Health care systems and policy questions

¶ … medical care sector, the decisions of what services should be produced, how they should be produced, how they should be distributed, and how to allow for growth and innovation must be made.

What combination of non-medical and medical goods and services should be produced in the macro-economy? In terms of guns or butter, the optimal balance of the production of non-medical and medical goods and services in the macro-economy would also include adequate provisions for defense. In sum, to the extent that this combination favored non-medical and medical goods and services in the macro-economy would be the extent to which defense spending would be diminished in the production-possibility frontier (Bandyopadhyay & Sandler, 2014).

What particular medical goods and services should be produced in the health economy? There is a growing recognition that preventive health care services are far more cost effective than reactive approaches that only intervene when people develop medical disorders (Palmer & Midgette, 2008). Therefore, besides conventional allopathic care, the health economy should also produce medical goods and services that address risky lifestyle behaviors that can cause and exacerbate health care disorders (Palmer & Midgette, 2008).

C. What specific health care resources should be used to produce the final medical goods and services? There is also growing recognition in the health care community that evidence-based practices are the foundation of effective interventions (Brown & Ecoff, 2011). Therefore, because health care resources are by definition scarce, priority should be given to those resources that produce the most efficacious medical goods and services that are based on gold standard research (Brown & Ecoff, 2011).

D. Who should receive the medical goods and services? For the above questions, how are these decisions currently being made? In an ideal world (and certain countries where socialized medicine exists), everyone who is in need of medical goods and services would receive them as resources allowed. In the current setting, though, medical goods and services are commodities that respond to the forces of supply and demand and more affluent consumers receive better health care as a result. Consequently, decisions concerning what combination of non-medical and medical goods and services should be produced in the macro-economy are based on their potential profitability rather than their utility in treating so-called "orphan diseases" that afflict the majority of humankind in less developed regions of the world (Picavet & Dooms, 2011).

E. What are the various purposes that prices serve? As noted above, the profitability of medical goods and services remains an overarching factor in determining what types and how much of expenditures are allocated to different medical goods and services. Although expenditures on drugs to treat orphan diseases are projected to increase in the coming years, these expenditures will still remain relatively low compared to the global expenditures for other medical goods and services (Picavet & Dooms, 2011).

F. If fewer high school graduates pursue a career in nursing, what effects will this have on the medical care market(s)? Taken to an extreme, if there was just one nurse in the entire world, he or she would command an exorbitant salary. Similarly, to the extent that shortages in the nursing profession exist because of a lack of new nurses entering the employment pipeline will be the extent to which the costs of medical care will increase in the future (Heller & Nichols, 2001).

Part II- Healthcare

2. Please discuss with detailed evidence some of the significant historical antecedents in the evolution of our health care delivery "industry" (sector), from 1776 to the present time.

In 1796, Edward Jenner's work with inoculations resulted in efficacious vaccinations for smallpox (Medical advances, 2015). On July 16, 1798, the U.S. Marine Hospital Service was established by President John Adams to provide relief for sick and disabled seamen (Chronology of events, 2015). In 1836, the present National Library of Medicine was established as the Library of the Office of the Surgeon General of the Army (Chronology of events, 2015). During the period from 1879 through 1896, vaccines were developed for cholera, anthrax, rabies and typhoid fever, and effective treatments for malaria and a vaccine for plague were introduced in 1897 (Medical advances, 2015). On December 1, 1873, regulations were issued concerning the appointment and promotion of medical doctors in the Marine Hospital Service, thereby establishing the first federal government career service for civilian employees (Chronology of events, 2015). In 1878, the first Federal Quarantine Act was passed and Congress appropriated funds "for investigating the origin and causes of epidemic diseases, especially yellow fever and cholera" (Chronology of events, 2015, para. 5). In addition, in 1879, the U.S. Congress approved the establishment of the National Board of Health which was the federal government's first formal medical research effort (Chronology of events, 2015).