With?coinciding?concerns?about?health?care?costs?and?the?imperative?to?improve?quality?of?care,?health?care providers?and?others?face?difficult?decisions?in?the?effort?to?achieve?an?appropriate?balance.?Such?decisions?often are?addressed?in?the?policy?arena.?How?do?policymakers?evaluate?which?health?care?services?should?be?financed through?government?programs??How?do?ethics?related?questions?and?other?considerations?play?into?this evaluation?process??Is?it?possible?to?contain?costs?and?provide?accessible,?high?quality?care?to?all,?or?is?the tension?between?cost?and?care?inherent?in?the?U.S.?health?care?delivery?system??These?questions?are?central?to health?care?financing?decisions?in?the?United?States. For?this?Discussion,?you?will?focus?on?the?policy?decision?making?process?that?determines?what?types?of?care?are covered?by?public?and?private?insurers?and?the?ethical?aspects?of?such?financial?decisions. Case?Study?1:?Hard?Economic?and?Finance?Choices?in?US?Healthcare? Applied?economics?is?all?about?managing?scarce?resources.?Economics?is?an?amoral?field?of?study:?it?is?neither moral?nor?immoral.?Morality?and?values?are?determined?by?individuals?at?the?personal?level?and?by?group consensus?or?majority?opinion?at?the?national?level.?State?and?federal?governments?determine?the??will?of?the people??about?how?to?use?scarce?resources?for?the?good?of?a?nation.? The?U.S.?health?care?system?is?an?exemplar?of?scarcity:?primary?care?physicians,?substance?abuse?treatment centers,?trauma?centers,?registered?nurses,?and?the?money?to?pay?for?goods?and?services.?Finance?is?all?about?how to?pay?for?goods?and?services.?The?Medicare?Payment?Advisory?Commission?(MedPAC)?is?appointed?by?the Executive?branch?of?the?federal?government?to?make?decisions?about?what?the?Medicare?program?will?and?will not?pay?for.?In?this?role,?MedPAC?makes?decisions?about?medications,?procedures?and?treatments.?Examples?of MedPAC?decisions?include?coverage?for?left?ventricular?assistive?devices?as?a?destination?therapy,?coverage?for bariatric?surgery,?and?in?2010,?coverage?of?the?drug?Provenge?.?By?law,?MedPAC?is?not?allowed?to?use?price?or cost?of?any?treatment?in?its?decision?making?processes. Review?the?information?in?the?Washington?Post?article??Review?of?Prostate?Cancer?Drugs?Provenge?Renews Medical?Cost?Benefit?Debate??in?the?Learning?Resources.?(website?that?is?included) 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. […]