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?