Response to discussion question 6b

I chose to evaluate the Affordable Care Act (ACA).  Randomized field experiments (RFE) are the standard for evaluations because there are very few issues associated with threats to internal validity (Langbein, 2012).  Additionally, the sample-size can be an issue with RFEs because they require many participants/subjects (2012).  The sample-size of a nation-wide program would be conducive to an RFE.

Since this program evaluation assumes that there is no financial restraint, I would suggest conducting a mixed-method evaluation design.  Mixed-methods is important and relevant because it incorporates multiple lines of evidence (McDavid, Huse, & Hawthorn (2013).  The specific approach that would be suggested is the concurrent triangulation approach where the qualitative information and the quantitative information are collected concurrently and the data is compared for similarities (2013).

While a quantitative approach can be utilized to determine the raw numbers, to develop a comprehensive evaluation, interviews/surveys need to be conducted to articulate the motivations behind how much medical care a person would use if it could be offered free of charge.  Importance should be placed on the randomized sampling within a given population because it promotes external validity (Langbein, 2012).  If cost were an issue, then the program evaluation should utilize a quantitative approach only.  

There are some ethical challenges with implementing a randomized sampling (Langbein, 2012).  Some program evaluators suggest that when withholding treatment is not possible, that perhaps treatment can be delayed (2012).  If treatment has been withheld or delayed it could potentially affect the outcome of the evaluation.

Langbein, L. (2012). Public program evaluation: A statistical guide (2nd ed.). Armonk, NY: ME Sharpe.

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.