HIM 500 5-1 Discussion Government Role
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Nov 24, 2024
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5-1 Discussion: Government Role
The US spends more on healthcare than any other nation in the world. However, the measured
outcomes of care are no better than and often inferior to those achieved by other developed
nations that spend substantially less. In the United States, governments at all levels (federal,
state, and local) have a specific responsibility to strive to create conditions where people can be
as healthy as possible (Catlin & Cowan, 2015). Critical to the government’s role in public health
are policymakers who must provide the political and financial support necessary for public
health agencies at all levels to be strong and effective. While the government’s role in healthcare
has changed and expanded over the years, it has influenced the political agendas of various
private and public organizations. Federal programs continue to have direct and indirect
influences regarding private health insurance plans and programs as well as public health
services and programs. From the establishment and implementation of Medicare and Medicaid in
1965 to the federal healthcare legislation of the Affordable Care Act in 2008, the governments
continue to influence and direct healthcare expenditures across public and private organizations,
protecting Americans who receive care under employer health insurance programs through
federal healthcare services (Catlin & Cowan, 2015). The federal government has contributed to
the population’s preventive health platform for chronic diseases, implementing prevention
programs and services that achieve better quality for the patient population.
The government’s responsibility to protect and advance society's interests includes delivering
high-quality healthcare. Even though our democratic and capitalist society offers a competitive
marketplace for consumers and employees to obtain healthcare services, insurance costs for
individuals can be too costly and steep (Kruk et al., 2018). To ensure that all citizens have access
to quality healthcare, the government supports the healthcare market to fill in gaps. It regulates
the market to control healthcare inefficiencies and inequity. By fostering strong partnerships with
state and local governments and the private sector, the federal government can work toward
delivering quality care to the US population (Kruk et al., 2018). A healthy and comprehensive
framework the government can implement to support the improvement of quality healthcare
delivery should include providing healthcare, ensuring access to quality care for vulnerable
populations, regulating healthcare markets, supporting the development of new knowledge, and
evaluating health technologies and practices; monitoring health care quality; informing health
care decision-makers; developing the health care workforce; and organizing stakeholders from
across the health care system (Kruk et al., 2018).
The number of uninsured Americans has increased for the third consecutive year since 2016. As
of 2019, there were 28.9 million non-elderly people without insurance, up from 27.9 million in
2018 (Kuroki, 2022). The burden of the COVID-19 pandemic has led to millions of employees
losing their jobs and, with those jobs, their health insurance. The cost of health coverage is still
listed as the number one barrier to lack of insurance, with almost 74% of uninsured non-elderly
adults confirming that the ability to obtain coverage is the main reason for not being insured
(Zewde & Rodriguez, 2023). The loss of health insurance on such a large scale jeopardized the
health of already disadvantaged and potentially vulnerable populations such as people of color,
further widening the disparities of health determinants. The American Medical Association has
efficiently summed up five steps to improve population health during these trying times (Zewde
& Rodriguez, 2023). These steps include Stabilizing individual insurance marketplaces and
retaining ACA market reforms; Addressing physician shortages and the ever-deepening shortage
of clinical workforce; Ensuring adequate funding of the Children’s Health Insurance Program;
retaining Medicaid expansion; and implementing expansion in more states.
References
Catlin, A. C., & Cowan, C. A. (2015). History of health spending in the United States, 1960-
2013.
Baltimore, MD: Centers for Medicare and Medicaid Services
.
Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., ... & Pate,
M. (2018). High-quality health systems in the Sustainable Development Goals era: time for a
revolution.
The Lancet global health
,
6
(11), e1196-e1252.
Kuroki, M. (2022). Healthcare coverage and out-of-pocket medical expenses: evidence from the
2017 Tax Cuts and Jobs Act and the medical expense deduction.
Public Health
,
205
, 58-62.
Zewde, N., & Rodriguez, S. R. (2023). Does Private Insurance Provide More Care?.
Journal of
Health Care for the Poor and Underserved
,
34
(1), 146-160.
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