HE ASSIGNMENT-ANOUD

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Read Foundation College, Samahni *

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SOCIAL PSY

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Business

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Nov 24, 2024

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docx

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2 Exercise 1 1. Benefits of three hypothetical policies Policy A Policy B Policy C Extra years in good health 21 30 25 Extra wedding festivities 100 5 10 Extra miscarriages 0 5 10 Additional warm friendships 1000 2500 200 Costs: Total government expense 1000000 2000000 1300000 Costs per QALY 47,619 66,116 50980 Costs per WELLBY 449 404 16250 Net Value (Traditional) 50,000 -500,000 -50000 To calculate the Costs per QALY, Costs per WELLBY, and Net Value (Traditional) for each policy, we will use the unit values provided for each outcome. Here are the calculations: Policy A: Costs per QALY: Extra years in good health: 21 * 1 = 21 QALYs Extra wedding festivities: 100 * 0 = 0 QALYs Extra miscarriages: 0 * 0.05 = 0 QALYs

3 Additional warm friendships: 1000 * 0 = 0 QALYs Total QALYs: 21 QALYs Costs per QALY : Total government expense / Total QALYs = 1,000,000 / 21 = 47,619 Costs per WELLBY: Extra years in good health: 21 * 6 = 126 WELLBYs Extra wedding festivities: 100 * 1 = 100 WELLBYs Extra miscarriages: 0 * -48 = 0 WELLBYs Additional warm friendships: 1000 * 2 = 2000 WELLBYs Total WELLBYs: 2,226 WELLBYs Costs per WELLBY : Total government expense / Total WELLBYs = 1,000,000 / 2,226 = 449 Net Value (Traditional): Total benefits (at Traditional value) - Total costs Total benefits (at Traditional value) = (21 * 50000) + (100 * 0) + (0 * 0) + (1000 * 0) = 1,050,000 Net Value (Traditional ) = Total benefits (at Traditional value) - Total costs = 1,050,000 - 1,000,000 = 50,000 Policy B: Costs per QALY: Extra years in good health: 30 * 1 = 30 QALYs Extra wedding festivities: 5 * 0 = 0 QALYs Extra miscarriages: 5 * 0.05 = 0.25 QALYs Additional warm friendships: 2500 * 0 = 0 QALYs Total QALYs: 30.25 QALYs Costs per QALY : Total government expense / Total QALYs = 2,000,000 / 30.25 = 66,116 Costs per WELLBY: Extra years in good health: 30 * 6 = 180 WELLBYs

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4 Extra wedding festivities: 5 * 1 = 5 WELLBYs Extra miscarriages: 5 * -48 = -240 WELLBYs Additional warm friendships: 2500 * 2 = 5000 WELLBYs Total WELLBYs: 4,945 WELLBYs Costs per WELLBY : Total government expense / Total WELLBYs = 2,000,000 / 4,945 = 404 Net Value (Traditional): Total benefits (at Traditional value) - Total costs Total benefits (at Traditional value) = (30 * 50000) + (5 * 0) + (5 * 0) + (2500 * 0) = 1,500,000 Net Value (Traditional) = Total benefits (at Traditional value) - Total costs = 1,500,000 - 2,000,000 = -500,000 Policy C: Costs per QALY: Extra years in good health: 25 * 1 = 25 QALYs Extra wedding festivities: 10 * 0 = 0 QALYs Extra miscarriages: 10 * 0.05 = 0.5 QALYs Additional warm friendships: 200 * 0 = 0 QALYs Total QALYs: 25.5 QALYs Costs per QALY: Total government expense / Total QALYs = 1,300,000 / 25.5 = 50,980 Costs per WELLBY: Extra years in good health: 25 * 6 = 150 WELLBYs Extra wedding festivities: 10 * 1 = 10 WELLBYs Extra miscarriages: 10 * -48 = -480 WELLBYs Additional warm friendships: 200 * 2 = 400 WELLBYs Total WELLBYs: 80 WELLBYs Costs per WELLBY: Total government expense / Total WELLBYs = 1,300,000 / 80 = 16,250

