Table of Contents
This paper begins with an introduction that presents a brief overview of the government and healthcare systems in the states of Maine and Massachusetts. It introduces the overall description of the healthcare system in the United States before narrowing down to the states of Maine and Massachusetts. The role of the government in the healthcare of the two states is thoroughly discussed in the beginning of the paper. The paper asserts that the national government and the federal government of Massachusetts involve themselves in regulation of healthcare and finances. The government takes part in the healthcare system in order to ensure that services are provided effectively and there is no mistreatment of citizens in the private health sector. The paper then proceeds with an analysis of life expectancy in these states. Life expectancy has been rising because of improved living standards and improved healthcare facilities in these states. This is especially common among the white population. Life expectancy of both Maine and Massachusetts has been on the increase because of the involvement of the government in healthcare, which ensured that there is adequate regulation. More so, the paper discusses healthcare systems in Maine and Massachusetts in relation to demographics. Most individuals are now able to access healthcare facilities because of the involvement of the government that promotes subsidization of healthcare services. According to the analysis presented in the paper, average incomes in both states have immensely risen and individuals are in a better position to access medical facilities. Hospitals in both states utilize money collected from medical services to improve infrastructure and facilities. Immunization is also given maximum consideration in both Massachusetts and Maine. The paper explains that immunizations are carried out regularly in order to prevent the spread of critical illnesses. The paper ends with a conclusion that recaps all the key points relating to government’s involvement in healthcare in Maine and Massachusetts.
Public health governance is proportional to the life expectancy of a nation. Life expectancy depends on the mortality rate. For instance, when life expectancy is low, then this means that mortality rate is high. However, health governance aims at reducing deaths of children at the infant stage. As a result, healthy people are born in the society. A healthy nation is the one, whose gross domestic product exceeds the amount of resources vested on curbing vulnerability to infection and consequent costs of treatment. The entire nation concentrates on building a strong economy as opposed to diversion of resources to fight illness. On the other hand, investments into health programs contribute to healthy living. According to Sultz, Sultz & Young (2010), health governance is the legislative response put by a state to address patients’ safety problems. In the United States, this safety problem is synonymous to the adverse event or medical error.
Each individual state has a policy to measure the quality of healthcare services vested to the people through centralized, although the private sector owns and runs most of the health care facilities. The governance of health facilities relies entirely on private policies. Despite the engagement of the private sector in health policies, the government plays a major role in legislative health policies. For instance, prenatal measures are government-funded projects that reduce child mortality rate. On the other hand, physicians in the United States are not only specialists trained by the US medical education system, but international medical graduates, who have undergone necessary training to own a medical license, which is officiated by the government. The rate of input into medical services is correlates positively to the rate of healthy living. Depiction of this relationship is easy through the demographic statistics of each state, which is a clear-cut disparity of the range of resources and revenue. Demographic statistics shows the extent to which a country acquires and manages its resources including people as the medium of implementation. Consequently, Statistical data reflects the performance of a country in terms of the ability of the government to manage planning of healthcare. The United Health Foundation presents rankings through different organizational structures that influence delivery of health services. It indicates that 28 % of the states have a centralized health service system (Carper, 1987). This means that public health agency provides all health services to people. Local health services in these states are coordinated through regional state offices that offer public health. Massachusetts is the fourth healthiest state having a population of approximately 6 million people. Books (2010) assert that there are about one million poor citizens in the state of Massachusetts making 20% of the entire population. The unemployment rate is 6%, while the uninsured population makes up 10%. The Medicare beneficiaries form the biggest part of the population. This has positively influenced its performance in the health scheme, beating other more resourceful states. On the other hand, the state of Maine has a population of approximately 1 million people.
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This research paper depicts the centrality of public health governance and discusses the effects emanating from forms of governance implemented by the Massachusetts state on one hand, and the state of Maine on the other. It gives an analysis of the demographic statistics for both states.
Firstly, the healthcare system in the state of Maine depicts a decentralized system of governance, although the legislative role entirely lies within the central government. For instance, the affordable care system, which ensures that all the people access medical insurance cover through controlling of the insurance rates to tally with personal income and reduce exploitation of the people by the insurers, was the sole role of the central government. Centralized governance is government controlled, where the government stipulates laws regarding the welfare of the nation. Morone, Litman & Robins (2008) assert that the central government is the major institution that passes laws affecting the state of marine, including budgetary allocation to health facilities and funding of medical schemes like health insurance policies. On the other hand, decentralization of health governance is the measure aimed to give people power to control their own affairs. Decentralized governance does not employ ideas of the legislative house, but leaves the people and the private sector to decide their way in accordance to the regulation of the central government. As much as decentralization aims at bringing services closer to people, centralization brings together all people despite factors influencing their lives. This means that centralized governance is probably the best solution for minimizing discrimination.
The largest state healthcare organization in the state of Maine is the Main Health, which coordinates training of professionals into the medical fraternity. It also provides direct health services to the people like the emergency cases and childcare, that has so far seen a decline in infant mortality rate for the people living in the state of Maine.
