Discussion: Population Health Advocacy
Respond to your colleagues by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
*Please keep in mind that your classmates will be referred to as colleagues throughout this program.
Post by a Classmate:
RE: Week 3 Discussion
NURS 6050- Population Health Policy and Advocacy
Discussion in Week 3
Healthcare, Economics, and Ethical Considerations
There is no doubt that money and economics drive our society today. Churches, charitable organizations, and humanitarian
organizations all require money and funding to stay open. There is an economic engine that drives healthcare delivery, and as our text graciously puts it, “Similarly, the healthcare market as viewed by economists is amoral: When confronted with finite resources, there will be losers and winners.” This is a difficult concept for nurses to grasp” (Mistead, 2016, p. 285).
This week’s topic is the tumultuous relationship between cost and care. As a registered nurse who has cared for many patients, I wish nothing but the best for their health and well-being. Though I would like to say that healthcare has strengthened its humanistic position as outlined by the Nightingale pledge, romanticized ideals of healthcare are fading, and a postmodern technology and economics driven engine is now propelling healthcare into the future.
The supply and demand curve is frequently used in a simple economic model to teach basic economic principles. One of the many factors contributing to rising healthcare costs is that demand exceeds supply (Knickman & Kovner, 2015, p. 219). When demand rises in the basic goods and services model, several things happen: first, prices tend to rise; second, the free market sees an opportunity to meet supply (and thus profit), so competition will supply the demanded goods and services; and finally, prices will stabilize once demand is met.
Demand for healthcare services is met in the healthcare market by hospitals, clinics, and other ancillary specialties that require trained and licensed professionals (Knickman & Kovner, 2015, p. 214-215). Of course, the healthcare market does not behave normally, because supply is “constrained by licensure and educational requirements” (Knickman & Kovner, 2015, p. 2019). Registered nurses, by far, make up the majority of health care occupations in the United States (Knickman & Kovner, 2015, p. 215), and they, like any supply chain, are susceptible to economic ups and downs.
Alameddine and his colleagues examined the implications of quality of care in healthcare when nursing labor forces froze or decreased in a narrative review on nursing labor markets during economic downturns (Alameddine et al., 2012). The paper advised larger healthcare employees and governments that adequately stabilizing, if not increasing, the nursing workforce during an economic downturn leads to the stabilization of healthcare provision and an increase in quality of care (Alameddine et al., 2012). It’s much easier said than done.
The Washington Post’s Rob Stein review of the prostate drug Provenge highlights the controversy that arose when Medicare officials considered the cost versus benefit of Provenge, in short, whether to pay for it or not (Stein, 2010). The debate over the cost of essential medications has recently dominated the healthcare debate, with pharmaceutical companies raising the price of Epipen and insulin. This raises the issue of the FDA issuing patents to companies to develop new drugs, effectively creating a monopoly in the market until the patent period expires and generics can be manufactured, a 20-year time frame (Pauly, 2018). Is it economically feasible to pay a million dollars for a brief increase in quality of life? In my opinion, it is not, but I recognize that 2 to 4 years with a loved one is subjectively invaluable for an individual but objectively costly for society.
There is widespread agreement that our medical care costs and delivery are inefficient and must be improved (Pauly, 2018). There is no silver bullet, in my opinion, because healthcare is a diverse and complex organism that necessitates a holistic, multidisciplinary approach to address inefficiency and waste. I believe that thorough discussion, free of personal biases, is the key to reaching compromises at all levels, from which we can eventually benefit society as a whole.
R. Stein (2010, November 08). The Provenge prostate cancer drug review reignites the medical cost-benefit debate. Retrieved on 14 March 2018 from http://www.washingtonpost.com/wp-dyn/content/artic…
M. Alameddine, A. Baumann, A. Laporte, and R. Deber (2012). A narrative review of the impact of economic downturns on the nursing labor market: policy and planning implications. 10 Human Resources for Health (1). doi:10.1186/1478-4491-10-23
J. Knickman, A. R. Kovner, and S. Jonas (2015). Health-care delivery in the United States, according to Jonas and Kovners (11th ed.). Springer Publishing Company, New York.
J. A. Milstead (2016). A Nurse’s Guide to Health Policy and Politics (5th ed.). Jones & Bartlett Learning, Burlington, MA.
M. V. Pauly (2018). Will the Business of Healthcare and the Economics of Healthcare Ever Meet? International Journal of Business Economics, 25(1), pp. 181-189. doi:10.1080/13571516.2017.1395241
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