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Week 5 Discussion 1: Cost and Quality Week 5 Discussion 1: Cost and Quality Week 5 Discussion 1: Cost and Quality Health care cost is consistently a concern for Americans. From insurance premiums to medication prices, to surprise medical bills, and much more, it is becoming a barrier to care. Even though the Affordable Care Act has decreased the amount of those who were uninsured, it has not made overall care affordable. One of the contributions to the high cost of care is colonoscopies. Colonoscopies are the most expensive screening test and are the first-line routine screening for colon cancer (Rosenthal, E. 2013). It is not the cost of the colonoscopy procedure that makes it expensive, it is the cost of anesthesia and the anesthesiologist that brings up the price. Only moderate sedation is required for the procedure, however, the United States standard practice is to use general anesthesia. This is not only more costly for the medication, but the patient must pay for the anesthesiologist’s time. Certain lobbying actions of the American Society of Anesthesiologists have prevented doctors’ offices and hospitals from switching to moderate sedation methods (Rosenthal, E. 2013). A pilot for a proposed policy took place in 2018, that mailed out fecal immunochemical tests for people to complete at home (S. Gupta et al., 2020). This test can screen for colon cancer just like a colonoscopy and is much more cost-effective for the consumer. The reason it has not been utilized more is due to a lack of knowledge of such tests. This program turned out to be successful but there need to be policies put into place to sustain such a system and follow up on data. I would propose that a task force be put together within the American Gastroenterology Association to sustain and advocate for this program. Another aspect of health care that causes high expenses is prescription medication prices. The reason for this is because, in the United States, pharmaceutical manufacturers are allowed to set their own prices. Since America is a capitalist country, we can expect that prices will begin at a ridiculous amount. When a new drug is first released, the manufacturer is given the opportunity to have exclusivity of sales for a 5-7 year period, however, these manufacturers have found strategies to extend this exclusivity period to 12.5 Week 5 Discussion 1 Cost and Quality years on average (L. N. McEwen et al., 2017). This is not fair to consumers to have only one option for a medication that could be potentially life-saving, but detrimental to their savings. This scenario is what leads to families having to choose between health and providing food and shelter for their children and dependent loved ones. The article states that when there are five manufacturers for the same medication, the cost drops down to 33% of the original price (L. N. McEwen et al., 2017). To keep the cost of medication so high when it could easily be lowered for the greater good for a greater number of people is just criminal. Policymakers should think about reducing the years of exclusivity to a 3-5 year period. I feel like that amount of time is a good compromise to thank the pharmaceutical companies for their hard work on the job, but also it is not too long to put consumers in debt or delay them from starting treatments. One policy that Europe has that the United States should evaluate is generic prescribing. There are 13 countries that make generic drugs the mainstream of prescribing medications whereas the United States allows physicians to choose if they want to prescribe generic drugs or brand name (WOUTERS et al., 2017b). It has been my experience that most people think that brand-name drugs are more effective than the generic counterparts. There should be awareness brought to this idea and end the stigma of generic drugs if we can call it that. References: Gupta, A., LaFaver, K., Duque, K. R., Lingaiah, A., Meriwether, K. V., Gaskins, J., Gomes, J., Espay, A. J., & Mahajan, A. (2021). Pelvic Floor Health in Women with Parkinson’s Disease. Journal of Parkinson’s Disease, 11(2), 857–864. https://doi.org/10.3233/jpd-202491 McEwen, L. N., Casagrande, S. S., Kuo, S., & Herman, W. H. (2017). Why Are Diabetes Medications So Expensive and What Can Be Done to Control Their Cost? Current Diabetes Reports, 17(9). https://doi.org/10.1007/s11892-017-0893-0 Rosenthal, E. (2013). The $2.7 trillion medical bill: Colonoscopies explain why U.S. leads the world in health expenditures. Retrieved from http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html. WOUTERS, O. J., KANAVOS, P. G., & McKEE, M. (2017b). Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending. The Milbank Quarterly, 95(3), 554–601. https://doi.org/10.1111/1468-0009.12279 Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: Week 5 Discussion 1: Cost and Quality Value: 100 points Due: In an effort to facilitate scholarly discourse, create your initial post by Day 4, and reply to at least two of your classmates, on two separate days, by Day 7. Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the question below. Initial Post Select one topic below to write about in your initial post. Please make it clearly which topic you chose to write about in your initial post. Write 500 to 750 words related to: Topic 1: Discuss two major reasons why health care costs are so high in the United States and recommend at least two public policies to control health care costs. Make clear in your entry if they are policies already adopted, proposed by others, and/or ones that you would propose. Topic 2: Discuss at least two major reasons why health outcomes are poor in the United States compared to other first-world countries and recommend at least two public policies to improve health care quality. Make clear in your entry if they are policies already adopted, proposed by others, and/or ones that you would propose. Cite additional sources beyond the Learning Materials for this week. Replies Reply to at least two of your classmates. In your reply posts, each reply should be on a topic different from the one you chose to write about. Each reply should be 200 to 400 words. You should cite at least one to two sources that add new information in response to your classmate’s post. Please refer to the Grading Rubric for details on how this activity will be graded. Posting to the Discussion Forum Select the appropriate Thread. Select Reply. Create your post. Select Post to Forum. Two important examples of why U.S. health care costs