1) See Part VII (Chapters 23–25) in our textbook, “The United States in International Context,” and/or additional resources such as those listed below. Specify the single most important lesson from the experience of some other country that YOU would recommend for use in the development or reform of U.S. health policy—and explain WHY.

(2) Describe IN DETAIL how you believe this lesson would apply to the U.S. context—including the benefits you would expect and likely obstacles to its successful implementation (cultural values, political alignments, stakeholder interests, economic factors, etc.).

(3) How would you propose to effectively address the objections and concerns of those whose positions on the matter differ from your own?

Other recommended resources: 

  • Beckfield, Jason, Sigrun Olafsdottir,      and Benjamin Sosnaud. 2013. “Healthcare Systems in Perspective:      Classification, Convergence, Institutions, Inequalities, and Five Missed      Turns.” Annual Review of Sociology 39:127–46.
  • Busse,      Reinhard, Miriam Blümel, Franz Knieps, and Till Bärnighausen. 2017.      “Statutory Health Insurance in Germany: A Health System Shaped by 135      Years of Solidarity, Self-Governance, and Competition.” The Lancet 390(10097):882–97.      doi:10.1016/S0140-6736(17)31280-1.
  • Herzlinger,      Regina E., Barak D. Richman, and Richard J. Boxer. 2017. “Achieving      Universal Coverage Without Turning to a Single Payer: Lessons from 3 Other      Countries.” JAMA 317(14):1409–10.      doi:10.1001/jama.2017.1475.
  • Maioni,      Antonia. 1997. “Parting at the Crossroads: The Development of Health      Insurance in Canada and the United States, 1940–1965.” Comparative      Politics 29(4):411–31.
  • Reid,      T. R. 2010. The Healing of America: A Global Quest for Better,      Cheaper, and Fairer Health Care. New York: Penguin Books.
  • The      Lancet Oncology. 2018. “The NHS: Failing to Deliver on Beveridge’s      Promise?” [editorial]. The Lancet Oncology 19(1):1.      doi:10.1016/S1470-2045(17)30918-X. Retrieved January 7, 2020 (https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30918-X/fulltext).

Your original discussion post should be at least 450 words; please include a word count at the end of your posting. You MUST use concepts, theories, facts, etc., from your textbook and/or from peer-reviewed journals or reputable internet sources in your discussion (and cite your sources). 

Deborah Stone introduces us to the two most important values in health
care. We cannot have all we want of both fairness and efficiency, so we
have to think about trade-offs between them. In the process. we Learn a
more fundamental Lesson: How to think about values in health policy?

Two powerful ideals- fairness and efficiency-drive health –
policy debates. These ideas unite us around lofty goals. only
to divide us the minute we get down to details. That’s not
only because there is an inherent tension between fairness
and efficiency. but also because each ideal has multiple mean-
ings. Different interpretations of fairness and efficiency define
different kinds of community. They draw different boundar-
ies. boundaries that include or privilege some people while
excl ud ing or disadvantaging others. Inside these grand ideals
lurk many dilemmas for those who would use them as ya rd-
sticks for policy evaluation.

EFFICIENCY
Let’s start with efficiency, for though it is less inspiring than
fai rn ess. it is more o ft en taken for granted as an objective
stan dard and an incontrovertible value in health policy.

Efficiency is another word for a bargain . It is getting the
most for t h e least or. in slightl y more economic terms .
producing the most output fo r a given input. All policy

reformers promise to give the country a bargain. Every per-
son with a program to peddle promises that this program
will save more than 1t costs. Efficiency is one of those
motherhood values that everybody 1s for. so long as no
one spells out exactly what it means-but 1t papers over a
lot of conflicts

The idea behind efficiency is engagingly simple: First. we
measure the costs and benefits of any program. proposal. or
procedure. Then with measurements in hand. we compare
them and choose the course of action with the highest ratio of
benefits to costs That’s all eff1c1ency is: getting the most we
can for a given cost. A smart policy analyst or manager should
be able to determine the most efficient way of accomplish-
ing a goal. Who could be against efficiency? It is obviously a
universal good.

Or is it? I want to challenge the assumption that efficiency
1s an empirically measurable fact I want to suggest. instead.
that efficiency is a concept that always comes from a point of
view. Efficiency can be Judged only from a particular vantage
point. and just as there are multiple vantage points in society.

I I APT ER I • Values in I lea Ith Policy: Understanding Fairness and Efficiency

so there are muluple effic1enc1es From a political science per-
spective. efficiencies are like poht1c1ans-they are tied to con·
stJtuenc1es And 1f we understand eH1c1ency this way. 1t will
be easy to see why someone might be against a policy reform
that promises efficiency let me illustrate with five examples.

The

1) See Part VII (Chapters 23–25) in our textbook, “The United States in International Context,” and/or additional resources such as those listed below. Specify the single most important lesson from the experience of some other country that YOU would recommend for use in the development or reform of U.S. health policy—and explain WHY.

(2) Describe IN DETAIL how you believe this lesson would apply to the U.S. context—including the benefits you would expect and likely obstacles to its successful implementation (cultural values, political alignments, stakeholder interests, economic factors, etc.).

(3) How would you propose to effectively address the objections and concerns of those whose positions on the matter differ from your own?

Other recommended resources:

· Beckfield, Jason, Sigrun Olafsdottir, and Benjamin Sosnaud. 2013. “Healthcare Systems in Perspective: Classification, Convergence, Institutions, Inequalities, and Five Missed Turns.” Annual Review of Sociology 39:127–46.

· Busse, Reinhard, Miriam Blümel, Franz Knieps, and Till Bärnighausen. 2017. “Statutory Health Insurance in Germany: A Health System Shaped by 135 Years of Solidarity, Self-Governance, and Competition.” The Lancet 390(10097):882–97. doi:10.1016/S0140-6736(17)31280-1.

· Herzlinger, Regina E., Barak D. Richman, and Richard J. Boxer. 2017. “Achieving Universal Coverage Without Turning to a Single Payer: Lessons from 3 Other Countries.” JAMA 317(14):1409–10. doi:10.1001/jama.2017.1475.

· Maioni, Antonia. 1997. “Parting at the Crossroads: The Development of Health Insurance in Canada and the United States, 1940–1965.” Comparative Politics 29(4):411–31.

· Reid, T. R. 2010. The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Books.

· The Lancet Oncology. 2018. “The NHS: Failing to Deliver on Beveridge’s Promise?” [editorial]. The Lancet Oncology 19(1):1. doi:10.1016/S1470-2045(17)30918-X. Retrieved January 7, 2020 (https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30918-X/fulltext).

Your original discussion post should be at least 450 words; please include a word count at the end of your posting. You MUST use concepts, theories, facts, etc., from your textbook and/or from peer-reviewed journals or reputable internet sources in your discussion (and cite your sources).