Wednesday, March 18, 2009

My Individual Project

Hey Team,
Just to let you know, I picked my topic. I'm reforming the general health care program in the US (different from Sanjay's cause it's for all ages). Hope you guys are having fun with your project.
Thanks,
Niko

Tuesday, March 17, 2009

Communicable Disease

General Subject Area
Communicable diseases account for one of the largest and most avoidable losses of welfare in the world. Estimates place mortality at about 90% of all avoidable diseases in most age and sex groups. Much of the global harm caused by imperative healthcare factors exists in Sub-Saharan Africa, including 90% of malaria cases. These types of illness negatively impact welfare by causing direct effects through death and loss of productivity. With a smaller workforce, the GDP of countries decreases and families relying on those wages to be earned also suffer. Indirectly, shorter life spans decrease the value of education. A workforce with less education is less innovative, not as productive, and the country as a whole will lag behind developed countries. As people choose not to save, there are less capital funds available to invest into the economy. This further stagnates economic growth in developing countries and would be circumvented through reformed healthcare.
Projects in Detail
Three opportunities are discussed. (1) Malaria is estimated to cause 1 to 3 million deaths every year. This project includes the use of insecticide-treated mosquito nets for children, a two-stage treatment of pregnant women in their first pregnancy, and a switch to more effective drug combination for treatment of those affected. (2) HIV/AIDS is a problem that drastically effect’s the developing world. Over 5% of all deaths worldwide are the cause of AIDS and it is estimated that in 2003 2.5 to 3.5 million died due to this disease. The specific project posed focuses primarily on the prevention of HIV/AIDS in high-risk areas. (3) The strengthening of health services would follow the World Bank’s 1993 World Development Report. This report called for a package that includes: comprehensive immunization, various public health programs, and clinical care for pregnancy and sick children.
Benefits
Based on estimates from the macroeconomic models provided at the Copenhagen Consensus, the economists predicted that the annualized net benefits of eliminating just 50% of malaria cases would cost Int$10-37 billion, with benefit-cost ratios between 1.9-4.7. When looking at the benefits of intervening in the HIV/AIDS crises, the study directed their attention to North Africa, the Middle East, and Asian countries that represent the worst off. They estimated that intervening would result in saving 15-30% of 2000 GNP by 2025. The annualized net benefit of HIV/AIDS control was Int$3.4 billion and a benefit-cost ratio of 14.2. Lastly, when considering just improving the basic health services of developing countries, the models predicted that the annualized net benefit would result in Int$18.2 billion and a benefit-cost ratio of 2.1.
Costs
The costs of Malaria control were based on providing the insecticide treated nets for children and infection treatment drugs. Costs based on macroeconomic models were $18 per capita with a total annualized cost of $10.177 million. A package of Malaria interventions did not have a per capita cost, however total annualized costs were $2,942 million. Costs in HIV/AIDS control include prevention programs and healthcare services. Prevention methods include blood safety using hospital testing. The promotion and distribution of condoms, AIDS education and out reach to high-risk groups. Treatment includes voluntary counseling and testing and available health care services. Based on the Thai program of prevention costs came to $4.25 per capita or $260 million total costs annualized. A Package prevention of HIV/AIDS in six regions came to $1.42 per capita or $7,345 million total costs annualized. Costs of reforming basic healthcare included providing greater immunization and school health programs. Costs based on increase health expenditure: thirteen HIPCs was $584 per child with a total annualized cost of $16,080 million. The 1993 world Development Report minimum package: low-middle-income countries costs came to $65 per capita or $337,073 million total costs annualized.
Quantifying—Dollar Value
Placing a dollar value on human life was very hard to derive for the researches considering the projects. The relation between illness and income were complex for the project managers. They came up with sources to help give those feasible numbers to attach to their projects to control diseases. The project managers looked at the microeconomic and macroeconomic studies to help determine the relationships of disease and economic outcomes on the individual level as well as a wide range of outcomes on a national level. In the end, these studies were used to evaluate efficiency of health interventions and a monetary value could be placed on human life. When looking at the specific projects of HIV/AIDS and Malaria several areas were examined to quantify the value of life. Some of the sources used were macroeconomic impact of disease, studies of cost effectiveness of intervention programs, and evidence of costs and health benefits of large country scale programs already in place. For the basic health services project, regression models were analyzed that measured the efficiency of health expenditures in generating health outcomes. Also, costs and health benefits of the package of interventions recommended in the 1993 World Development Report was considered. A year of life lost was valued at 2003 per capita Gross National Income; this was the ceiling ratio.
Discount Rate
According to the World Health Organization’s (WHO) 2002 World Health Report, the discount rate for the costs of a health program is the opportunity cost of capital, which is the rate of return that investors could be making in financial markets. In the current bear market, a good representation of the opportunity cost of capital is the rate of return of U.S. treasury bonds, because they are viewed as safe investments; the rate of return of 10-year treasury bonds as of March 13, 2009, is 2.87%, according to Google finance. The discount rate for the potential benefits of a program, however, is debatable, and the WHO report states that studies have used discount rates for benefits that range from zero to 5%. Nevertheless, the WHO report recommends that the same discount rate be used for costs and benefits. Therefore, we will use the discount rate of 3% for our cost/benefit analysis because it is the WHO discount rate, and it is a good representation of the current opportunity cost of capital.
Conclusion
When looking malaria, HIV/AIDS, and basic health services, all three produced positive net benefits. Benefits for a package of malaria interventions outweighed those based on evidence from macroeconomic models, by more than $10,000 mil in the best-case scenario. Package for prevention of HIV/AIDS greatly outweighed that of the Thai prevention program, $359, 424 mil to $3,444 mil. The benefit shown in the World Development Report for basic health services was $534,084 mil compared to the increased health expenditures net benefit of $18,236 mil. The benefits vary based on the value of life attributed, with a rather low net benefit with the US$1,250 value compared to the US$100,000 which produced a much greater net benefit. The three categories are interconnected in the fact that strengthening basic health services will improve control of malaria and HIV/AIDS, suggesting that there may be less benefits between the benefit-cost ratios when looking at disease specific interventions and general health interventions separately. Although, there is a lack of evidential base for the findings a clear message stems from the calculations—investments in communicable disease eradication or control greatly exceeds the costs.

