Although there is often political pressure to create programs that increase access to services, these programs often are unfunded mandates. The expansion of insurance coverage is directly linked to health care costs, and controlling these costs presents a tremendous challenge. This week’s readings present information on cost evaluation; potential trade-offs related to cost, quality, and access; and financial and economic principles that apply to cost evaluation in delivering health care services.
An example of the difficulty of addressing these competing interests can be seen in a case study concerning the economics of end-stage renal disease (ESRD). In 1972, Congress implemented a Medicare program to offset the cost of treating ESRD; however, rising costs and an expanding ESRD patient population have led to an unanticipated level of spending. As a result, Medicare’s ESRD program presents policy makers with the challenge of balancing cost, quality, and access. This Assignment focuses on ethical, financial, and quality of care aspects surrounding the issue.
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