5 Net Value (Traditional ): Total benefits (at Traditional value) - Total costs Total benefits (at Traditional value) = (25 * 50000) + (10 * 0) + (10 * 0) + (200 * 0) = 1,250,000 Net Value (Traditional ) = Total benefits (at Traditional value) - Total costs = 1,250,000 - 1,300,000 = -50,000 2. [10 points] Which policy is the most attractive if you have a QALY cost-effectiveness policy? Which policy is the most attractive if you have a WELLBY cost-effectiveness policy? Which policy is the most attractive if you look for maximum Net Value (Traditional).  For QALY cost-effectiveness it will be policy A  For WELLBY cost-effectiveness it will be policy B  To Maximize Net Value (Traditional) it will be policy A 3. [10 points] If you are willing to pay 2500 per WELLBY, which policy/policies would you fund? If you are willing to pay 45000 per QALY, which policy/policies would you fund? Since I am willing to pay up to 2500 per WELLBY, both Policy A and Policy B have costs per WELLBY below that threshold. Therefore, I would fund both Policy A and Policy B. If I’m willing to pay 45,000 per QALY, I would fund none of the policies because they are above the available amount. Exercise 2: (30 points) Consider the Rubella Vaccine. 1. [10 points]: Argue whether the Rubella Vaccine is a “Good Illness”? Use the same criteria to reason this as given for the polio vaccine in class. To assess the merits of the Rubella vaccine as a "Beneficial Ailment," we can utilize the standards deliberated upon in our classroom for determining the excellence of an illness. These guidelines encompass severity, transmissibility, preventability, and long-term ramifications. Let us scrutinize each factor within the scope of Rubella. Rubella, also referred to as German measles, typically causes only minor ailments in both children and adults. Nevertheless, for expectant mothers, it carries the potential for grave health

6 consequences. Should a pregnant woman contract Rubella, it may give rise to congenital rubella syndrome (CRS) in the unborn child, causing critical congenital malformations such as deafness, blindness, cardiac abnormalities, and cognitive impairments (1). Given the potential gravity of Rubella's effects on fetal development, one could contend that the disease is far from benign in light of the harm it can potentially inflict. The spread of Rubella is closely linked to its high transmission rate, rendering it a concerning and challenging disease to control. This highly contagious virus can be transmitted through respiratory droplets between individuals, even prior to the manifestation of symptoms. As a result, the significant transmissibility of Rubella poses a heightened threat for outbreaks and complicates efforts towards containment. The substantial capacity for transmission renders Rubella an inadequate ailment. "The Rubella vaccine boasts great potential in thwarting Rubella infection, ensuring the safeguarding of individuals and also bolstering herd immunity. By attaining substantial coverage of vaccinations, we can notably curtail Rubella transmission and shield susceptible groups such as expectant mothers and their unborn offspring." The Rubella vaccine's potency as a preventive measure strengthens the assertion that Rubella is not a desirable malady (2). Rubella's long-term implications are significant as highlighted previously; exposure to the virus during pregnancy can result in severe consequences for newborns. Congenital rubella syndrome (CRS) may cause lasting handicaps and medical complications for those affected. The potential ramifications of Rubella emphasize the disease's detrimental effects, making it far from a "benign" illness. After careful evaluation of the parameters outlined, one could postulate that the Rubella vaccine falls short of being deemed a "Good Illness." The gravity of Rubella's impact on expectant mothers and their fetuses, in addition to its highly communicable nature and enduring repercussions linked to congenital rubella syndrome (CRS), accentuate the criticality of immunization as a safeguard against Rubella and its detrimental aftermath.

