interview may be conducted over the phone or

    via e-mail, or in person if you prefer. (Note: You must

    transcribe or summarize your interview and post it.)

    Prepare your thoughts and questions carefully in

    advance so you can be succinct in your interview. In

    your interview, you should ask them questions along

    these lines, as well as any other questions you think are

    appropriate to the organization or individual you are

    working with:

    1.
    2. How do you assess the needs of your

    community? How often do you conduct assessments?
    3. What use did you make of the assessment

    data? Did you develop a strategic plan or something

    similar for your department and/or for the community?

    Please describe this plan. (For example, how detailed

    is it? Is it a long-range plan?)
    4. What are your thoughts about the

    assessment process? How well is it working? What are

    specifc strengths of the process from your

    perspectives? Any barriers or difficulties to overcome?

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