Ok friends, this is great and an ENDLESS issue so let's have a quick tweetorial on opportunity costs and why you shouldn't get mad when they exist #epitwitter 1/ https://twitter.com/BrianCAlbrecht/status/1094997227578130432 …
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(Note: the original tweet wasn't only about opportunity costs, but it's one of the biggest areas that people complain about in health economics) 2/
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The basic premise of an opportunity cost is this: there is a fixed pot of money available Spending some of that money on one thing means BY DEFINITION that the money is not available to spend on something else 3/pic.twitter.com/BKgMswx85R
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One of my favorite theoretical examples of this is The Road Not Taken by Robert Frost Two roads, but you can only pick one Both might be good, but whichever you choose, there is a cost: you miss out on the other road 4/pic.twitter.com/1DuQ9FqR7Y
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How does this apply to epidemiology, you ask? Well, almost every part of public health has an opportunity cost There is never enough money to do everything 5/pic.twitter.com/ulpXv3DltB
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Want to open a new dialysis unit? You might have to cut funding for hip replacements Want to provide prenatal care to disadvantaged youth? That money has to come from somewhere, too 6/
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Having worked in hospital finance, I can GUARANTEE that these decisions have to be made every day Staffing a ward correctly over a high-intensity period might mean cancelling improvement projects 7/
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This doesn't mean that either upscaling to meet demand or quality improvements in a clinical setting are unimportant, but usually the situation forces you to pick one or the other Rarely can you do both 8/pic.twitter.com/b7VnvdNErb
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This is why funding in health is HARD Almost every decision you make has an opportunity cost Sometimes we fund the most cost-effective things. Most of the time, we actually don't 9/
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This has been studied: when push comes to shove, we prioritize saving people - the "Rule of Rescue" - over what is objectively the most cost-effective choice 10/pic.twitter.com/P7APVuJDZB
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Often the trade-off between the two 'roads' of public health is whether we prioritize cost-effectiveness or the ethical imperative to save people who are sick 11/
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But regardless of the difference between two choices, it's worth remembering that opportunity costs come with almost every decision That doesn't mean that we are ignoring one choice It just means we are prioritizing as best we can 12/
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