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Imagine you are GP in a health system such as the National Health Service in the UK. Health care is available at no cost [in
Imagine you are GP in a health system such as the National Health Service in the UK. Health care is available at no cost [in part of the UK, patients have a limited pharmaceutical benefit; we are ignoring that detail here}. But sometimes patients must wait queue a long time for ca re. The GP controls the gate to seeing a specialist and having expensive surgery. 15 patients come to your clinic this week seeking hip replacement surgery. Hip replacement can dramatically improve the life of many people, especially elderly people, who are otherwise in good health. Disease and damage to hips cause significant pain and loss of mobility. The surgery is highly specialized; relatively few surgeons are trained to do it. The rehabilitation is demanding; patients must be willing to stick with a long course of physical therapy. The components of the implants are expensive and in short supply. Nonetheless, aii15 patients are good candidates for the surgery: all will obtain benefit from the surgery and, as best as you can tell, all will stick with the rehab. Candidates for Hip Replacement Surgery D F Amount {utils} Pain [utils per NPV fL'f NPV of Life Change in NW Willing 3: Able week waiting for _ O l e without of Life because to Pay for Wlth surgery _ surgery] surgery of Surgery Private Procedure As shown in the table, the fifteen patients come to your clinic in the order given, from 1 to 15 [column A], three on Monday and two each day for the rest of the week. The current, preoperative condition of the hip causes pain for each patient. You can estimate the net present value of the life ofeach patient, considering income, enjoyment, and expected remaining years of life both with [column C} and without [column B] the surgery. This allows you to estimate the improvement in a patient's life if the patient has the surgery {column E}. Note that all 15 patients will receive benefit from the surgery. Although most people in the UK receive their care through the NHS, private treatment is available if one can afford it. Three of your patients [column F} might be able and willing to pay the indicated amounts to avoid the queue for the surgeryl
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