you guys wrote too much!

Hello,
I'm doing some serious chopping. Hope you don't mind. You'll have a nice copy of the final draft waiting for you in the morning.
Sincerely,
The Butcher

Sunday, March 15, 2009

Project’s Enumerated Costs:

(I couldn't figure out how to shorten my section, enumerated costs I thought needed to identify what each project spent money on. If this is covered sufficently in another section I must have misunderstood and go ahead and remove unessesary information.

Note: The Table on Pg 104 is a good summary of costs / benefits for all three projects)

The costs of Malaria control were based on providing insecticide treated nets for children and infection treatment drugs. Costs based on macroeconomic models were $18 per capita with a total annualized cost of $10.177 million. A package of Malaria interventions did not have a per capita cost however total annualized costs were $2,942 million. Costs in HIV/AIDS control include prevention programs and healthcare services. Prevention methods include blood safety using hospital testing. The promotion and distribution of condoms, AIDS education and out reach to high risk groups. Treatment includes voluntary counseling and testing and available health care services. Based on the Thai programme of prevention costs came to $4.25 per capita or $260 million total costs annualized. A Package prevention of HIV/AIDS in six regions came to $1.42 per capita or $7,345 million total costs annualized. Costs of Basic Healthcare included providing greater immunization and school health programs. Costs based on increase Health expenditure: thirteen HIPCs was $584 per child with a total annualized cost of $16,080 million. The 1993 world Development Report minimum package: low-middle-income countries costs came to $65 per capita or $337,073 million total costs annualized.

John's Part on Discount Rate

According to the World Health Organization’s (WHO) 2002 World Health Report, the discount rate for the costs of a health program is the opportunity cost of capital, which is the rate of return that investors could be making in financial markets. In the current bear market, a good representation of the opportunity cost of capital is the rate of return of U.S. treasury bonds, because they are viewed as safe investments; the rate of return of 10-year treasury bonds as of March 13, 2009, is 2.87%, according to Google finance. The discount rate for the potential benefits of a program, however, is debatable, and the WHO report states that studies have used discount rates for benefits that range from zero to 5%. Nevertheless, the WHO report recommends that the same discount rate be used for costs and benefits, and the discount rate that the WHO uses is 3%. Therefore, we will use a discount rate of 3% for our cost/benefit analysis because it is the WHO discount rate, and it is a good representation of the current opportunity cost of capital.