are exuberantly high today include: pharmaceutical drug costs and salaries of our medical professionals. According to Karen Feldscher of the Harvard Chan School Communications (2018), the average salary for a general practice physician in the U.S. was $218,173, while in other countries the salary range was $86,607 to $154,126. However, it is not just physicians but nurses, anesthesiologists, technicians, and other medical staff in comparison to other developed countries (Harvey, 2020). Unlike other countries around the globe many governments have caps in their health workers salaries, healthcare systems costs, and put price tags on things like office visits, medication costs, and insurance reimbursements. An example of cost control in other places around the world is the use of global budgets. They are utilized on a national level and distribute resources within budgetary constraints (Shi & Singh, 2019). One bill I would propose in hopes to reduce the cost of Medicare and Medicaid as we got older, would be called the Non-Usage Act. This Act would target the many young healthy adults or even older healthy adults that have minimally utilized health care. For those who are relatively healthy and only see a MD for physicals would be a prime candidate. By not utilizing their health care would in turn produce savings for future (personal) usage. The savings would not go back to the insurance company but rather reinvested back into the patient. This would be most useful for life events such as, job loss, accidents, disability, or early retirement. A yearly fixed stipend would go into a personal health care account and saved for you when you really need it the most down the road. The introduction to Biosimilars were suggested to increase pharmaceutical competition and have the potential to “reduce health care spending by $54 billion over the next decade” (Taylor, 2015). One past proposed health reform bill was from Hillary Clinton in 1994 called The Health Security Act. This bill proposed that pharmaceutical costs be offset by rebates, price caps, and the formation of a formal advisory council that would collaborate on setting realistic drug prices, recommendations of cost, and “was intended to reduce drug prices by influencing Medicare, Medicaid, and private insurance formularies” (Daemmrich, 2011). But after millions of dollars were spent on advertisements on behalf of the drug companies the bill didn’t even reach the house or the senate. Austin Smith, head of the pharmaceutical industry trade association and a physician and former editor of the Journal of the American Medical Association opposingly stated, “that high prices compared to the costs of manufacturing were necessary to recoup the expense of failed research” (Daemmrich, 2011).References Daemmrich, A. (2011, September 14). U.S. Healthcare Reform and the Pharmaceutical Industry. U.S. Healthcare Reform          and the Pharmaceutical Industry . https://www.hbs.edu/ris/Publication%20Files/12-015.pdf. Harvey, A. (2020, May 13). Six Reasons HealthCare is so Expensive in the U.S. The Entrepreneur. The Entrepreneur Fund.          https://theentrepreneurfund.com/6-reasons-healthcare-is-so-expensive-in-the-u s/#:~:text=6%20Reasons%20Healthcare%20Is%20So%20Expensive%20in%20the,are%20 Shi, L., & Singh, D. A. (2019). Delivering health care in America: A systems approach (7th ed.). Jones & Barlett Learning.           free%20to%20charge%20what%20the%20market%20. Taylor, E. Rand Health Care. Small Ideas for Saving Big Health Care Dollars. Retrieved from https://www.rand.org/health-         care/projects/small-ideas.html. Graduate Program in Health Administration Discussion Question Rubric Note: The value of each of the criterion on this rubric represents a point range (example: 25–20 points, 20–15 points, 15–10 points, 10–0 points). Discussion Board Rubric – 100 Points Criteria Exceeds Expectations Meets Expectations Needs Improvement Inadequate Total Points Quality of Initial Post Initial post is on time and of the correct length (500–750 words). All components of the initial post requirements are addressed. Course content synthesis is applied. References are included according to the Discussion instructions. 25 points Initial post is on time and of the correct length (500–750 words). Most components of the initial post requirements are addressed. Course content synthesis is applied but limited. References are included according to the Discussion instructions. 20 points Initial post is one day late. Does not meet the correct length (500–750 words). Some components of the initial post requirements are addressed. Course content synthesis is weak or missing. References are included but not according to the Discussion instructions. 15 points Initial post is more than one day late. Initial post much fewer than (500–750 words). Few components of the initial post requirements are addressed. Course content synthesis is missing. References are not included. 10 points 25 Peer Replies On time. There was substantial evidence and synthesis of course content utilizing course topics and the introduction of questions and new information. Replies are 200–400 words. References are included according to the Discussion instructions. 25 points On time. There was some evidence and synthesis of course content utilizing course topics and the introduction of questions or new information. Replies are 200–400 words. References are included according to the Discussion instructions. 20 points There was either some synthesis of course content or the introduction of questions or new information. Replies are less than 200 words. References are included but not according to the Discussion instructions. 15 points There was little or no evidence of course content utilizing course topics or the introduction of questions or new information. Replies are less than 200 words References are not included. 10 points 25 Frequency of Contribution Initial post with two peer replies posted on two separate days. 25 points Initial post with two peer replies posted on the same day. 20 points Initial post with one peer reply. 15 points Only initial post submitted or only replied to peers. 10 points 25 Organization, Writing Mechanics, and APA Format Clearly organized, no or limited writing mechanics and/or APA errors. 25 points Clearly organized, few to some writing mechanics and/or APA errors. 20 points Poorly organized, several to moderate writing mechanics and/or APA errors. 15 points Poorly organized, many writing mechanics and/or APA errors. 10 points 25 Total points 100 Order Now