Despite the fact that the healthcare system in the state of Maine is centralized, it is the role of the private sector and other non-governmental organizations to implement these legislations. For instance, the Maine Quality Forum (MFQ), the Quality Counts (QC) and the Maine Health Management Coalition, are organizations have authorization from the government to oversee the promotion of healthcare services to the people. The Maine Quality Forum has the mandate of statistical analysis of demographic data and publishing of quality data that seeks to promote healthcare. The organization reports to the consumer and the government. The Quality Counts supports the people of Maine directly by ensuring local patient care. Its goals are to ensure delivery of quality care by ensuring access of healthcare facilities. This organization also ensures cost effective facilities by controlling the upsurge of costs levied on patients. This ensures prevalence of quality and affordable health services.
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The (MHMC) organization works in collaboration with other organizations in and in partnership with the Main Care to ensure the activation of employees into initiatives of facilitating healthcare programs. On the other hand, the state of Maine lies within the stipulation of the American government living with the requirement of working 25% longer in order to raise funds for healthcare schemes. This heavy funding of medical schemes has seen the state to increase its life expectancy to 78 years, and the projection is that this figure will further increase.
Heavy funding of health care system resulted in the increased number of health facilities and services. The future funding of health care projects aims at incorporation of information communication technology (ICT) in healthcare. This will improve health services by increasing the quality of care and its efficiency. It will also reduce operating costs of clinical services and consequently reduce administrative costs. The involvement of ICT in health care will have a role of introducing entirely new modes of care The first step was the reform of insurance markets, which sought to end discrimination of the sick by the insurer. The second consideration was the individual mandate, which required affordable schemes. It is in this regard that a proposal for an 8% cost on the gross income was mediated. The mandate is critical because it leaves no room for insurers to exploit the insured, making insurance affordable to all people. The third step was the mandate of extensive subsidies that made insurance schemes affordable to the people with low average income. These reforms have enabled two thirds of the population to acquire health insurance schemes in the past five years in the state of Maine.
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This implies that governance of healthcare in the state of Maine is entirely organizational. This type of governance has brought about a number of achievements to the state enabling it to compete with other State in terms of national rankings. Firstly, it has enabled advocacy for better participation both at local and international levels. It has also encouraged more investment from stakeholders and shaped human resource management in health systems. It has also facilitated enactment of policies into productive goals through overseeing implementation. This has been possible through seeking for finance from the central government and maintenance of outlines that stipulate resolutions and decisions made. This has increased accountability within the infrastructure of management. The organizational management has also fostered development of missions and policies that effect healthcare. The average income reported by Kaiser Foundation shows that the state of Maine has a foreclosure rate of 6810 per household. This shows that 4.3 homes on mortgages were on a foreclosure. The board of statistics for the state of Maine does not measure the rates of fore closure, but concentrates on assuming the sums of homes with defaulted mortgages. On the contrary, the governance in the state of Maine does not reflect centralization. This has negatively affected the nature of health schemes, resulting in higher infant mortality rates. Above all, the organizational health governance depicted in the State of Maine has been beneficial to the realization of the set goals in healthcare management.
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Massachusetts Healthcare Governance
Hhealthcare governance in the state of Massachusetts depicts collaboration between centralization and decentralization. The central government sets most of the policies that affect healthcare. The decentralized system is evident from the fact that it is the role of the private sector to run the healthcare initiatives. However, healthcare management in the state of Massachusetts is the role of all the people. For instance, funding for health insurance schemes is form the income of each citizen, who contributes 8% of the income. This has enabled better healthcare services enabling the state to remain among the healthiest states. Categorically, it is the fourth healthiest state. Good performance in health care of the state of Massachusetts does not only depend on the demographic information, but emanates from healthcare policies. For instance, the Affordable Care Act has caused a fundamental reform in the healthcare system. In this type of policy, the true meaning of healthcare is vague without health insurance. In fact, it is a requirement for every employer to provide health insurance schemes for their employees. This has influenced the population under insurance in different ways.
The first step was the reform of insurance markets, which sought to end discrimination of the sick by the insurer. The second consideration was the individual mandate, which required affordable schemes. It is in this regard that a proposal for an 8% cost on the gross income was mediated. The mandate is critical because it leaves no room for insurers to exploit the insured, making insurance affordable to all people. The third step was the mandate of extensive subsidies that made insurance schemes affordable to the people with low average income. These reforms have enabled two thirds of the population to acquire health insurance schemes in the past five years in the state of Massachusetts.
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On the other hand, the state of Massachusetts lies within the stipulation of the American government living with the requirement of working 25% longer in order to raise funds for healthcare schemes. This excess toil goes to funding of the healthcare systems this heavy funding of medical schemes has seen the state to increase its life expectancy to 78 years, and the projection is that this figure will further increase. Heavy funding of health care system resulted in the increased number of health facilities and services. The future funding of health care projects aims at incorporation of information communication technology (ICT) in healthcare. This will improve health services by increasing the quality of care and its efficiency. It will also reduce operating costs of clinical services and consequently reduce administrative costs. The involvement of ICT in health care will have a role of introducing entirely new modes of care.
