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Medicare and cost-effectiveness analysis: time to ask the taxpayers
Marthe R Gold1, Shoshanna Sofaer, Taryn Siegelberg
1City University of New York Medical School, New York City, NY, USA. goldmr@med.cuny.edu
Health Affairs (Project Hope)
|September 13, 2007
Summary
Americans may accept healthcare limits if involved in decision-making. Engaging the public in cost-effectiveness analysis (CEA) for Medicare coverage can help address affordability concerns and resource allocation challenges.
Area of Science:
- Health economics
- Public policy
- Bioethics
Background:
- Medicare faces increasing affordability challenges for taxpayers and beneficiaries.
- Cost containment strategies are proposed, but cost-effectiveness analysis (CEA) is underutilized for coverage decisions.
- Public willingness to accept healthcare constraints is largely untested.
Purpose of the Study:
- To review evidence on public willingness to accept healthcare limits and priority setting.
- To explore the potential role of the public in Medicare's resource allocation decisions using CEA.
- To address the perception that Americans are unwilling to accept healthcare constraints.
Main Methods:
- Literature review of existing evidence on public attitudes towards healthcare constraints.
- Analysis of ethical and normative issues surrounding CEA in healthcare.
- Examination of public engagement models for resource allocation.
Main Results:
- Evidence suggests the public may be willing to accept healthcare constraints when informed and involved.
- Public engagement in CEA can address ethical and normative concerns.
- The public is suitable for involvement in broad Medicare resource allocation discussions.
Conclusions:
- Public engagement is a viable strategy for shaping Medicare's resource allocation.
- CEA can be a tool for Medicare coverage decisions with public input.
- Addressing public perceptions is key to implementing healthcare cost-containment measures.
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