APA Style Research Paper at Master's Level

Federal Government in Health Care

Alexander Ludena

Saint Joseph’s University

Health Care Organization

HAD 553

Instructor: Dr. Charl Mattheus

12/10/2017

Abstract

The federal government plays an important role in influencing all facets of health care through its different roles in the American health care sector. This paper will discuss the involvement of the federal government in the health care system through its various roles and how that contributes to health care access, affordability, and quality. This includes its role in purchasing health care services, regulation of healthcare, provider of health care services, sponsor of learning and training programs and in health care research. Through its role as purchaser, the government is involved in buying health care insurance for millions of Americans. This is accomplished through programs including Medicare and Medicaid. In its role as regulator, the government is involved in establishing safety and quality standards aimed at ensuring that patients receive appropriate care. It is also involved in reforming healthcare to ensure it’s affordable, contains value and is accessible to all. This paper will also discuss the involvement of the federal government as provider of health services. As provider, the federal government is involved in the ownership and management of various health care institutions. At this particular capacity, it’s involved in employment of healthcare professionals and as operator of health care delivery systems. This paper will discuss how the federal government is involved in providing health care to diverse population through various federal agencies such as the VHA and the HIS. The federal government has a key role in shaping research in health care through its role as sponsor of applied health care services. It’ll be further discussed government involvement as it plays an imperative role in supporting the development of knowledge and creation of tools required to augment the government in carryings its various roles. This include government sponsorship of research through various agencies including the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH).

Federal Government in Health Care

The provision of health care services to America’s diverse population represents one of the largest segments of the American economy. The federal government is involved in all aspects of the health care sector. Its role and mandate in the healthcare system areis defined by the constitution. It plays somea number of different roles in the American health care field, including the regulation of the medical industry, purchasing health care, health care services provision, sponsorship of education and training programs for health care professionals as well health care services research.

The federal government is majorly involved in healthcare through its role as healthcare purchaser. It contributes directly to medical benefits for various groups of people such as the elderly, veterans and financially challenged individuals. This follows the enactment of the Affordable Care Act that established a shared responsibility between the government, state government and the private sector in the healthcare coverage for the Americans. Through the Centers for Medicare and Medicaid Services (CMS), the federal government administers Medicare and Medicaid. These are the leading programs through which the government is involved in the purchase of health care (Gaynor, 2014). Medicare is involved in the purchase of healthcare for elderly Americans who are 65 years and older and those individuals with disabilities. Medicaid is involved in purchasing healthcare coverage for the low- income earners and poor Americans. Through the Children’s Health Insurance Program (CHIP), government is also involved in purchasing healthcare for families whose earnings disqualify them from Medicaid.

The federal government has recently surpassed the private buyers to become the nation’s biggest purchaser of health care. This is particularly due to the expansion of the Medicaid program. According to a report released by the CMS, healthcare expenditure stood at $3.2 trillion in 2016. The federal government’s spending grew at the fastest rate when compared with other health care purchasers which reached $918.5 billion. The government also purchases health care services through its role as an employer. And is thus involved in healthcare as a purchaser, a role that it will continue to be enforced in the future.

Government is also involved in the rendering of health care services. This is through the ownership of health care facilities which employ medical professionals to deliver care and health care services to the populations that required medical assistance. The federal government, for instance, for instance provides comprehensive care programs through the Veterans Health Administration (VHA). The VHA is the leading integrated health care system in America serving millions of veterans. Through this system, the federal government serves more than 9 million enrolled veterans annually. This is spread across 1,243 health care facilities under agency management. Some of the common services that are provided by the VHA Medical Centers include surgical treatments, mental health services, apothecary, and physical therapy. Some of the VHA medical centers also provide advanced health services such as organ transplants and cosmetic surgery. Presently at each of the VHA facilities are patient advocates that address veteran’s concerns regarding numerous features of their healthcare experience. This approach ensures that such individuals in need of medical assistance receive quality healthcare from the federal government.

The government is also involved in the provision of health care services through the Indian Health Service (HIS). The HIS is an agency within the Department of Health and Human Services hence part of the federal government. Through the HIS, the federal government provides health services to the American Indians and Alaska Natives. This includes both inpatient and outpatient services such as pharmaceuticals, dental services, inoculations, and optometry services. Through this agency, the government provides comprehensive care to more than 2 million Americans and ensures that their health status is elevated to the highest possible standards.

As regulator, the federal government is involved in the establishments of healthcare standards. The government is also involved in establishing regulations that protect beneficiaries from inept and incompetently trained medical practitioners as well as healthcare organizations that lack the required means to carry out quality medical care to consumers and patients in need. However, it is vital that the federal government ensures that it does not establish regulations that create superfluous burden on healthcare professionals and providers.

As regulator, government agencies are in charge of the supervision, safety, and efficacy of medical devices and drugs which are made available to the public. Such agencies can further leverage on their role in regulating and controlling big pharmaceutical, insurance, and healthcare industry marketing expenses in order to reduce the cost of healthcare making it affordable to Americans. Studies by various organizations have shown that a large amount that is spent on healthcare is allocated towards administrative costs. This include expenses such as advertising and other marketing expenditures. They also include unnecessary administrative costs such as underwriting as well as the costs for processing applicants that qualify for reimbursements. The government meticulously attempts to reduce costs in often unnecessary areas where funds can be allocated and used more efficiently. The government is further involved in regulating various players in the health market in order to ensure that the rising costs are contained without jeopardizing the integrity of medical services which are provided to many consumers and patients.