The average income reported by Kaiser Foundation shows that the fore closure rank for the state of Massachusetts stands at 1379, in comparison to the rank given for the state of Maine, the disparity is due to the difference of population sizes. The foreclosure rank for the state of Maine is 47, while that for Massachusetts is 34. On the other hand, the percentage change in monthly unemployment rank is equal. Massachusetts has higher health rank as compared to the state of Maine. This is because of the larger population in Massachusetts, which is not only the source of labor, but also the medium for implementation of strategies aimed at healthcare improvement.
The most effective public healthcare programs in the 20th century in states of Massachusetts were the programs of immunization. These practices aimed towards strengthening immune systems of people by vaccination against disease causing organisms. This proved especially important for people with weak immune systems. State laws stipulate that vaccination is mandatory. These states have laws requiring every to child get vaccination before enrolling in private or public schools. This has helped to reduce vulnerability to communicable diseases. There are centers for disease control and prevention that schedule immunization programs. The most common diseases on the schedule are measles, polio, and diphtheria.
To ensure the success of the immunization program, the statute of Massachusetts obliges all boards of health to maintain public safety by enforcing vaccination and revaccination of all habitants. In this case, whoever refuses to comply with the regulation is liable for a fine. This measure ensures that all habitants participate in vaccination programs. However, there are exceptions to this rule in special cases, for instance when immunization can cause harm to the person. This exemption is only valid if one holds a valid health physician report, showing that the person is subject to exemption from immunization. There are also situations, which call for emergency immunization, for instance, outbreak of communicable diseases.
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Further, the health program of the state of Massachusetts is an integration of both centralized and decentralized governance. Central government provides legislation for healthcare. The state of Massachusetts has radical practices that have seen it stand out in providing health services to people. For instance, effective management provided by state authorities has helped people of Massachusetts to access health insurance schemes easily through giving the directive to all employers to seek for health insurance programs for their employees. The figure for the rate of health insurance scheme is 8% on the net income for all the people of Massachusetts. This rate is standard without reservations to make sure that the program is harmonious and affordable to all including the low-income earners. This act has helped the state to increase life expectancy of its people. On the other hand, just like other states, the state of Maine has 25% more working hours above the norm. The funds received due to this hard work are useful for purchasing health equipment and drugs (Carper, 1987).
In combating disease outbreaks, the state employs immunization projects, which have legislative roles attached. For instance, one cannot avoid immunizations, otherwise risk paying substantial amount of money as a fine. The states subject foreigners to health tests to know their health status. This prevents foreign infection from spreading among people. However, it is important to note that the health plan for foreigners does not necessarily involve immunization. In the case of an outbreak of a communicable disease, all inhabitants undergo immunization except for those with physician’s reports exempting them from such kind of immunization.
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This shows that there is a correlation between the form of government, which involves centralization and decentralization of health care, and of the likelihood that for the likelihood of achieving the desired life expectancy. The major factors that affect life expectancy and health are education, crime rates, economic background of people, and the form of legislation. The health of a nation is directly proportional to these factors, which affect health directly and indirectly. For instance, life expectancy in the state of Massachusetts is higher among educated women and lower among the uneducated ones.
In conclusion, the state of Massachusetts embraces the use of centralized governance of healthcare in collaboration with the decentralized system due to its high population. The population is an added advantage as it is the source of implementation of the healthcare policies. On the other hand, the state of Maine uses the decentralized system of health governance where it is organizational. The United States Foundation report ranks all states according to the range of health. This helps in designing special measures aimed to address health issues of these states. Vermont is the healthiest state, rising in the past 13 years to the top. New Hampshire is second healthiest, moving a position higher from the previous ranking. There are states that get the top ten ranks every year, while some continue to be at the end. Massachusetts comes barely at position four after Connecticut and Hawaii. Oklahoma is the last state according to the current ranking. Jonas (2003) asserts that factors that contribute to the rank attained by a state is education, income per capita, crime rates, health insurance schemes, and public funding. This ranking presents a challenge to underperforming states, which go a long way towards devising an action plan for improvement. For a state to improve the health of its population there must be efforts to change the determinants of health. However, if a state underscores in determinants comparatively to the score for outcomes, its health rank is likely to decrease. Consequently, the future ranking is likely to increase if the current trend is positive, and it is likely to decline if the trend is negative. The ranking remains the same if the trend is neutral.
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The people of Massachusetts use their resources as investments into healthcare modernization. However, there are projections for further improvement of these healthcare systems, which seek to achieve these goals effectively and efficiently. For instance, there are plans to integrate information communication technology into healthcare institutions. This will lead to improvements in service delivery, increase the accuracy of services, and raise the life expectancy. This initiative solely relies on legislative roles of central government, local government, and federal government. Therefore, it calls for the cooperation between the public and private sectors to help achieve these goals.
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