Important Aspects in Policy Making of Healthcare

Policy Decision-Making Process

The American health bill's financial costs reside with people ultimately sponsoring the payments; these are federal, state, and local governments, private businesses, and families. They disburse out-of-pocket costs and insurance premiums, or fund healthcare via general incomes or dedicated tax. Additionally, they determine the kinds of health schemes to be provided, persons entitled to plan participation, cost-sharing plans to enforce (deductibles, premiums, and co-payments), and the amount of coverage made available. The above sponsors also hold the responsibility of amassing finances and bankrolling programs or payers, such as Medicare, Medicaid, and private insurance (National Health Expenditures 2010, n.d.).

Healthcare expenditure burdens on care sponsors can be assessed by means of the ratio of individual sponsors' spending towards health in relation to the resources they possess. In the case of private businesses, the health spending burden is examined in relation to aggregate compensation (salaries and wages). Private businesses' healthcare expenditure in 2010 constituted 10.2% of private salaries and wages, and 8.5% of overall staff compensation. Both these percentages were reduced by a slight amount in 2010, following a peak in the previous year. Health spending burden on families is assessed in relation to their adjusted personal earnings. This share, from 2003 to 2008, remained relatively stable (around 6%). It rose to 6.3% in 2009, while the next year, it marginally reduced to 6.2%. The marginally smaller household healthcare burden in 2010 resulted from a larger rise in personal earnings, compared to their health spending. In the case of local, state and federal governments, healthcare spending burden is evaluated as a percentage of revenues. The federal revenue share that financed federal government healthcare spending soared from 38% (2008) to 53% (2009), with an increase in federal spending towards Medicaid and Medicare; meanwhile, federal revenues dropped because of the December 2007 economic recession (National Health Expenditures 2010, n.d.).

Washington Post example

An atypical review is being performed by federal authorities to ascertain whether a costly new prostate cancer medication must be financed by the government; a debate has been reawakened over whether the cost of some treatments is too high. While Medicare isn't expected to count cost as a factor in making such decisions, the resolution of initiating a formal inspection has led cancer specialists, drug companies, policymakers, advocates and patients suffering from prostate cancer to voice concerns. These have been augmented because of the review emerging after a harsh debate on healthcare reform, tainted by accusations of 'death panels' and rationing. Often, new drugs for cancer are covered by Medicare following Food and Drug Administration (FDA) approval. Many Congress members contested the decision to inspect the prostate drug 'Provenge'. This has for some time remained controversial. In 2007, the treatment's approval was delayed by the FDA. This rejection gave rise to patient outrage, in addition to bringing down the ire of Dendreon investors and advocate groups. Dendreon is the Seattle-based firm which developed Provenge. Firm executives claim that the drug's cost is in keeping with the cost of other medications for cancer. Every Provenge treatment, (development cost estimated by the firm at 1 billion dollars), is customized to individual patient needs, leading to higher costs, according to Dendreon's CEO, Mitchell H. Gold (Stein, 2010).

Consider how policy decisions currently are made about what will and will not be paid for and what changes, if any, could improve the process