Federalism in the US is intertwined with major health policy matters; Healthy People 2020 suggests that major policies need to be implemented for the benefit of the American people. Federalism provides scaffolding for the dissemination of power and influences on how medical providers are reimbursed and remunerated for their important and very crucial services. The federal government fosters cohesion and it also affects the quality of medical care that Americans receive. Federalism provides legitimate opportunities for the states to grow and develop themselves. Simultaneous according to healthy people 2020, there was an increase in the economic growth.
The United States mirrors the system in Australia in devolution of the power from the central government to the states, deviating from the norm in non-federal states where the egocentric states have centralized power. Medicare which is the brainchild of the federal government has proven over and over again to be very important. Medicare covers the debilitated and the underprivileged; the ones over 65 years are protected since at the time the low estrogens and testosterone levels make the individuals weaker. The federal congress determines the Medicare system application and its socio-economic effects.
There has been a significant achievement made in the healthcare system of the United States Medicare unlike the health Systems that are there in the developing countries. In such countries there are pharmaceuticals own by multinationals companies, which tend to show greed by increasing the price for the essential drugs. They do so with since they know that people must pay for any drugs for them to survive.
The Medicare usually provides a countrywide support with the aid of the federal government around the states.
In 1994 the reforms in welfare became real and actualized, elucidating that the following data is useful since it is crucial for administrative purposes. The statistics gathering was sponsored by the government for policy formulation; the percentages varied from a low of 36 percent in South Dakota to a high of 79 percent in Vermont, statistically significant lows of 30 percent in Nevada, and also the 39 percent in Florida (Weiner, 2003). The difference in the levels of these services is inherently the differences in the Medicaid services in each average recipient. There was a range from low of $2,386 in 1998 in the state of California to $8,961 which was the highest in New York. This high difference, is due to the fact that the two states have different cost of health services, thus not in a position to be simply explained away (Weiner, 2003).
The federal government on its pedestal assesses the health sector and provides a way forward; the conservatives and liberals hold the belief that the federal government should wield the mammoth of the power to deal with national issues effectively, although the ambiguity of the constitution still presents a gaping chiasm which paves way for a myriad of arguments. Legislation has been enacted with respect to the response to all the health issues experienced nationally.
The main federal statutory schemes which are of major significance are Medicaid, ERISA, and Medicare. Since the year 1965, Medicare and Medicaid have been hallmarks of the federal response to health problems; they are the cornerstone of the US health care federalism (Weiner, J. 2003). Retrospectively, in 1996, the historic reform of the welfare system basically substituted the Temporary Assistance to Needy Families (TANF) for Aid to Families with Dependent Children (AFDC) (Weiner, 2003).
Medicaid is the best way to exemplify and scrutinize the reach of federalism in the making of policies as concerns to health care. Medicaid was conceptualized and set up with the mentality of creating a symbiotic affiliation between the federal government and the state with the national government responsible for setting general program guidelines, while state governments had the capability to come up with their programs to fit the conditions and circumstances that a particular state is subject to as concerns health care. Since its inception, federalism and its health checking mechanism have been crucial elements of the eclectic grand design, checking the high prevalence of diseases nationally, since they affect a great number of Americans and the social significance is pertinent for development (Scheinder, 2012).
Logistical challenges are common, and over the years the balance of power between these two levels of government in Medicaid policy making has shifted. The time curve of Medicaid (program of the federal government) provides a clear illustration that federal system is static in nature, thus various enthusiasts describe it as being cyclical in its rudimentary nature.
The Affordable Care Act is a legislation that caused consternations among many legislators and in the general public as a whole. The major purpose of ACA is to avail insurance at affordable rates to citizens without considering the condition of the health of the insured person. The Act aims to realize this objective by barring insurers the denial coverage of pre-existing circumstances and from rejecting feasibility because of health condition, medical status, or any kind of disability. It demands that insurance companies avail coverage to sickly persons despite the deleterious effects it might have to them. Hale and hearty patients, when it comes to cases like that, are exempted from any purchase of insurance until the appropriate time when they are in need of health care, because they know that they have an assured cover. Consequently, those who need a cover that is of high cost, is the group who need expensive health care which will be the insurer. Therefore, Healthy persons who are insured will reduce in number, there will be an increase in dividends, and thus most people will not be in a position to meet the expenses of insurance cover, thus reducing the number of insurers. (Smith, 2012).
Congress realized its folly in its upfront regulations of the market for insurance. Case in point, the stipulation that persons with pre-existing conditions be provided with extended coverage was injurious to the nation as well as the insurers. These efforts are pointless if the Act does not stipulate that the maintenance of insurance coverage is mandatory. Thus, even when a person is in good health, the ACA comprises a necessity that a minimal obligatory coverage gets maintained by every individual. Failure to do so forces one to pay a penalty when the individual files his or her tax return. Thus, under this individual mandate, individuals cannot, without penalty, just simply wait to purchase health insurance until they need health care. (Smith, 2012)
The need for individuals, by the Affordable Care Act, to get a health insurance was a surprise to most of the people, thus incited the House of representatives in South Dakota, to come up with a bill that required the residents to have firearms as a rapid response to ACA. Many members from the House of Representatives of South Dakota, in February 2011, came up with a legislation that required that any person above 21years old to have firearm, this was simply a basic protest. This reflects one instance where the federal government has overstepped; Representative Hal Wick stated that they did not believe that the federal government can actually order every citizen to buy health insurance.
A majority of the Conservatives disputed president Obama’s health reform, because it invades the boundaries of authority of state. This is so even as they champion the enforcement of immigration with the immigration reform bill, revisiting of the rights on abortion, and disbandment of same sex marriage. The liberals normally center on roles like the control of immigration and commerce which they insist on the categorical reservation of such roles to the federal government. The iconoclasts both factions of the divide simply argue that the U.S. Constitution distinctively demarcates apart federal and state authority. However, the U.S. account of federalism does not distinguish the federal and state functions distinctively; the clear distinction is usually absent. Federalism is best comprehended as a dynamic system of warring factions that war over different issues at different times in different regions. From the past to the present, partisans have appealed to editions of federalism selectively and appropriately, as regards the distribution of power and the current political objectives (Robertson, 2012).
Medicare, ERISA, Medicaid, the Americans with Disabilities Act and the other federal statutes constrain and inhibit state initiatives and can be condemned for their interference with states’ capacity to address health care problems on their own. Thus, constricting the autonomity of the states, these statutes do reflect the federal concerns and policies, such as the redistribution of resources for the benefit of the elderly and the poor. It also helps in protecting the victims of discrimination and also regulates employer-employee relations for firms which are in the interstate commerce at a national level.
The frequency of granting waivers from the federal regulatory requirements for state Medicaid programs elucidates the ideology of federalism and gives it more grasp and grip plus the changed state programs are sufficiently established to be resistant to relinquishing their independence back to federal regulators.
The funding for professional medical training and medical professionals’ levels of compensation has fallen significantly. Private insurers are facing serious hindrances and challenges to their profitability, partly due to the rising costs that resist their management techniques and high business acumen.
Private insurers are no longer immune and protected from state regulation of employer-provided coverage for employees. The pharmaceutical industry also faces challenges to its pricing of patented drugs, but the prices of these drugs continues to overrun the other health care costs, at least in popular view and especially among the elderly. The issues facing the educational system by health predicaments of some students disrupting those institutions are even more clearly and precipitate an increasingly concerned political response from the public (Weiner, 2003).