Health Management

Instructor Manual Chapter 3

INTRODUCTION

As discussed in chapter one, during the Depression and World War II, the U.S. had no funds to start a universal health care program—an issue that had been discussed for years. As a result, a private sector system was developed which did not provide health care services to all citizens. However, the government’s role of providing health care coverage evolved as a regulatory body to ensure that the elderly and poor were able to receive healthcare. The passage of the Social Security Act of 1935 and the establishment of Medicaid and Medicare programs in 1965 mandated government’s increased role in providing health care coverage. Also, the State Children’s Health Insurance Program (SCHIP), established in 1997, which has been reauthorized through 2010, continues to expand government’s role in children’s health care (Buchbinder&Shanks, 2007).

In both these instances, the government increased accessibility to health care as well as provide financing for health care to certain targeted populations. This chapter will focus on the different roles the federal, state and local government play in the U.S. health care system. This chapter will also highlight different government programs and regulations that focus on monitoring how health care is being provided.

CONCLUSION

The government plays an important role in the quality of the U.S. health care system. The federal government provides funding for state and local government programs. Federal health care regulations are implemented at the state and local level and are enforced at these levels. Primarily, funding is distributed from the federal government to the state government which consequently allocates funding to their local health departments. Local health departments provide the majority of services for their constituents. More local health departments are working with local organizations such as schools, physicians, to increase their ability to provide services such as immunizations, education and prevention.

NACCHO and ASTHO are important support organizations for both state and local governments. They support them by providing policy expertise, technical advice and lobby at the federal level for appropriate funding and regulations. The Department of Homeland Security (DHS) and its FEMA agency now play an integral role in the management and oversight of any catastrophic events such as natural disasters, earthquakes, floods, pandemic diseases, and bioterrorism. DHS and FEMA collaborate closely with the Centers for Disease Control to ensure that both the state and local health departments have a crisis management plan in place for these events. Although these attacks were horrific and frightening with a tremendous loss of lives, as a result, the state and local health departments are more prepared to deal with catastrophic events. They were required to develop plans and be trained to deal effectively with many of these catastrophic issues.