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The Balance of Power Between Federal and State Government in Healthcare Policy in the United States


Separate legal entities in the United States have been bestowed with the duty of providing healthcare to the citizens of America. The government as well as the private sector plays a great role in healthcare provision, with the government being the primary provider of health insurance. However, federalism has led problem of power balancing in the healthcare policy between federal and state governments. This paper is therefore an exploration of the issue of power balancing between federal and state government in the healthcare policy in the United States (Boybjerg et al, 2003, p.1).

The relevance of the issue from a health policy standpoint

The issue of power balance between the federal and state government is of great importance from the healthcare perspective. This means that each division of the government is accorded responsibilities, which it ought to perform perfectly. If that is done, any defaults in health policy implementation can be easily noticed hence immediately correcting them to ensure smooth running of the healthcare services in the state.

Historical policies and programs addressing the issue

Just like in other nations, the provision of healthcare in the ancient times in United States of America was not at its best. This was because, the government was the sole provider seeking assistance from the non-profit organizations such as the missionary institutions.

Historical Programs

Despite being underdeveloped, the health sector of the United States created several programs which were all aimed at improving the healthcare status of the nation. Such programs include the development of the Bureau OF Chemistry, National Quarantine Act, Marine hospital and the Federal Security Agency just to mention a few.

Present policies and programs addressing the issue

Unlike in the ancient times, the provision of healthcare is now shared, thus making it to be of high quality. The government has taken the role of providing health insurance to its citizens to ensure that each and every person is under a medical cover. The private sector on the other hand, provides those services that the government cannot afford to provide. This in turn has led to the improvement of the healthcare services in the United States.

Recent Programs

In the recent past, several programs have been created in a bid to improve the welfare of the society in terms of healthcare provision. Such programs include the common Medicare, Medicaid and TRICARE programs among other programs which ensure comprehensive healthcare is available to the American citizens.

The success of the Programs

Most of the programs (present and historical) developed to improve healthcare service provision have been a success story. A good example is the health insurance program which has made it possible for many people to access healthcare services despite their financial status.

The failures of these programs

Despite being a success story, the some of the healthcare programs have been faced with many challenges that have led to their failure. The common challenges include; lack of financial support, political influences and lack of cooperation from the citizens among others.

Major stakeholders involved in healthcare policies

Several stakeholders have been involved in healthcare policies starting from the community to the government. However, the major stakeholders involved are the government and part of the private sector. The federal government, has been a key financial contributor in the form of grants.


The process of making policies, evaluating and implementing healthcare programs is not an easy one. Several factors have to be considered to have successful programs that will favor each and every person in the society.

Policy Solutions

The policy solutions are geared towards enhancing the service provision in healthcare. Since the healthcare sector requires a lot of funding, the federal and state government should take that responsibility. In doing this, the healthcare centers will be able to retain skilled service providers as well as improve the capacity and ability of medical schools to train more professionals.

Healthcare Reforms

The United States had been going through several crisis in its healthcare sector which compelled it to make reforms on the same. Some of these reforms included, the development of the Public Health Fund which was to fund the projects in healthcare. Other reforms concerned the terms of insurance where the age limit of young adults was extended to 26 years as well as discounting costs on Medicaid and Medicare (Network, 2011, p.1).


Despite the fact that healthcare reforms have been made in the recent past, several adjustments must be made to improve the quality of services offered. For example, it is recommendable that the primary care doctors are encouraged to work through incentives such as off duty (Wood, 2009, p.3). The state and federal government should also improve on its funding, as well as create homes for the disabled people among other reforms.


From the above discussion, it is clear that the role of healthcare service provision is in the hands of several stakeholders. But, as mentioned earlier, the major stakeholders are the government and the private sector. The government has balanced the roles in healthcare between the state and federal divisions. The federal government is the key funding organization in healthcare while the state comes in to ensure equitable resource allocation.

Reference List

Boybjerg, R., Weiner, J and Houseman, M. (2003). State and Federal Roles in Health Care: Rationales for Allocating Responsibilities. Web.

Network. (2011). What is changing already as the healthcare reform law is implemented? Web.

Penny, T. (n.d). The Changing Relationship between Federal, State, and Local Government. Web.

Wood, R. (2009). Health Policy Brief. Web.