Through its regulatory role, the federal government is also involved in healthcare reform. This is comprised of creating major policies and changes with regards to health care delivery in the United States. The federal government involvement in healthcare reform is typically intended to broaden populations that are covered either through government programs or by the private sector. The debate on health care reform in the country typically revolves around concerns such as a right to health care, access, equity, affordability and quality of care. The United States currently spends more oin healthcare as a share of GDP than other advanced economies which spend relatively less and hold higher standards in healthcare. This has resulted in concerns regarding the cost of such spending on the long term health of the economy and the country’s competitiveness and sustainability.

Reforms particularly in regards to cost containment and the governance of health care is conducive for the federal government in order to achieve reform. The federal government cost of healthcare in the United States has in the past been involved in health care reform through the enactment of the ACA in 2010. This legislation was passed and signed into law with the goals of increasing access, quality and the affordability of health care. The federal government has also been involved in giving incentives to health care providers in order to facilitate the adoption of new technology in the medical arena. The implementation of technology in the medical field creates transparency and expedites information across many departments. The government recognizes the important role that technology plays in improving the quality of care while simultaneously upholding cost effectiveness. Through the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009, the federal government has offered monetary incentives for the adoption of Electronic Health Records (EHR) systems galvanizing medical providers.

Government agencies additionally safeguard that its citizens have access to high-quality care. This is due to the fundamental obligation to defend and advance the interests of the American people as it relates to medical assistance. The private sector as a stand-alone unit cannot ensure that all citizens have access to quality care forcing the federal government to step in, in order to uphold access and care. This can be through complementing the market where there are gaps and amending the market where there is inefficiency or lack of equality. Achieving quality health care also involves strong collaboration between the federal, state and local agencies as well as the private sector. This is because all levels of government and the private sector play key roles in specific actions that ensure the responsibility and duties of the federal government.

The various roles of the government as regulator, health care purchaser, provider of health care services, sponsor of education and training programs for health care professionals and applied health care services can also support the advancement of high-quality care for its consumers and patients. The government can leverage on regulatory processes to establish clinical standards that ensure the quality of care. Through its role in the purchase of health care, it can establish conditions for disbursement to ensure that its citizens access quality care.

The enactment of laws that affect various elements of the healthcare sector has additionally created involvement by the government. This is particularly achieved through Congress, which is the legislative arm of government. The federal government can leverage on its legislative role to manage the healthcare aspects of access to care, cost containment or affordability and quality of care (Stabile & Thomson, 2013). An aspect of healthcare legislation that particularly remains thorny is on the funding of healthcare. Changes to Medicaid which is a federal-state program for low- income earners has effectively created difficulty as policymakers grapple with increasing healthcare cost which isare often financed by the federal government. Congress for instance enacted the Affordable Care Act to create a joint responsibility between the government, employers, and individuals in ensuring that all Americans have access to affordable and high- quality care. Therefore, government can achieve various healthcare objectives through laws which focal point is to increaseing access to affordable and exceptional medical care. A repeal of the 2010 Affordable Healthcare Act has the potential to reduce federal spending but very easily leave behind millions of low- income Americans without health care coverage.

The federal government is also involved in the sponsorship of applied health care research. Robust evidence- based research is a critical element of healthcare. Medical research significantly contributes to the enhancement of health care practice guidelines as it relates to health care professionals and organizations in the delivery of medical care. The government further ensures that achievement of various healthcare research objectives through the provision of funding for health care research are met (Whitsel, 2017). Funding to various organizations such as the Agency for Healthcare Research and Quality (AHRQ) that conducts applied research on various aspects of health care are managed by the government.

In its role in sponsoring health care research services, the federal government also supports the creation of knowledge and tools required to effectively carry out its various roles as regulator, purchaser and provider of health care. The federal government supports applied health research to address the financing and delivery issues essential for increasing access to care, reducing expense and promoting an environment that supports quality. The National Institute of Health (NIH) which is an agency of the U.S Department of Health and Human Services and therefore a federal agency is also engaged in applied health care research. The federal agency offers far-reaching support for clinical research aimed at expanding scientific education and developing new medical technology. The NIH also offers support for the training of researchers through various mechanism which isare later discovered and enhanced. By way of research, various approaches to medical care are implemented in order to enhance patient to provider experience.

The government provides in-depth support for education and training programs forof healthcare professionals. This program renders an opportunity to increase access to medical care while considering the leading and future challenges that the healthcare sector faces as it relates to the shortage of medical practitioners. Various agencies within the Department of Health and Human Services play a role in various healthcare professionals training programs. Funding for programs that generate the development of post-graduate training aimed at improving the delivery of care is made available by government agencies. Furthermore, sponsored training programs in areas such as health information technology are made available.

Overall, the government has a responsibility in advancing the interests of society through its involvement in the health care system. Through its various roles, government plays a vital role in ensuring that its citizens have access to affordable and high quality care. The government ensures the preservation of the interests and rights of Americans in regards to healthcare. This includes policies to reduce medical errors and enhance patient safety through regulations and incentives to healthcare organizations as well as patient medical satisfaction. It further plays a role in research and the acquisition of new knowledge that can be used to inform health care decision and policy makers. The federal government’s role in healthcare reform has also ensured the reduction of expenses and increased health insurance coverage for many Americans. TIn order to achieve its ultimate goals in regards to healthcare, government agencies additionally require the collaboration and partnership with other levels of government and the private sector. All these approaches come into play to ultimately benefit consumers and patient medical needs.

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