Although the United States has made significant investments in healthcare, some problems seem to defy solution. For example, a sizable proportion of the Asian population in the United States is more prone than others to the Hepatitis B viral disease. In addition to the social problems associated with the disease (like isolation), one out of every four chronically infected individuals stands the risk of suffering from liver cancer or cirrhosis if the disease is not treated effectively. Managing this disease could be very costly. There are a number of control measures, including screening, vaccination, and treatment procedures. The government is reluctant to spend money on any method of control if it is not cost- effective and there is no proof of increased health for people afflicted with the disease. Even though not all the control measures are optimal for all situations, the best method or combination of methods for combatting the disease are not yet known.

Questions for Discussion
1. Explain the advantage of operations research methods such as simulation over clinical trial methods in determining the best control measure for Hepatitis B.
2. In what ways do the decision and Markov models provide cost-effective ways of combating the disease?
3. Discuss how multidisciplinary background is an asset in finding a solution for the problem described in the case.
4. Besides healthcare, in what other domain could such a modeling approach help reduce cost?