Is the EU Closing the Gap on
Health Inequities?

1.
The World Health
Organization and European Union (EU) DETERMINE Consortium has acknowledged gaps
in health equities within and between member countries. A variety of efforts
are underway to help close those gaps.

To prepare for this
Discussion, review your Learning Resources, particularly the readings from the
DETERMINE Consortium and European Commission and the National Social Marketing
Centre video programs. Select two EU countries to focus on. Look at efforts in
those countries designed to reduce health inequities and inequality and examine
appropriate outcomes for those efforts. Evaluate the performance of the health
systems in those countries as reflected in population health data for each of
the countries. Be sure to access the CIA country profiles and WHO websites
provided earlier for the most current resources.

By Day 4, post a brief comparison
of the health status of the two EU countries you selected with that of the U.S.
Then, describe two efforts in those EU countries to reduce health inequities,
the outcome measures used to evaluate those efforts, and how those efforts
embody the EU’s fundamental principles for action on health disparities.
Finally, explain what lessons can be learned from the EU efforts you selected
that can be implemented in the U.S. nationally or by individual states.

Use APA formatting for your
discussion and to cite your resources.

NOTE: THE FIRST PART OF THE ASSIGNMENT
(DISCUSSION) IS DUE TOMORROW. THE SECOND PART (Journal Article Critique) is due
Sunday.

2.
Journal Article
Critique

Critiquing scholarly research
is an important skill for a scholar-practitioner. This week, you find an
article related to health equity in one or more countries of the European
Union.

To prepare for this
Application Assignment, select a scholarly article related to this week’s topic
(Is the EU Closing the Gap on Health Inequities?)

To complete this Application
Assignment, write a 1- to 2-page critique of the article you selected. The
first section will draw attention to substantive issues of the work. Subsequent
sections should provide an in-depth critique of the methodological
considerations of the journal article. This should not be a simple overview of
the article, but a thoughtful analysis of the scholarly work and how it relates
to the overall course or the specific weekly topic.

Your written assignments must
follow APA guidelines. Be sure to support your work with specific citations
from this week’s Learning Resources and additional scholarly sources as
appropriate. Refer to the Publication Manual of the American Psychological
Association to ensure your in-text citations and reference list are correct.

Resources: Additional case
studies of social determinants are available at
http://www.nsmcentre.org.uk/content/health-equity-social-determinants/Casestudies

Readings:

•Article: Commission of the
European Communities. (2007). Together for health: A strategic approach for the
EU 2008-2013 [White paper]. Retrieved from
http://ec.europa.eu/health-eu/doc/whitepaper_en.pdf

Together For Health: A Strategic Approach For
The EU 2008-2013: White Paper by Commission of the European Communities.
Copyright 2007 by European Union. Reprinted by permission of European Union.

•Article: European
Commission. (2003). Tackling health inequalities in the EU: The contributions
of Various EU-level actors. Retrieved from
http://ec.europa.eu/health/ph_projects/2003/action3/docs/2003_3_15_rep2_en.pdf

European Commission. (2003).
Tackling Health Inequalities in the EU: The Contributions of Various EU-level
Actors. Retrieved February 16, 2011, from
http://ec.europa.eu/health/ph_projects/2003/action3/docs/2003_3_15_rep2_en.pdf.

Read pages 1–17.

•Article: Gele, A., &
Harsløf, I. (2010). Types of social capital resources and self-rated health
among the Norwegian adult population. International Journal for Equity in
Health, 9, 8.

Retrieved from the Walden Library using the
PubMed Central database.

To continue the discussion about health care in the state of Maryland, we will discuss this week on how it is delivered. The State of Maryland is unique in that hospital rates (the cost charged for each patient admitted into a Maryland hospital) are governed by the Maryland Health Services Cost Review Commission (HSCRC). Other state’s rates are driven by what the market will bear and the prices charged are what the hospitals set themselves for the services they provide.

For example, “When a patient arrives at Bayonne Hospital Center in New Jersey requiring treatment for the respiratory ailment known as COPD, or chronic obstructive pulmonary disease, she faces an official price tag of $99,690. Less than 30 miles away in the Bronx, N.Y., the Lincoln Medical and Mental Health Center charges only $7,044 for the same treatment, according to a massive federal database of national health care costs.” (Boice, Bycoffe and Scheinkman, 2013. Huffington Post, Hospital Prices No Longer Secret As New Data Reveals Bewildering System, Staggering Cost Differences.http://huffingtonpost.com/2013/05/08/hospital-prices-cost-differences_n_3232678.html). These inflated costs are also used for negotiating discounts with private insurance companies (Medicare and Medicaid rates are set for each diagnosis).

With Maryland’s rates being set by the HSCRC, the cost of insurance here is among the cheapest in the country. Health plans that will operate on the new health exchanges created under the federal reforms will charge among the lowest premiums of any state.

Maryland is not the only state that has implemented rate setting. New York, New Jersey, Connecticut, Massachusetts, Washington and West Virginia all experimented with rate setting in the past as well. However, these states have since discontinued.

Given the success Maryland has found in providing lower health care cost, (based on the readings and your research) why do you think these states did not continue with regulating hospital rate setting?

Could price controls work nationwide? Should the federal government impose mandates on all states to have a state agency such as the HSCRC in Maryland to regulate their hospital rates? Please be specific with your reasons for why or why not and show justification from your research.

What could be the negative effects of each state’s rates being regulated as it relates to patient care?

Below is supplemental reading to this week’s discussion:

http://commonwealthfund.org/~/media/Files/Publications/Issue{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}20Brief/2009/Oct/1332_Atkinson_state_hospital_ratesetting_revisited_1015.pdf

http://marylandhbe.com/wp-content/uploads/2013/07/Analysis-of-Individual-Market-Rates-for-Health-Plans-on-Maryland-Health-Connection.pdf

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Q- 2

The Maryland Health Care Commission regulates health care in the State of Maryland. As you will note from the second assigned reading, it is comprised of 5 Centers who are very distinct. Please list out one service from each of the 5 Centers that you would find helpful as a health care administrator and why (be specific). FYI – you will have 5 separate services upon completion of this exercise.

For example, as a health care administrator (in a hospital), I am interested in adding a new service line and need to obtain a Certificate of Need. In order to obtain this Certificate of Need, I will work with the Center for Hospital Services to find out what I need to do in order to facilitate this process.

Please also see the following link for information about Maryland Certificate of Need.

http://mhcc.maryland.gov/consumerinfo/hospitalguide/practitioners/other_information/overview_of_maryland_regulatory_system_for_hospital_oversight.html

-minimum 200 words Maximum 400 words for each question.