Health Topic
Chapter 4
Government’s Role in Healthcare
Interesting Facts
Social regulation focuses on actions such as those in the healthcare industry that impact an individual’s safety or well-being.
The U.S. Surgeon General is the chief health educator in the United States.
The FDA is responsible for accrediting and inspecting mammography facilities.
Interesting Facts
Over the last several years, there has been a trend to regionalize local health departments in order to maximize population services.
The Department of Homeland Security is responsible for ensuring that all government levels have an emergency preparedness
Introduction
During the Depression and World War II the United States had no funds to start a universal healthcare program—an issue that had been discussed for years.
As a result, a private sector system was developed that did not provide healthcare services to all citizens.
However, the government’s role of providing healthcare coverage evolved as a regulatory body to ensure that the elderly and poor were able to receive health care.
Introduction
The passage of the Social Security Act of 1935 and the establishment of the Medicaid and Medicare programs in 1965 mandated the government’s increased role in providing healthcare coverage.
The ACA has increased government interaction with the healthcare system by developing several of the government initiatives that focus on increasing the ability of individuals to make informed decisions about their health care.
Governmental Activities
Regulatory healthcare power is shared among federal and state governments.
State governments have a dominant role of regulating constituents in their jurisdiction.
To assure success in this regulatory process, state governments also developed local government levels to provide direct services to constituents and regulate their geographic region.
Their legal authority is derived from legislatures that establish the legal framework for their authority.
Centers for Disease Control and Prevention (CDC)
Established in 1946 and headquartered in Atlanta, Georgia, the CDC’s mission is to protect health and promote quality of life through the prevention and control of disease, injury, and disability.
The CDC’s main goal is public health.
Administration for Community Living (ACL)
Established in 2012, the ACL brings together the efforts and achievements of the Administration on Aging, the Administration on Intellectual and Developmental Disabilities, and the HHS Office on Disability to serve as the federal agency responsible for increasing access to community supports, while focusing attention and resources on the unique needs of older Americans and people with disabilities across the lifespan.
Agency for Toxic Substances and Disease Registry (ATSDR)
ATSDR is the lead federal public health agency responsible for determining human health effects associated with toxic exposures, preventing continued exposures, and mitigating associated human health risks.
ATSDR is administered organizationally with the CDC.
National Institutes of Health (NIH)
This agency is the primary federal agency for research toward preventing and curing disease worldwide.
They have 27 institutes and centers that focus on different diseases and conditions including cancer, ophthalmology, heart and lung and blood, genes, aging, alcoholism and drug abuse, infectious diseases, chronic diseases, children’s diseases, and mental health.
The Health Resources and Services Administration (HRSA)
The HRSA is the primary federal agency for improving access to healthcare services for people in every state who are uninsured, isolated, or medically vulnerable.
Tens of millions of Americans get affordable health care and other help through HRSA’s 100-plus programs and more than 3,000 grantees.
The Agency for Healthcare Research and Quality (AHRQ)
AHRQ focuses on the following areas of research: healthcare costs and utilization, information technology, disaster preparedness, medication safety, healthcare consumerism, prevention of illness, and special needs populations.
There is a Coalition for Health Services Research (CHSR), an organization of volunteers who advocate for the AHRQ.
Indian Health Service (IHS)
The mission of IHS is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.
It is also their mission to assure that comprehensive, culturally acceptable health services are available and accessible to them.
The IHS provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 566 federally recognized tribes.
The Substance Abuse and Mental Health Services Administration (SAMHSA)
The SAMHSA is the main federal agency for improving access to quality substance abuse and mental health services in the United States by working with state, community, and private organizations.
U.S. Food and Drug Administration
The FDA is responsible for ensuring that the following products are safe: food, human and veterinary products, biologic products, medical devices, cosmetics, and electronic products.
The FDA is also responsible for ensuring that consumer product information is accurate.
