Week 1 Post

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Government’ s Role in U.S. Health Care

CHAPTER 3

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Learning Objectives

Describe five U.S. governmental organizations and their roles in health care.

Analyze the integration of the collaboration of the Department of Homeland Security (DHS) and the Federal Emergency Management Agency and its importance to disaster management.

Discuss the regulatory responsibility in health care of the U.S. Food and Drug Administration (FDA).

Evaluate the role of the Centers for Medicare and Medicaid Services (CMS) in health care.

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Introduction (1 of 2)

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.

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Introduction (2 of 2)

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 Affordable Care Act developed several government programs which increase the ability of individuals to make informed decisions about their health care and increase access to health care.

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Governmental Activities

Reminder: Social regulation focuses on actions such as those in the healthcare industry that impact an individual’s safety or well-being.

Regulatory healthcare power is shared among federal and state governments.

Local health governments provide direct services.

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U.S. Department of Health and Human Services

Most important federal agency with regard to health care

Cabinet-level, executive branch of the federal government

Has 11 operating divisions (discussed on the following slides)

Collaborates with state and local government levels because many of their activities operate at those levels

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Centers for Disease Control and Prevention (CDC)

http://www.cdc.gov Established in 1946 and headquartered in Atlanta, Georgia

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. Played a huge role in the pandemic regarding health policy (e.g., vaccine schedules, mask wearing)

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Administration for Community Living (ACL)

http://www.acl.gov Established in 2012, is 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

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Agency for Toxic Substances and Disease Registry (ASTDR)

http://www.atsdr.gov 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.

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National Institutes of Health (NIH)

https://www.nih.gov The primary federal agency for research toward preventing and curing disease worldwide

Has 27 institutes and centers that focus on different diseases and conditions, including cancer; ophthalmology; heart, lung, and blood; genes; aging; alcoholism and drug abuse; infectious diseases; chronic diseases; children’s diseases; and mental health.

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Health Resources and Services Administration (HRSA)

http://www.hrsa.gov 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.

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Indian Health Service (IHS)

http://www.ihs.gov Mission is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

Ensures that comprehensive, culturally acceptable health services are available and accessible to these populations

Provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 566 federally recognized tribes

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http://www.samhsa.gov 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

The Substance Abuse and Mental Health Services Administration (SAMHSA)Substance Abuse and Mental Health Services Administration (SAMHSA)

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U.S. Food and Drug Administration (FDA)

http://www.fda.gov Responsible for ensuring that the following products are safe: food, human and veterinary products, biologic products, medical devices, cosmetics, and electronic products

Also responsible for ensuring that consumer product information is accurate

Advances public health by speeding up innovations to make medicine and food more effective, safer, and more affordable

Huge role in approving COVID-19 vaccines

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Administration for Children and Families (ACF)

http://www.acf.gov Responsible for federal programs that promote the economic and social well-being of families, children, individuals, and communities

Has 10 regional offices

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Centers for Medicare and Medicaid Services (CMS) (1 of 2)

http://www.cms.gov Established when the Medicare and Medicaid programs were signed into law in 1965 by President Johnson as a result of the Social Security Act

Has over 20 offices that oversee different aspects of their programs

Primary responsibility is to provide policy, funding, and oversight to healthcare programs that serve the elderly and poor

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Centers for Medicare and Medicaid Services (CMS) (2 of 2)

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.

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Occupational Safety and Health Administration (OSHA)

http://www.osha.gov Established to govern workplace environments to ensure that employees have a safe and healthy environment

Played a huge role in ensuring that employers had safe workplaces during the pandemic

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Surgeon General/ U.S. Public Health Service (1 of 2)

http://www.surgeongeneral.gov Surgeon General is the nation’s chief health educator. Provides information on how to improve the health of the U.S. population

Appointed by the president Office of the Surgeon General oversees the operations of the commissioned U.S. Public Health Service Corps.

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Surgeon General/ U.S. Public Health Service (2 of 2)

The U.S. Public Health Service Commissioned Corps consists of 6,500 public health professionals who are stationed within federal agencies and programs.

Played a role in educating the public about COVID-19

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http://www.dhs.gov and http://www.fema.gov 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.

They are responsible for coordinating efforts at all government levels to ensure emergency preparedness for any catastrophic events such as bioterrorism.

Department of Homeland Security (DHS) & Federal Emergency Management Agency (FEMA)

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http://www.aspr.gov Created under the Pandemic and All Hazards Preparedness Act in the wake of Hurricane Katrina to prevent, prepare for, and respond to the adverse health effects of public health emergencies and disasters

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

Office of the Assistant Secretary for Preparedness and Response (ASPR)

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State Health Departments’ Role in Health Care

Monitor communities to identify health problems

Develop policies to support community health Enforce laws and regulations to promote health and safety

Responsible for or share responsibility for federal programs related to maternal and infant health services and cancer prevention

Collect health statistics License healthcare professionals License healthcare facilities

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The government organizations that provide the most direct services to the population

Over 90% of local health departments provide immunizations to adults and children.

Over 90% offer communicable/infectious disease surveillance.

Over 80% offer tuberculosis screening and 75% offer tuberculosis treatment.

State Health Departments’ Role in Health Care Local Health Departments’ Role (1 of 2)

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Local Health Departments’ Role (2 or 2)

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 2,800 local health departments across the United States.

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Conclusion (1 of 2)

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 governments, which consequently allocate funding to their local health departments.

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Conclusion (2 or 2)

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.