Sources:

World Health Organization. (2002). Technical considerations for cost-effectiveness analysis. The World Health Report 2002. Retrieved March 13, 2009, from http://www.who.int.ezproxy1.lib.asu.edu/whr/2002/chapter5/en/index4.html

Matt's Part E

The dollar values being attached to the certain projects that were considered were not easy to put a price tag on. Placing a dollar value on human life was very hard to derive for the people considering the project. The relation between illness and income were complex for the project managers. The project managers came up with sources to help give those feasible numbers to attach to their projects to control diseases. The project managers looked at the microeconomic and macroeconomic studies to help determine the relationships of disease and economic outcomes on the individual level as well as a wide range of outcomes on a national level. The project managers used these studies to evaluate efficiency of health interventions in units so that they could place a monetary value on human life. When looking at the specific projects of HIVAIDs and Malaria, the project managers looked at several areas to help place dollar value on human life and specific units used in their project. Some of the sources used were macroeconomic impact of disease, studies of cost effectiveness of intervention programs, and evidence of costs and health benefits of large country scale programs already in place. For the basic health services project, the group analyzed regression models that measured the efficiency of health expenditures in generating health outcomes. Also, the group looked at the costs and health benefits of a package of interventions recommended in the 1993 World Development Report. To the project managers, a year of life lost was valued at 2003 per capita Gross National Income which was their ceiling ratio. The discount rates they came up with was 3%, and with their sensitivity analysis, they applied a 6% discount rate for the cost benefit project for HIV/AIDS, malaria, and basic health services.

Friday, March 13, 2009

Specific Projects Considered

Hey Guys,
Josh finished his section: Specific Projects Considered. I'd like to congratulate him on his early completion. Here it is.

There are three specific projects being considered to combat the challenges of communicable disease. These projects include: Malaria control, HIV/AIDS control, and the strengthening of basic health services.
Malaria is a parasitic disease, which is spread by the Anopheles mosquito. It is transmitted in 103 countries and is estimated to cause 1 to 3 million deaths every year. This project includes the use of insecticide-treated mosquito nets for children, a two-stage treatment of pregnant women in their first pregnancy, and a switch to more effective drug combination for treatment of those affected. HIV/AIDS is a problem that drastically effect’s the developing world. Over 5% of all deaths worldwide are the cause of AIDS and it is estimated that in 2003 2.5 to 3.5 million died due to this disease. The specific project posed focuses primarily on the prevention of HIV/AIDS in high-risk areas. The strengthening of health services would follow the World Bank’s 1993 World Development Report. This report called for a minimum package which includes: comprehensive immunization, a range of public health programs, and clinical care for pregnancy and sick children.


Monday, March 9, 2009

individual ideas

some ideas that we discussed as a group that people could be doing for individual portions:

Nutrition- Josh
HIV/AIDS - Kurtis
Cancer-
Heart Disease-
Universal Health insurance (age 5 and lower) - Sanjay
Type II Diabetes- John B
Fast Food Tax - Mark
Prescription/FDA -
Hospital modernization (eltronic conversion)-
Medical Marijuana- John

feel free to add more ideas to the pot or grab one out for yourself

Presentation

Any creative ideas for our presentation?

We can all cover the sections in our paper, but that might be boring...and I wouldn't have much to do.

Maybe a couple (2, 3 or 4) of us can focus on the presentation? What do you guys think? Who wants to do that?

-Niko

Contacts

Here's our updated Contact List:

Austin, Josh Joshua.M.Austin@asu.edu
Dorf, Mark Mark.Dorff@asu.edu 480 220 4653
Hingston, Kurtis Kurtis.Hingston@asu.edu 509 531 7990
Kumar, Sanjay Sanjay.Kumar.1@asu.edu 480 296 4002
Mirtahami, Matt M_M2324@yahoo.com 818 913 4440
Simpson, Kyle Ksimpson30@cox.net 480 215 8460
Skievaski, Nikolai nikolaiskievaski@gmail.com 480 577 9058
Snyder, Jonathon jrsnyder@asu.edu 480 603 6922

Written Project

Hey Guys,
Sorry to take so long in getting this out. Anyways, with McDowell’s intricately detailed instructions it was easy to split up the work. There are seven main parts. Here’s how we decided to do it:


A. Kurtis - General Subject Area
B. Josh - Specific Projects Considered
C. Matt or Kyle - Project's Enumerated Benefits
D. Mark - Project's Enumerated Costs
E. Kyle or Matt - How dollar values are attached to the enumerated costs/benefits and actual dollar values
F. John - Discount rate used
G. Sanjay - Summarization/Conclusion


Kyle and Matt can choose their respective sections. Let us know. The above seven sections need to fill up four double-spaced pages (exactly). That means each of you can use a little over a half page. Obviously some will be longer and others will be shorter.

I'll be gather and compiling all sections and editing for constant tone and diction, etc. If you reference any data tables please let me know the source and I'll attach in pages 6 and 7. If your section is dependent on anyone elses please feel free to contact that person and get the info you need.

All sections (save the conclusion) are due by Sunday, March 15th. I'll spend Monday putting it all together and Sanjay will write the conclusion. By Tuesday morning we should have a final draft.

Please use this blog as our communication. Post your questions and drafts etc.

Thanks,

Niko