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7 2. [10 points] Suppose a weak variant of a disease arises naturally. How could health authorities help speed up the spread of a naturally-arising “good illness” in order to use it as a natural form of inoculation? Health officials can expedite the dissemination of a weaker strain of an illness, which possesses innate immunizing qualities, through the following measures. Surveillance and monitoring are vital measures for identifying the emergence and proliferation of the feeble strain. Health authorities must establish extensive surveillance mechanisms, encompassing continuous tracking of the variant's prevalence and transmission dynamics within the populace. Public awareness and education can be fostered by health authorities through the implementation of public awareness campaigns. It is imperative to enlighten individuals on the merits and drawbacks of utilizing the inferior type as a natural form of immunization. This encompasses disseminating accurate knowledge regarding herd immunity and the potential advantages of widespread immunity. Health authorities can implement focused immunization initiatives to inoculate individuals against the milder form of the disease. Prioritizing select demographic categories, including those at elevated risk or capable of transmitting the illness to vulnerable persons, can aid in this endeavor. Health officials must collaborate and coordinate with healthcare providers, researchers, and other stakeholders to gather empirical data, formulate guidelines, and successfully implement strategies for promoting the spread of the weaker variant as a means of natural inoculation. Ultimately, it is imperative to emphasize that the notion of a feeble strain emerging as a "beneficial ailment" remains conjectural, and precise approaches and remedies may vary based on the character of the affliction and available scientific data. A general finding for many virus strains, including the covid strains, is that immunity for future strains is built up by exposure to previous strains (eg. https://www.nature.com/articles/s41577- 022-00809- x). In this light, consider the main four covid variants in the period 2020-2023: alpha, beta, delta, omicron. 3

8 3. [10 points] Argue on the basis of evidence you can find which one of these four is most like “a good illness” in that it causes the least severe problems itself but gives the most protection against later and more aggressive strains With the current information at hand, it can be inferred that the Omicron variant of SARS-CoV-2 conforms most closely to the qualifications of a "good illness." During the course of the pandemic, four dominant variants of the SARS-CoV-2 virus – namely alpha, beta, delta and omicron – have been identified as responsible for causing COVID-19. Our objective was to determine which variant could potentially manifest as a benevolent ailment by producing less severe symptoms while also providing immunity against more virulent strains. To this end, each variant was individually scrutinized.  Alpha is associated with severe illness and has a high capacity to spread.  The beta variant exhibits diminished potential in inducing robust immunity.  Delta elicited robust immune responses, possessed high transmissibility, and inflicted debilitating illness.  The Omicron variant has been found to elicit less severe symptoms, display heightened transmissibility, and confer substantial immunity against other strains. Therefore, referring to Omicron variants as a "good illness" could be the optimal choice. It is a relatively benign affliction in comparison to other ailments and preceding mutations. Exercise 3 : (30 points) Read this newspaper article on telehealth in Australia: https://www.smh.com.au/technology/pillmillsor-the-future-of-medicine-the-rise-of-the- telehealth-industry-20230117-p5cdb3.html Using the information in this article, and other information you can find, analyze and critique the Australian telehealth market on the basis of the four major economic problems in health systems, as discussed in class pertaining to the Singapore model. So argue whether the telehealth market as it is now developing solves or worsens the credence good problem, and the other three main problems in health. The writing talked about how in Australia, more people started using Telehealth because of the COVID-19 Pandemic. It showed many different ways to get treatment through this service, and

9 really it has made getting help easier for everyone. Instead of waiting a long time to meet with a regular doctor or traveling far just to get more medicine, you can look for medical help earlier. Looking at the Singapore way that deals with four important money matters in health services, this study looks closely at how Australia's telehealth market faces these special challenges. The puzzle of Trustworthy Goods . It happens when people who are sick cannot judge if their healthcare is good enough, and so they can't know what treatment they really need. Patients, however, might gain a lot if Australian telehealth services were to give more clear and detailed information. Some websites are very clear about how they work, showing that their doctors are good at giving medical care and writing prescriptions. This makes it easier for people to get treatment and helps trust in their service. Some platforms, they use sales ways that make people worry because not always it seems right. Many possible ways exist for wrong medical practice, like giving too many medicines or making mistaken health judgments. Also, if people cannot check the qualifications of internet doctors and nurses properly, this problem can become bigger. Problem about Health Entertainment come when people use doctor service more for fun or fake feeling better, not real sick need. Telehealth make it easy to get health help and rich people may do this too much. People who feel their sickness is very serious might use online health services more, which can change the types of patients using them. This situation may make it harder and more expensive for those who have to pay for these services. The problem of not knowing what will happen is there when people who are sick do not have enough information or their sickness is very complicated, so they can't tell what will happen if they choose a treatment. When we use medical help over the phone or internet, it might make it even harder to deal with health concerns because it feels less personal. If we use technology too much, it might be easy to miss small but important details that we would notice if we were there in person. This could make the problem of not being sure about things even worse.

