Editorial Commentary: Fixing Health Care Requires Us to Evaluate Policy Through an Ethical and Societal (And Not Just a Financial) Lens.

Abstract

Health care systems globally, including in the United States, continue to undergo a much-needed transformation focused on optimizing value-or health outcomes per dollar spent across a full cycle of care-for patients. Given the traditionally high cost and use of orthopaedic surgery services, the field is ripe for in-depth assessment and comparison of interventions to ensure that evidence-based, high-value care is prioritized. Cost-effectiveness analyses (CEAs) provide an important framework from which to begin effective policy discussions, and a recent study suggests that current orthopaedic economic literature is of high quality. However, the same study demonstrated that no authors published CEAs that also provided commentary on how their work can actually guide policy decisions. Furthermore, the ethical implications of their research or insight into the larger consequences of their findings within and outside the health care sector was not discussed. We must be better at "connecting the dots" between CEAs and value-based health care research and practical policy initiatives while also considering how such proposals promote health equity and address systemic injustices currently found in our health care system.