Discussion: Healthcare, Economics, and Moral

There is no doubt that money and economics makes things move in our society today. Even churches, charitable organizations, and humanitarian groups need money and funding to stay open. Healthcare is no exception, there is an economic engine that drives deliverance of healthcare, and as our text puts it graciously, “Similarly, the healthcare market as viewed by economists is amoral: When confronted with finite resources, there will be losers and winners. This is a tough concept for nurses to swallow” (Mistead, 2016, p. 285).

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This week’s discussion is about the turbulent relationship between cost and care. As a registered nurse who have taken care of numerous patients, I wish nothing but the best for my patients far as their health and wellbeing. Though I would like to say that healthcare has strengthen in the humanistic position outlined by the Nightingale pledge, the romanticized ideals of healthcare is diminishing, and the postmodern technology and economics driven engine is now driving healthcare towards its future.

In a simple model of economics, supply and demand curve is often used to teach basic principles of economy. One of the many factors of growing prices of healthcare is that demand is greater than the supply (Knickman & Kovner, 2015, p. 219). In the basic goods and services model, when demand rises, several things happen: first prices tend to go up, two the free market sees an opportunity to meet supply (thus make profit) so competition will supply the demanded goods and services, and lastly prices will stabilize once demand is met.

In the healthcare market, demands for healthcare services provided is met by hospitals, clinics, and other ancillary specialties that required trained and licensed professionals (Knickman & Kovner, 2015, p. 214-215). However, of course, the healthcare market does not behave in the standard economic behavior, for supply is “constrained by licensure and educational requirements (Knickman & Kovner, 2015, p. 2019). Registered nurses, by far, comprise of the largest portion of the health care occupations in the United States (Knickman & Kovner, 2015, p. 215), and just like any supply chain, it too can be affected by economic upwind and downturns.

In a narrative review on nursing labor markets during economic downturns, Alameddine and his colleagues reviewed the implications of quality of care in healthcare when the nursing labor forces froze or decreased (Alameddine et al., 2012). The paper recommended to larger healthcare employees and governments that adequately stabilizing and even increasing the nursing workforce during an economic downturn lead to stabilization of providence of healthcare and increased quality of care (Alameddine et al., 2012). This is easier said than done.

The Washinton Post review by Rob Stein, regarding prostate drug Provenge, brings in light the controversy that occurred when Medicare officials reviewed if the cost versus benefit of Provenge, in short, whether to pay for it or not (Stein, 2010). The debate on prices for essential medication has been in the topic of healthcare debate recently, to include Epipen and insulin price hike by pharmaceuticals. This bring up the issue of FDA providing patents for companies to come up with new drugs, essentially creating a monopoly in the market place, until the patent period runs out and generics can be manufactured, a 20-year time frame (Pauly, 2018). In an economic sense, is paying a million dollars for a short prolongation of quality of life worth it? In my opinion, it is not, but I realize that subjectively, 2 to 4 years with a loved one is invaluable for an individual, but objectively costly for society.

There is a consensus that our medical care cost and delivery is inefficient and needs to be improved (Pauly, 2018). To me, there is not silver bullet, for healthcare is a divers and complex organism that require a holistic, multidisciplinary approach to solve for its inefficiency and waste. I believe that by discussing thoroughly, with personal biases aside, is the key to making compromise at all level, in which we can finally benefit society as a whole.

Reference

Stein, R. (2010, November 08). Review of prostate cancer drug Provenge renews medical cost-benefit debate. Retrieved March 14, 2018, from http://www.washingtonpost.com/wp-dyn/content/artic…

Alameddine, M., Baumann, A., Laporte, A., & Deber, R. (2012). A narrative review on the effect of economic downturns on the nursing labour market: implications for policy and planning. Human Resources for Health,10(1). doi:10.1186/1478-4491-10-23

Knickman, J., Kovner, A. R., & Jonas, S. (2015). Jonas and Kovners health care delivery in the United States(11th ed.). New York: Springer Publishing Company.

Milstead, J. A. (2016). Health policy and politics: a nurses guide(5th ed.). Burlington, MA: Jones & Bartlett Learning.

Pauly, M. V. (2018). The Business of Healthcare and the Economics of Healthcare: Shall Ever the Twain Meet? International Journal of the Economics of Business,25(1), 181-189. doi:10.1080/13571516.2017.1395241