The government plays multiple roles in healthcare by implementing laws, regulations, policies,
healthcare services, research, and training to ensure that patients get effective healthcare. All
healthcare facilities share the same vision, which is to provide quality care to all patients regardless
of their background. Medicare and Medicaid were signed into law on July 30th, 1965, by President
Lyndon B. Johnson to provide medical coverage to the disabled, people diagnosed with ESRD (end
stage renal disease) and people over the age 65 (cms.gov).
Health insurance assists in reducing the cost of medical office visits, procedures, diagnostic
testing’s, medication, and any other medical related services that are approved. Without health
insurance the uninsured would have to pay out of pocket, which be costly. The risk of costly
healthcare can lead to people avoiding medical treatment which can be tragic because this can be
avoided.
Proving affordable insurance to the population to all without the (almost) impossible criteria.
Canadian healthcare is provided to everyone, and healthcare is paid by taxes as to American
healthcare is paid through premiums and co-pays (medical.rossu.edu). Although Canada provides
insurance to the people their specialty clinics have a longer wait period but provide more General
Practitioners to the public (medical.rossu.edu).
The federal and state government has laws that protect people’s rights and access to health care.
For example, the HIPAA Health Insurance Portability and Accountability Act (HIPAA) is a “Mandated
administrative simplification regulations that govern privacy, security, and electronic transactions
standards for health care information”. The Affordable Care Act (ACA) of 2010, also known as
Obama Care, makes affordable health care available to more people. The state and federal
government also provides health care to many Americans through Medicare (Title 18) and
Medicaid (Title 19). All health care providers must put in place policy and procedures that meet
the government’s regulations. This includes maintaining and sharing copious records for billing and
auditing purposes (Bowie, Mary Jo, 2019).
I have worked in a nursing home and several substance abuse and behavioural health agencies and
can attest that much of my time is spent on paperwork and checking other’s paperwork for
completeness. In my opinion, the best way to reduce the number of uninsured while maximizing
quality and minimizing costs is to reduce waste, such as paperwork, in the health care
administration. Health care information systems can contribute to this through automation and
digitization.
What is the government's role in healthcare? How does the government impact healthcare
organizations?
The government controls a multitude of rules and regulations. The Do’s and don’ts so to speak,
who can get free healthcare, and who cannot, and what will be covered and what is not. e
Healthcare is a trillion-dollar business that affects us all in some way or fashion. e The government
outlines the framework nationally. They help with ensuring funding, creating guidelines, enforcing
legislation, and making healthcare accessible to most. Many organizations have their own vision,
and mission on how they want to operate and serve their patients. e Due to certain laws,
provisional guidelines, and legislation they cannot operate solely how they would like. e Some
organizations can do depending on their funding source.
How does health insurance impact healthcare delivery?
Having health insurance vs not having health insurance plays a major role in the delivery. If you do
not have health insurance you are more likely not getting preventative care at all, resulting in
uncared-for health issues. e If you have health insurance that is provided by the government many
services are free, and others will not be covered. e You also have employer-sponsored insurance
where you must meet a deductible and a portion of it is paid by yourself and the employer. e The
“type” of insurance you hold is often looked up and you are treated accordingly. All services are
not covered, and many individuals go into debt resulting from health care bills. “The Affordable
Care Act was the largest federal health policy initiative since the creation of Medicare and
Medicaid. It brought about structural changes in the health-care system, which included efforts to
improve access to health-care insurance elimination of pre-existing condition restrictions in
coverage, elimination of lifetime caps on health-care spending, and slowing of growth in
healthcare costs through innovative payment reforms.” (www.ncbi.com)
How can we reduce the number of uninsured people while maximizing quality and access and
minimizing costs?
One way to reduce is to focus on quality rather than quantity. Not having so much red tape for
certain tests, procedures, and qualifying age factors. e Individuals should not have to go into debt
over trying to be healthy. e Provide more qualified health Centres in all geographic areas.
https://brainmass.com/health-sciences/the-role-of-government-in-health-care
https://www.ncbi.nlm.nih.gov/books/NBK500098/
Mayberry, R. M., Nicewander, D. A., Qin, H., & Ballard, D. J. (2006). Improving quality and reducing
inequities: a challenge in achieving best care. Proceedings (Baylor University. Medical Center),
19(2), 103–118. https://doi.org/10.1080/08998280.2006.11928138
Bowie, Mary Jo (2019). Essentials of health information management principles and practices (4th
ed.) Cengage. https://www.cengage.com/
History (2022) retrieved on 7 July 2022 from https://www.cms.gov/about-cms/agency-
information/history
US vs Canada Healthcare: What is the Difference? (11 May 2022) retrieved on 7 July 2022 from
https://medical.rossu.edu/about/blog/us-vs-canadian-healthcare
