Introduction
Local, state, and federal governments all play an important role in implementing policies that mitigate healthcare issues. At the local level, governments can implement policies encouraging health-promoting behaviors, such as increasing access to healthy food options, creating smoke-free zones, and increasing physical activity opportunities (Butler, 2020). State governments can fund healthcare programs, such as Medicaid and Children’s Health Insurance Program (CHIP), that help provide healthcare coverage for low-income families. They can also establish regulations to ensure the safety of healthcare providers and facilities. Finally, the federal government is critical in providing funding for healthcare programs and research and setting standards for healthcare coverage, such as the Affordable Care Act (Cigler, 2021). Despite efforts to enhance care, the US ranks 11th among the global superpowers meaning governance is still an issue. Therefore, this research highlights how different levels of government collaborate in healthcare initiatives, and the advantages, disadvantages, and efficacy of this type of engagement.
The Role of Government in Implementing Healthcare Policies
Local governments are responsible for providing access to healthcare services in their communities by creating and enforcing laws and policies that improve healthcare quality and promote access to healthcare services. Local governments can create and implement policies to address healthcare issues, such as expanding access to preventive care, expanding Medicaid coverage, and increasing access to mental health and substance use services (Cigler, 2021). Regulating local healthcare facilities is another role that ensures the quality standards are enhanced (Cigler, 2021). The government also provides the community with avenues to get help, such as creating awareness of Medicare provisions through educative programs.
State governments are responsible for implementing and enforcing healthcare policies and programs tailored to their state’s specific needs. For instance, creating immunization programs such as vaccination against measles for children in case of an outbreak is the state’s responsibility (Cigler, 2021). They also ensure that emergency responses for health issues are always available and that reliable data collection systems promote research (Cigler, 2021). This government can create and implement policies to address healthcare issues, such as expanding access to health insurance, providing access to mental health and substance use services, and improving access to care in rural and underserved communities through government insurance subsidies.
The federal government is responsible for establishing national standards for healthcare, such as the Affordable Care Act, which enhances universal health service provision. The federal government also provides funding for state and local healthcare programs, such as reimbursement of Medicaid services to ensure enhanced health operations (Cigler, 2021). The federal government can create and implement policies to address healthcare issues, such as increasing access to preventive care, expanding Medicaid coverage, and providing funding for mental health and substance use services.
Advantages of Inclusive Government Engagement in Healthcare Initiatives
All three levels of government ensure that all citizens have equal access to healthcare regardless of location. This factor helps to reduce disparities in health outcomes among different population groups. Having all three levels of government involved makes it easier to coordinate the delivery of healthcare services, which helps reduce costs and increase efficiency (Butler, 2020). Additionally, collaborative engagement among governments helps Improve coordination between providers. All three levels of government can work together to ensure that providers are better coordinated and provide the best possible care (Butler, 2020). This strategy ensures that accountability is guaranteed for better outcomes considering that the governance tier ensures that everyone is accountable for their actions in their specific jurisdiction.
Local, state, and federal governments can implement public health initiatives that can help reduce the spread of disease and improve overall health outcomes. The government is also responsible for improved public health, considering that they create initiatives that promote patient safety and protect healthcare providers from malpractice, such as tort reforms which enhance the quality of care while reducing the malpractices (Butler, 2020). Such practices ensure that the general population’s health is enhanced to ensure that increased patient safety is enhanced accordingly.
Disadvantages of Government Involvement in Healthcare Initiatives
The involvement of local, state, and federal governments in addressing healthcare issues can be costly, as these entities must allocate funds for research, training, resources, and other necessary activities. The cost of these activities can be high, leading to higher taxes for citizens. Another issue is that government involvement in healthcare can be slow and bureaucratic due to the hierarchical system of governance (Butler, 2020). This tier of leadership can lead to delays in decision-making and implementation of solutions, which can be detrimental to the health of citizens. Disagreements between levels and among officials lead to delays in decision-making and implementation of solutions (Butler, 2020). Politics can often be involved when government entities are involved in healthcare issues. Political influences can lead to decisions not based on data or science but on political considerations.
Different levels of government involvement in healthcare can lead to inefficient spending, as governments often must manage large healthcare budgets. This leeway can lead to fraud and abuse of office due to increased corruption. Their involvement can also lead to inadequate regulation and oversight, leading to mistakes and errors in delivering healthcare services and, thus, complexity in evaluating general performance. With so many experts involved, innovation is limited, and program customization becomes rigid, which can influence service provision. Additionally, the government can become unresponsive to healthcare needs due to the high tier of consultations needed to pass a single policy.
Government Performance in Addressing Healthcare Issues
As stipulated in the figure, the government has moderately helped establish affordability and accessibility of healthcare services through an insurance program. The reason is that public insurance covers only 34% while 8.5% are uninsured; meaning that some citizens still lack accessible health services (The Commonwealth Fund, 2020). The United States Federal government has the most influence and power when tackling healthcare problems. They are responsible for providing funding for the healthcare system, creating and enforcing laws, and regulating insurance companies (The Commonwealth Fund, 2020). However, their effectiveness at tackling cost and accessibility issues is moderate due to the underperformance in regulating costs which is the responsibility of the state and federal government.
The medical malpractice rate has significantly indicated the government’s insufficient action to enhance care quality. A report by the medical malpractice annual report indicates that approximately 25% of the deaths due to malpractices and errors resulted in paid indemnity in 2020 (Medical Malpractice Annual Report, 2020). The rate of grave permanent injuries in US hospitals was 10%, indicating significant health issues. This factor indicates that despite the policies on malpractices and government regulations to enhance quality, healthcare quality is still low (Medical Malpractice Annual Report, 2020). Therefore, the federal and state government is moderately effective in their plans. Local governments are less effective at tackling healthcare problems. They do not have the same level of authority as the Federal and State governments and thus cannot create or enforce healthcare laws or regulations.
Justification for Discontinuing Three Levels Of Government Involvement In Healthcare
As an economic superpower, the US should be where other leaders come to benchmark. However, the underperformance in different aspects indicates that the government should change its strategy to ensure that healthcare quality is sustained (The Commonwealth Fund, 2021). The federal government should take charge of health initiatives to ensure sustained uniformity and maintain standards. Among countries like Australia, France, and the UK, the US ranks 11th in the scale in the care process, administrative efficiency, equity, and healthcare outcome (The Commonwealth Fund, 2021). This poor ranking indicates that the government should consider centralizing healthcare efforts to the federal government to enhance health processes and decision-making
Conclusion
Federal, state, and local governments should not work together in healthcare initiatives since the jurisdiction among the different levels of government healthcare systems varies significantly. The federal government is responsible for creating national policies and programs, while state and local governments implement rules and provide services to their citizens. This issue can create confusion and delayed processes due to conflicts and political engagement which makes it difficult to coordinate efforts, leading to inefficiencies and decreased effectiveness. Therefore, a centralized system eradicates confusion, conflicts, and poor outcomes which enhance the overall health system.
References
Butler, S. M. (2020). After COVID-19—thinking differently about running the health care system. In JAMA Health Forum. 1 (4), 234-468. American Medical Association. Web.
Cigler, B. A. (2021). Fighting Covid-19 in the United States with federalism and other constitutional and statutory authority. The Journal of Federalism, 51(4), 673-692. Web.
The Commonwealth Fund. (2020). International health care system profiles: United States. Web.
The Commonwealth Fund (2021). Mirror, mirror 2021: Reflecting poorly. Web.
Medical Malpractice Annual Report. 2020 Medical Malpractice Annual Report: Claims closed from Jan. 1, 2015, through Dec. 31, 2019. Web.