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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