Landmark healthcare reform act

Field experiments have been used to test the effectiveness of policy “nudges”—attempts by government to align desirable social behavior with individual incentives in policy areas ranging from retirement planning to tax compliance. Both the Democratic administration of President Obama and the Conservative government of David Cameron in the U.K. have supported this type of research. For your Discussion this week, choose one of the two scenarios provided and complete the corresponding prompts.

Scenario 1: Affordable Care Act

Assume that the Affordable Care Act (ACA), a landmark healthcare reform act passed by the United States Government in 2012, is still in the process of full implementation. Prior to its passage, earlier versions originally proposed the provision of medical care free of charge to the U.S. population. Suppose that you have been asked to evaluate the potential effects of the ACA nationwide. There are two key issues to consider. One issue has to do with how much more medical care people would use if it could be offered free of charge. The second issue has to do with what effect the medical care would have on the health of the average person. Assume you have 3–5 years to conduct the evaluation.

Post a response to the following:

• Assuming no financial restraint, briefly outline what method(s) you would suggest using for assessing the impact of free coverage on usage of medical services and on health outcomes. Use a randomized field experimental design, a cost benefit/effectiveness quantitative evaluation design, or both, and explain your choice.

Scenario 2: Nudging

Post a response to the following:

• Briefly describe a nudging field experiment design focused on encouraging more self-employed taxpayers to file their estimated taxes. Consider both coercive and nudge style mechanisms to accomplish this, with an aim to demonstrate the effectiveness of the methods.
• Langbein, L. (2012). Public program evaluation: A statistical guide (2nd ed.). Armonk, NY: ME Sharpe.
  • Chapter 4, “Randomized Field Experiments” (pp. 73–109)
  • Chapter 5, “The Quasi Experiment” (pp. 110–142)
  • Chapter 6, “The Nonexperimental Design: Variations on the Multiple Regression Theme” (pp. 143–208)
• McDavid, J. C., Huse, I., & Hawthorn, L. R. L. (2013). Program evaluation and performance measurement: An introduction to practice (2nd ed.). Thousand Oaks, CA: Sage.
  • Chapter 7, “Concepts and Issues in Economic Evaluation” (pp. 271–308)
• Mills, C. (2013). Why nudges matter: A reply to Goodwin. Politics, 33(1), 28–36.
  Retrieved from the Walden Library databases.
• USAID. (2013). Impact evaluations. Retrieved from http://www.usaid.gov/sites/default/files/documents/1870/IE_Technical_Note_2013_0903_Final.pdf
• United States Government Accountability Office (USGAO). (2009). Randomized experiments can provide the most credible evidence of effectiveness under certain conditions. In Program evaluation: A variety of rigorous methods can help identify effective interventions (pp. 20–26). Retrieved from http://www.gao.gov/assets/300/298907.pdf
• Green, D., & Winik, D. (2010). Using random judge assignments to estimate the effects of incarceration and probation on recidivism among drug offenders. Criminology, 48, 357–359.
• Institute of Politics. (Producer). (2013). “Nudging” policy: Behavioral economics in the public square[Video file]. Retrieved from https://www.youtube.com/watch?v=cv75iXJMkfc
• Johnson, E., & Goldstein, D. (2003). Do defaults save lives? Retrieved from http://www.dangoldstein.com/papers/DefaultsScience.pdf
• Khandker, S. R., Koolwal, G. B., & Samad, H. A. (2010). Handbook on impact evaluation: Quantitative methods and practices. Retrieved from https://openknowledge.worldbank.org/bitstream/handle/10986/2693/520990PUB0EPI1101Official0Use0Only1.pdf?sequence=1
• McKinsey Quarterly. (Producer). (2011, June). Nudging the world toward smarter public policy: An interview with Richard Thaler [Audio podcast]. Retrieved from http://www.mckinsey.com/insights/public_sector/nudging_the_world_toward_smarter_public_policy_an_interview_with_richard_thaler
• The World Bank Independent Evaluation Group. (2006). Impact evaluation: The experience of the independent evaluation group of the World Bank. Retrieved from http://ieg.worldbank.org/Data/reports/impact_evaluation.pdf