Health System – Imagine an alternative universe where ‘health insurance


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Answer at least FIVE (5) any of the following ELEVEN (11) questions for full credit. You may also answer a sixth for extra credit (optional).

You may use any resources necessary to help you answer these questions. Please note that I will value your own, original perspectives more than just repeating what another author says, but if you do use numbers, make sure you identify the source.

All of them are designed to have multiple ways of answering. I am never looking for one specific solution, just your personal ideas, viewpoints and assessments.

One paragraph to one page per answer should suffice to address most of them, but do not worry so much about length as long as you answer what was asked. Sometimes even bulleted lists may be appropriate. Just make sure you give attention to each part of a multi-part question.


1. Imagine an alternative universe where ‘health insurance’ was suddenly outlawed in the USA. All medical payments become an out-of-pocket expense directly charged by doctors, hospitals and pharmacists . No Medicare, no Medicaid, No Private insurance. Ten years later, compared with the present day situation, describe the impact on:


a. Health care providers (doctors and hospitals)

b. Household finances (savings, standard of living)

c. Business profits (retail goods, restaurants, manufacturing, etc.)

d. Population health (life expectancy, infant mortality)



2. Outline at least five (5) of the major steps that would be required to convert our current healthcare system into one resembling the HC systems of Switzerland or the Netherlands. What kinds of jobs would be lost and what kind of jobs would be created? What would happen to large insurance companies?


3. Frederick Banting discovered insulin in 1923 and refused to put his name on the patent because he found it unethical for a doctor to profit from a life-saving discovery. His co-inventors James Collip sold the patent to the University of Toronto for $1 because they wanted everyone who needed it to be able to afford it. Given that history:

Insulin prices have skyrocketed in recent years, forcing people with inadequate health insurance and limited incomes to make some difficult choices.

A. Discuss what benefit value-based pricing insulin offers to the US population versus pricing based on cost of production.

B. What negative impacts might be imposed on our economy and society by pricing insulin according to “Willingness to Pay” versus “Ability to Pay”?

C. If the government were to subsidize insulin for people who can’t afford it, who do you think should set the prices for it? The government? Or pharmaceutical companies? Explain your reasoning.

D. What case could there be made for excluding Type II diabetics from an insulin-assistance program?


4. What community/population/economic class in the USA (describe them in general terms or provide an income range) do you feel is most at risk of financial ruin from a serious medical issue?


A. How would these people most likely pay for medical care?


B. Does anything in the structure of our healthcare system make them particularly vulnerable?


C. For the insured, what category or type of health insurance would be most likely to send them into medical bankruptcy (or severe financial disruption).


D. What specific aspects of healthcare systems in other wealthy countries (pick any one) prevent medical bankruptcy from ever being an issue? (Describe what happens when a not-so-wealthy person suffers from a major medical issue and contrast it with what happens here in the USA).


5. Design a (3) THREE step messaging/marketing approach that would help explain the benefits of a universal healthcare system to Americans who are unfamiliar with how healthcare gets done in other countries.


Your marketing campaign can include bumper sticker slogans and/or T-shirt designs.


Make sure you include some mention of how a changeover to such a system will affect their overall take-home pay and ability to save money. You might consider as well an explanation how the changeover would affect their healthcare experiences at the point of service (doctor’s office or hospital).



6. Mavenclad, used to combat the progression of multiple sclerosis, is one of the most expensive drugs prescribed in the USA.




What is the minimum cost of a ten day supply (10 10mg tablets) of Mavenclad in Canada versus the USA?


(Note: Patients generally take only ten pills per year)


Why are drugs so much less expensive in almost every country but the USA? Provide at least THREE (3) reasonable explanations for why drugs are so expensive in the USA and predict what would happen to the price of drugs in these other countries if the USA were to switch over to a universal healthcare system.

7. Several recent studies including one by the American Medical Association found that when cardiologists go away to conferences for a week, heart patients visiting at their clinics and hospitals tend to have fewer heart attacks and are less prone to heart failure than when the cardiologists are back and working at their institutions. Heart patients are also less likely to die during cardiology conferences.


A. Provide a reasonable and rational explanation for how this might occur.

B. Is this something you think would be unique to the USA or universal across all health systems? Explain why you think the way you do, either way.

C. Should this phenomenon change the way we care for cardiac patients?


8. How does medical care supply and demand differ from the normal economic relationship for consumer commodities and services?


Describe at least one specific scenario where the availability of some type of medical care increases in a community and explain how and why community demand might respond to that.


Note: The example can be entirely made up (fictitious) and you may draw a supply/demand curve to illustrate (optional).


Make sure you explain why medical care responds differently to supply and demand from other sectors of the economy.


9. If you were asked to design a Public Option to plug into the State Healthcare Exchanges as a competitive and less costly alternative to private insurance, what would it look like? (Describe its structure in terms of type of doctor network, deductibles, co-pays, etc.).

Make sure you describe how it would be financed and how its benefits would compare to private options already available on the exchanges

What effect would it have on private insurance products already available in the exchanges?

Note: your public option can be modeled on something that already exists or be something entirely new.

10. Respiratory Syncytial Virus (RSV) is now causing unprecedented outbreaks in hospitals all over the world (particularly in Canada where the Red Cross has come in to provide support to pediatric hospitals).

a. Describe at least three (3) of the major reasons or contributing factors for this outbreak happening so intensely at this time.

b. Do these explanations conflict and contradict each other or are they mutually supportive? Explain your reasoning.

c. Does the fact that infants less than six months old are also experiencing an unusually high incidence of RSV contradict any of these explanations.

11. Study the following maps and discuss at least TWO (2) hypotheses for why pancreatic cancer displays the incidence pattern shown:


Pancreatic Cancer


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