Both federal and state governments generally regulate health care in three ways: (1) enforcing after setting standards for professionals, health care organizations, and the environment; (2) purchasing services or creating health programs for people that are poor; and (3) administering federal programs. When it comes to setting of standards, the federal or state governments use their police powers to come up with standards that ensure the quality of health care organizations, health professionals, and insurance companies operating within the state is high. It also formulates quality standards for water and local food supplies, sewage disposal, environmental hazards and other sanitation matters. More so, it carries out local disease surveillance to ensure that epidemics are kept at bay. Finally, the federal court system applies principles of common law in the event that there are insurance claims, medical malpractices, and other matters related to health. (Porter 1994)
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The most common example of federal standard setting is the licensing of health care professionals, organizations, and insurance companies. Licensure laws that are individual are meant to ensure that any person who practices in the field of medicine must at least certain minimum set standards. This law ensures that for any person to practice as a medical practitioner, he or she must have graduated from a reputable university, and has passed an examination for qualifying. Federal and state governments enforce this licensure law by delegating their authority to a committee, called board registration in nursing or medicine. In so doing, the laws ensure that physicians should not discriminate their patients based on their color, religion, color or nationality. Federal and state governments have ensured that licenses are renewed yearly so that physicians are competent during their practice in the field.
Another role of federal and state governments is to provide direct services. Different types of state owned health care organizations have been created by state and federal to ensure that those patients that cannot afford expensive health care are catered for. This include hospitals that are acute care, mental health hospitals, family planning clinics, general health clinics, and maternal and child health programs. Those people who work in these hospitals and clinics are mostly employees of state governments. Some private organizations have assumed community support functions, for example, through immunization programs. Organizations that are funded must always act in line that the federal and state governments put on the grant. Therefore, the conditions of state contracts and grants are controlled by federal and state governments.
Another responsibility of federal and state governments in public health is the administration of federal programs. The states play the role of administrators to ensure carrying out of federal health care laws. The best example is the medical program. The state and federal government define the class of people who can be considered for medical care, and also some basic medical services. The state has the responsibility of administering this program. It checks which individuals are eligible for enrollment into the medical beneficiaries, and also pays for their care within the state. By so doing, the states have the freedom to requirements that make one eligible so that the number of individuals can increase.
Describe current challenges that the federal and state government is encountering with its role in public health
As the government tries to ensure that its citizens get the best medical care, it has to overcome some hurdles. The United States is made up of more than 50 states, which means that each state can have its own policy concerning a single health care issue. These varying state policies might be so inconsistent, which makes keeping of track difficult. For instance, physicians who gave up with their practice to join and practice medicine in their state could move to a different state and obtain a license that allows them to practice there. There was publicity about physicians who moved from state to state after their licenses had been taken away, without informing the licensing boards that their licenses had been taken away from them. The federal government then decided to come up with a national list of physicians. Hospitals, states and physicians were needed to report any disciplinary action that had been taken against physicians.
Another problem that the federal and state governments face in providing public health is the high costs of medical coverage. The health care system that is in place currently is based on HMOs that are run privately. The system is not nationalized because people have to sign up with a company, who then pay monthly premiums. A universal system should be adopted by the United States. This is because the poor people who can afford the huge costs of medication have to jump through bureaucratic red tape and hoops in case there is an urgent medical care. The insurance industry has become a business that is only concerned with doing business and making profits. Another challenge facing federal governments is the competing priorities. Medical care was fragmented by the narrow clinical services that public health provided. Today, the preparedness mission of infectious diseases is often considered as a focus of the public health. Another issue is the outdated staffing model. Health security requires the best trained and the brightest workforce, yet their compensation packages are too small to facilitate this. Most people who achieve advanced education in public health opt to venture into research and academic careers instead of practicing in governmental public health. (Runnells 1997)
Describe sources of public health funding for federal and state governments
Public health gets funding from several sources. These include insurance payments, foundations and patients regulatory fees. State governments raise their money for public health mainly through state income taxes. States provide public health through contracts with local agencies that also meet the costs of medication. At the grass root level, funds originate from city and county taxation policies. Funding also comes from appropriations from local governments, from fees charged for services like direct patient care and inspections. Federal and state governments also get funding from organizations that willfully donate money for provision of public health. (Turncock 2007)
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