The FDA is also responsible for advancing public health by speeding up innovations to make medicine and food more effective, safer, and more affordable.
The Administration for Children and Families (ACF)
The ACF, which has 10 regional offices, is responsible for federal programs that promote the economic and social well-being of families, children, individuals, and communities.
Centers for Medicare and Medicaid Services (CMS)
CMS was established when the Medicare and Medicaid programs were signed into law in 1965 by President Johnson as a result of the Social Security Act.
The CMS has over 20 offices that oversee different aspects of their programs.
Their primary responsibility is to provide policy, funding, and oversight to the elderly and poor healthcare programs.
Centers for Medicare and Medicaid Services (CMS)
As part of the Affordable Care Act, the Innovation Center was established for the purpose of testing “innovative payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care” for those individuals who receive Medicare, Medicaid, or CHIP benefits
Occupational Safety and Health Administration (OSHA)
OSHA was established to govern workplace environments to ensure that employees have a safe and healthy environment.
Surgeon General/U.S. Public Health Service
The Surgeon General is the U.S. chief health educator who provides information on how to improve the health of the U.S. population.
The Surgeon General, who is appointed by the President, and the Office of the Surgeon General oversee the operations of the commissioned U.S. Public Health Service Corps
The U.S. Public Health Service Commissioned Corps consists of 6,500 public health professionals who are stationed within federal agencies and programs.
Department of Homeland Security (DHS) Federal Emergency Management Agency (FEMA)
DHS was established in 2002 as a result of the 2001 terrorist attack on the United States. It combined 22 different federal departments to form the DHS.
FEMA, which is responsible for managing catastrophic events, was integrated into DHS in 2003.
Together, they are responsible for coordinating efforts at all government levels to ensure emergency preparedness for any catastrophic events such as bioterrorism; chemical and radiation emergencies; mass casualties; and disease outbreaks.
Office of the Assistant Secretary for Preparedness and Response (ASPR)
ASPR was created under the Pandemic and All Hazards Preparedness Act in the wake of Hurricane Katrina to prevent, prepare, and respond to the adverse health effects of public health emergencies and disasters.
ASPR focuses on preparedness planning and response; building federal emergency medical operational capabilities; countermeasures research, advance development, and procurement; and grants to strengthen hospitals and healthcare systems in public health emergencies and medical disasters
State Health Departments’ Role in Health Care
They monitor communities to identify health problems.
They also develop policies to support community health.
They must enforce laws and regulations to promote health and safety.
Most state agencies are responsible for or share responsibility for federal programs related to maternal and infant health services and cancer prevention.
State Health Departments’ Role in Health Care
Vital statistics collected include deaths, births, marriages, and health and disease statuses of the population.
These statistics are important to collect because they serve as a basis for funding.
State health departments also license health professionals such as physicians, dentists, chiropractors, nurses, pharmacists, optometrists, and veterinarians who practice within the state.
Further, they inspect and license healthcare facilities such as hospitals and nursing homes.
Local Health Departments’ Role
The government organizations that provide the most direct services to the population.
Over 90% of local health departments provide adult and children immunizations.
Over 90% offer communicable/infectious disease surveillance.
Over 80% offer tuberculosis screening and 75% offer tuberculosis treatment.
Local Health Departments’ Role
Over 75% offer environmental surveillance.
Approximately 70% offer population nutrition services.
Nearly 75% provide school/day care center inspection.
Approximately 75% provide food safety education
There are 2,700 local health departments across the US.
Conclusion
The federal government plays an important role in the quality of the U.S. healthcare system and provides funding for state and local government programs.
Federal healthcare regulations are implemented and enforced at the state and local levels.
Funding is primarily distributed from the federal government to the state government, which consequently allocates funding to their local health departments.
Conclusion
Local health departments provide the majority of services for their constituents.
More local health departments are working with local organizations such as schools and physicians to increase their ability to provide education and prevention services.