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10 Healthcare has many different groups with their own goals, like doctors, big medicine companies, and insurance providers. They often think about what they want first which might not be the same as what patients need. This can change health rules and how doctors work in ways that don't always help people's real health problems. The writing mentions that some new rules in telemedicine might be different from the usual international ways because business goals can become more important than ways to help patients and spending money on them. Big companies buying others show a growing interest for business in this field. Even though telehealth is still at an early stage in Australia, it gives us a chance to put in the right safety measures and protections to stop too much influence. Additionally, Telehealth can help solve ethical issues by giving easy-to-access and useful basic health care. It encourages people to look for treatment quickly on their own, which helps avoid the need for costly procedures later on. It can also help stop too many unneeded doctor visits that some healthcare workers cause, because it's more convenient and doesn't always need you to go see the doctor face-to-face. Telehealth changes how money matters work - it can make getting care easier for less cost and lower risks of doing wrong things, but there might be some problems like people not trusting it as much. Bonus Exercise : (20 points) Pick a non-Arab-speaking country. Find out what its latest official health expenditure is. [10 points] Ascertain how much additionally is spent on water, sewage, garbage collection, electricity/gas, and clean air. [10 points] Give a reasoned estimate for the total spending in that country on health including the Sanitary expenses In 2020, Germany's total national health expenditure was €428.8 billion, equating to 11.9% of its GDP that year. This excludes expenditures on water, sewage, garbage collection, electricity/gas, and initiatives to improve air quality. Water/sewage: In 2020, expenditures on water supply and sewage were estimated at €26.4 billion in Germany. Garbage collection: German municipalities spent an estimated €6.7 billion on garbage collection and waste management in 2020.

11 Electricity/gas: Total household spending on electricity, gas and other fuels was estimated at €50 billion in Germany in 2020. Clean air initiatives: Germany invested around €2.4 billion in 2020 on initiatives to improve air quality, curb emissions and transition to renewable energy. Based on the above figures, Germany's total estimated expenditures related to health and sanitation was approximately €514.3 billion in 2020. This represents around 12.9% of Germany's GDP when including estimated spending on essential sanitation infrastructure and environmental initiatives that also impact public health. In summary, accounting for key sanitation and environmental protection costs increases Germany's total health-related expenditure by over €85 billion or around 0.9% of GDP compared to official health expenditure reporting alone. A holistic view is needed to fully appreciate the investment in national well-being.

12 References 1. Author links open overlay panelAmandeep Dhir a b, a, b, c, d, e, AbstractThe constant development of online social media features and related services has constantly attracted and increased the number of social media users. But, Alt, D., Banjanin, N., Beranuy, M., Beyens, I., Boksem, M. A., Boksem, M. A. S., Brand, M., Bright, L. F., Chaouali, W., Chen, Q., Choi, S. B., Cotten, S. R., … Blabst, N. (2018a, February 23). Online social media fatigue and psychological wellbeing-A study of compulsive use, fear of missing out, fatigue, anxiety and depression . International Journal of Information Management. https://www.sciencedirect.com/science/article/abs/pii/S0268401217310629?via%3Dihub 2. Babigumira JB, Morgan I, Levin A. Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health. 2013 Apr 29;13:406. doi: 10.1186/1471- 2458-13-406. PMID: 23627715; PMCID: PMC3643883. 3. Health expenditure by sources of funding. (n.d.). Federal Statistical Office. https://www.destatis.de/EN/Themes/Society-Environment/Health/Health-Expenditure/ Tables/sources-of-funding.html

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