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1- A 2 -B 3 -B 4- C 5 -D 6 -B

A study published in BMC Health Services Research in October 2008 considered the .2 cost-effectiveness of assisting general practitioners in management of patients with diabetes by use of a centralized database of clinical data to coordinate care. Based on five years of data a simulation model was used to predict patient outcomes and complications up to the .time of death The per patient increase in costs due to the program were estimated to be $3,000. Expected life-years (from start of the program and discounted at 5%) were calculated to be 11.3 years for those in the program and 10.9 if not in the program. For quality-adjusted life years the .comparable figures were 8.5 and 8.2. A year of perfect health is felt to be worth $50,000 ?a) Perform a cost-benefit analysis of the program. What do you conclude) Marginal benefit is 50,000 (8.5 8.2) = 50000 0.3 = $15,000. Marginal cost is $3,000. Conclude that program is worthwhile as MB > MC. ?b) Perform a cost-effectiveness analysis of the program. What do you conclude) Cost per QALY is 3000 / (8.5 8.2) = 3000 / 0.3 = $10,000. This is quite low, and less than $50,000. Conclude that program is worthwhile. (c) Consider the following screening test for cancer applied to 100,000 people of who 100 have cancer. Each test costs $5, picks up 80% of cancer cases, and additionally 10% of the time falsely diagnoses cancer. Detection of cancer (rightly or wrongly) leads to a further exact diagnostic test that costs $100. Correct early detection of cancer by the test is valued at $10,000. Is the first test worthwhile? Marginal benefit: Detect 0.8 100 cases = 80 cases at $10,000 each = $800,000. Marginal costs: Direct = 100,000 $5 = $500,000. Indirect: 80 true cases plus 10,000 false positive (0.1 100,000) = 10,080 $100 = $1,008,000. Not worthwhile as MB = $800,000 less than MC = $500,000 + $1,008,000 = $1,508,000.

3- Show on the graph below the consumer and producer surplus, and calculate the producer and consumer surplus.

C: - consumer surplus H: - producer surplus Consumer surplus :- ( base * height) / 2 32,000 $ Producer surplus 32,000 $ :- ( base * height) / 2 = = ((40-0) * (3600-2000)) / 2 ((40-0) * (2000-400)) / 2 = =

4- Explain the advantage and disadvantages of different type of insurance, what type of health do you recommend for Palestinian in the occupied territories, why?

private health insurance Manage by private sector, voluntary health insurance system, premium is according to the needed health services, depends on purchasing the health services. social health insurance system Manage be independent agency, mandatory for all society member, the premium is a percentage out of the personal income, provides all health services depending on purchasing the health services, health service basket include all essential services with ability for external referral. tax health insurance system : managed by the government, mandatory for all citizens, monthly premium is a percent of the income, availability of for external referral system, depend on the principle of purchasing the health services. I think social health insurance is good for Palestinian population, b\c it give percentage of income, also it sustain system for long time, b/c payment of high income people to lower income can maintain the payment for health care sysytem, also it achieve equity.

Also we add private health insurane, b/c high income people may refuse to take health care from govermental hospital as lower income people dp, also low income people dont have enough money to go for private health insurance.

5- What are the causes of market failure in health care, explain? What recommendation you can provide to improve equality while maintaining reasonable cost and quality? 1Uncertainty 2Externalities 3Asymmetric of knowledge. 4Consumer rationality and consumer sovereignty, 5Competition and barriers to market entry, 6Economics of scale and monopoly, My recommendation is: To go with iedeal condition of market which is certainty, no Externalities, perfect knowledge, consumer act free of self-inrtest, svseral small suppliers to promote genuine competition.