Economic Evaluation in Health Care Essay

Healthcare Economics Evaluation

This report is about a proposed healthcare economics investigation. Some early research has been done and will be described based on what was found and how it was found. The report will conclude with a proposed plan for further economic evaluation on that same topic with a great deal the expected and proper form and function of that research to be described in that section. A conclusion will wrap up the report.

Critical Appraisal of the Evidence

Topic Selected

The author of this report has chosen how to make health care affordable and have the most amount of people possible covered in the United States as this is one of the more omnipresent issues and matters in American society in the modern time. Health care being at the forefront of the American news cycle is nothing new as it is has been a huge part of the political and social discussions since the Great Depression and the pitch went up greatly in the 1960's when Medicare was enacted (Berkowitz, 2008). Healthcare as a "right" and getting people covered is important, but the amount of confusion and straight up demagoguery that is occurring is quite vile and really helps no one ("Protecting childen's right," 2012).

Research Found

There seem to be, at least to the author, two major points-of-view that exist in the American political sphere, both with politicians themselves and with the populace. The first opinion is commonly held by the right wing of American politics (mostly Republicans and Libertarians) that feel that government intrusion and over-regulation of health care is the wrong way to go and should not be happening. They feel that either the market can and should regulate itself and/or they feel that the government intruding into the healthcare sphere is wrong on its face.

The common argument for the former is that the market can do better on its own at all times than if the government intercedes and that the greater the intrusion and footprint the government has, the worse off everyone is. The argument commonly made for latter can be presented using an example. The linchpin of the recent Patient Protection and Affordable Care Act (PPACA), often referred to as "ObamaCare," is that American citizens are compelled by matter of law to get insurance or pay a penalty (Souter & Gurevitz, 2012)("The gloves off," 2012).

Many right-wing voices, including Libertarians, view this oft-referred to "individual mandate" as unconstitutional and thus the entire law must be struck down (Klein, 2012). The Supreme Court of the United States has weighed in on this already but has thus far refused to strike down ObamaCare (Souter & Gurevitz, 2012). The left has generally labeled right-wing politicians who wish to limit growth (or repeal) legislation like ObamaCare and the like as heartless and greedy. Many proponents say the individual mandate is too weak because the fine is not high enough and doesn't discourage people from skipping getting health insurance even when they can afford it and should get it (Souter & Gurevitz, 2012).

The left wing American politics postulates that health care is a right that all Americans are entitled to and any/all government resources (including massive amounts of taxpayer income) should be dedicated to getting people insured through setting up of health care exchanges, expansion of Medicaid and other general assistance and stipends for the poor (Daly, 2012)(Dunn, 2012). The left generally favors expansion (or at least a consistent baseline based on inflation and population growth) of existing programs and often push for tax hikes to fund more initiatives or expansions of existing initiatives. This leads many right-wing people to refer to the left wing as "tax and spend liberals" ("Budget problems," 2012)(Hofer, Abraham & Moscovice, 2011).

There are a few factors and thoughts that greatly fuel the invective on this subject and it often leads to some disgusting banter and public relations initiatives on both sides, both from politicians and non-politicians. A few general examples were touched upon above, but there are many, many more. A specific example would be when House Representative Paul Ryan first proposed his budget framework to revamp Medicare due to projections that it would be completely bankrupt within a generation or two. Not long thereafter, an ad surfaced of a person depicting Paul Ryan pushing a wheelchair-bound woman off a cliff (Ephraim, 2012). Similar accusations have been made against Republicans making accusations against President Obama, up to and including racism (Enck-Wanzer, 2012).

However, politicians simply mudslinging rather than trying to work together given the divided states of Congress right now with the GOP in firm control of the House and the Democrats easily having control over the filibuster and what bills are even brought to the floor in the Senate, there are indeed some pertinent and important questions that should be asked (and answered) if there is truly any desire to get a firm resolution to the healthcare cost and spending problems in the United States (Mayer, 2010).

One of those factors is mentioned at the end of the last paragraph, that being spending. One dimension of spending that has to be address is the spending level of the federal government. Many people are sounding the alarm about spending and deficits with the United States and there is indeed some causes for concern. The total amount of United States debt is going up quite sharply. Second, the United States has run trillion dollar deficits every single year for roughly a half a decade now. Third, the projected annual spending arcs for Medicare, Medicaid and Social Security all look extremely dire given the amount of money that will be required to cover the top-heavy (age demographic-wise) nature of the United States population, with retiring Baby Boomers and the benefits they will require far out-stripping the funds that will be coming in when they are need over the next few decades (Samuelson, 2009).

Another factor that also has to be named, and it also relates to spending, is the terrible choices that a lot of patients make, and they take several different forms. One example is people going to the doctor for the most minor thing for no good reason. Sure, there is reason to be concerned if someone that is very young, very old or that has a compromised immune system getting sick and those people should get strict and detailed attention (Warren, 2012)(Wong et al., 2011). However, an average person in average health should not ever be going to the doctor for a common cold or flu bug unless it gets really nasty including such things as a very high fever, the virus not going away timely or something like that. Similarly, many people go the emergency room for mundane and minor reasons and that is deemed by many to be a bad trend as well (Sun et al., 2010).

One major part of any reform package is increased malpractice lawsuit protections for doctors. Many doctors and healthcare professionals prolifically overuse healthcare tests and procedures so as to avoid lawsuits if something is missed. That needs to stop. Even doctors' groups, and their mission is to "do no harm," admit that testing is far over-done when it is simply not called for. Being sure of a diagnosis and prognosis is fine, but wasting money (especially money from government/taxpayer sources) should not be occurring as it is in finite supply. Even therapy methids and types are overused as well. It is not limited to the simple diagnosis phase of the medical process (Bovbjerg & Schoenbaum, 2004).

The aforementioned poor health choices of many Americans is the "elephant in the room" that many people refuse or are unable to talk about. People that do deign to point out the malfeasance and carelessness of many Americans are often condemned as heartless. However, to suggest that many disorders and diseases are not of the person's own doing or at least simply negligence is simply a fallacy and no amount of politically correct speech, whatever that means to any given person, is going to change that.

One great example is the extensive drug use and smoking of many Americans of all ages. It is undeniable fact that extensive smoking often leads to cancer, organ failure and so forth and the amount of money that goes into keeping these people functional or even just alive is jaw-dropping. This is not to suggest that these people should be forsaken and left to die. Instead, it needs to be recognized that a lot of the people contributing to the rising healthcare costs are people that are creating costs out of their own stupidity and these folks are often many of the same people that cannot or will not pay their own way vis-a-vis healthcare, whether it be by getting a job that gets them covered or at least paying their own bills as they come up. The above doesn't even mention illicit drugs (or illicit drug use) such as illegal prescription drug use or hard drug (heroin,…