Ethical Issues Which Have Prevented the U.S. from Maximizing Quality of Life Years

The cost of healthcare interventions varies greatly with age, with a significant fraction of cost being spent in the last two years of life. Treating a child can save orders of magnitude more life-years than an octogenarian treated for the same disease, such as cancer. While Quality-Adjusted Life Years (QALYs) can be used to plan a roadmap for how resources should be expended to maximize quality of life the execution of those plans often fail due to societal norms which trump the carefully measured QALYs, resulting in lowered average number and/or quality of years lived. The ethical issues concerning age, sex, lifestyle (smoking, drinking, obesity), cost transparency, and extreme examples (war, population explosion vs. collapse) will be discussed.

A cross-sectional analysis of out-of-pocket expenses for people living with a cancer in rural and outer metropolitan Western Australia

ObjectiveTo determine the extent of medical and non-medical out-of-pocket expenses (OOPE) among regional/rural and outer metropolitan Western Australian patients diagnosed with cancer, and the factors associated with higher costs. MethodsCross-sectional data were collected from adult patients living in four regional/rural areas and two outer metropolitan regions in Western Australia who had been diagnosed with breast, prostate, colorectal or lung cancer. Consenting participants were mailed demographic and financial questionnaires, and requested to report all OOPE related to their cancer treatment. ResultsThe median total OOPE reported by 308 regional/rural participants and 119 outer metropolitan participants were A$1518 (interquartile range (IQR): A$581–A$3769) and A$2855 (IQR: A$958–A$7142) respectively. Participants most likely to experience higher total OOPE were younger than 65 years of age, male, resided in the outer metropolitan area, worked prior to diagnosis, had private health insurance, were in a relationship, and underwent surgery. Multivariate analysis of regional/rural participants revealed that receiving care at a rural cancer centre was associated with significantly lower non-medical OOPE (estimated mean A$805, 95% confidence interval (CI): A$735–A$875, P=0.038; compared with other rural participants (A$1347, 95% CI: A$743–A$1951, P<0.001)). ConclusionThe cancer patients who participated in this study experienced variation in OOPE, with outer metropolitan participants reporting higher OOPE compared with their regional/rural counterparts. There is a need for cost transparency and access to care close to home, so that patients can make informed choices about where to receive their care. What is known about the topic?In recent years, OOPE for health care in general and cancer in particular have been widely debated by consumers and not-for-profit organisations; the topic has attracted much political attention because it affects both equity and access to care and has wider financial implications for the community. Research studies and reports from both consumer organisations and a Ministerial Advisory Committee found that cancer patients can face exorbitant out-of-pocket costs, and that individuals with private health insurance and those with prostate and breast cancer reported higher costs. In Western Australia, a cancer centre providing comprehensive cancer care was established in the second most populous region to ameliorate the high costs for travel and accommodation that regional cancer patients are known to experience. What does this paper add?This study is unique because it collected detailed cost information from patients and reports on the OOPE of regional/rural and outer metropolitan Western Australian patients receiving care for one of the four most common cancers; it therefore offers novel insight into the experiences of these groups. This study demonstrates that outer metropolitan cancer patients are experiencing much higher OOPE compared with regional/rural cancer patients. Additionally, regional/rural study participants who accessed a Regional Cancer Centre experienced significantly lower non-medical OOPE, compared with regional/rural study participants receiving care elsewhere. What are the implications for practitioners?First, there is a need for improved communication of OOPE to minimise costs to the patient, for example, by facilitating access to local cancer care. Health service providers and insurance companies can improve cost transparency for cancer patients by making this information more readily available, allowing patients to make informed financial choices about where to seek care. Second, the needs of working patients deserve specific attention. These patients face significant work uncertainty and additional distress following a cancer diagnosis.

Effects of transparent brand communication on perceived brand authenticity and consumer responses

Purpose This study aims to understand the effects of brands’ transparent communication (i.e. production transparency and cost transparency) on consumers’ perceptions of a brand’s perceived transparency and authenticity, as well as how such perceptions impact consumers’ attitude, trust and behavioral intentions. Design/methodology/approach Two between-participants factorial design experiments (n = 176 for Study 1 and n = 169 for Study 2) were conducted to examine consumers’ responses to a brand’s cost transparency and production transparency. Findings The results revealed that transparency in the focal brand’s communication of production and cost would increase consumers’ perceptions of the brand’s transparency and authenticity because of its perceived information sensitivity. Such positive effects were found to similarly impact consumers’ attitude, trust and behavioral intention toward the brand. Practical implications The results point to the importance of brand transparency in marketing communication, specifically as it pertains to the influence that the inclusion of transparent cost and production information can have on consumers’ perceptions of authenticity, trust and attitude, as well as how these perceptions translate into behavioral intention. Originality/value To the best of the authors’ knowledge, this study is among the first to explore the differences between production transparency and cost transparency in influencing consumer responses and the underlying mechanisms. The findings also expand to the literature on brand transparency and brand authenticity.

Dutch investment advisors’ perceptions towards the MiFID II directive

Purpose The Markets in Financial Instruments Directive (MiFID) II directive was enforced in the EU in January 2018. While EU-member states implemented this directive in their national legislation, investment firms are still enforcing compliance. With the purpose of “investor protection”, the purpose of this study is to investigate the effectiveness of transparency, suitability, warning and information requirements. How do investment advisers view and embrace these MiFID II requirements? Are differences evident within this group of professionals? Design/methodology/approach In total, 267 Dutch investment advisors serving non-professional investors daily completed structured surveys on their opinion of the acceptance and effectiveness of the MiFID II requirements. The findings are compared with existing literature to examine similarities with other legislation. Findings The results demonstrated differences depending on the investment firms’ size and investment advisors’ seniority and gender. Professionals should be critical of new legislation and regulations, as it limits their autonomy. However, female investment advisors and those with up to ten years’ experience are less critical of the effectiveness of the MiFID II requirements, embracing them without discussion. Investment advisors in large investment firms believe that MiFID II contributes to investors’ interests, whereas those in small and medium-sized investment firms often do not share this opinion. For example, respondents considered cost transparency an effective requirement to achieve better investment services and protect investors’ interests. Originality/value The effectiveness and applicability of legislation are often viewed from a legal perspective, and enforcement is essential. However, this study explores legislation from the perspective of professionals under supervision.

Lifting the Veil: The Benefits of Cost Transparency

We investigate when and why the disclosure of cost information by firms can increase consumers’ purchase interest.

Inside Industry

The following topics are under this section: Providing emotional support for patients with Type 2 Diabetes Netherlands-based speciality chemicals and food ingredients distributor opens its doors to Asia Pacific First of its kind Human Heart-in-a-Jar Model for therapeutic solutions More than one million dollars of grants awarded to HIV-related community-led projects in Asia Impact of chronic stress-related conditions on health expenditure Addressing needs of Asia’s Agri-Food production ecosystem Health Sciences Authority in Singapore approves world-first medical AI Software Using artificial intelligence for greater cost transparency in healthcare expenditure Official launch of NSG BioLabs first co-working laboratory and office space in Singapore Creating cell-based solutions to meet global protein demands