Federal, State and Local Governments
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Differentiate Among Federal, State And Local Governments And Their Roles In Governing And Influencing Health Care And Nursing.
In the United States of America, federal, state and local governments are independent in the making of laws and budgets and serve different responsibilities. However, they all function together under the federal government, which makes laws for the uniformity of a nation. The federal government entails a country as a whole, and as such, it gets expenditure money through taxation (Katz, Attal-Juncqua, & Fischer, 2017). Because the United States is a vast country with different needs based on where people live, the founding fathers came up with state government so that the US states could have a sense of independence and so they would govern based on their needs. As for the state and local governments, they only entail their states, cities, counties and districts. To be more specific, in the United States, local government refers to government jurisdictions below the state level. Federal laws are applicable in the entire US and amongst them include immigration law, patent and copyright laws, and bankruptcy laws. Every state in the United States has its system of rules and courts which deal with issues like business contracts, criminal matters as well as real estate. The local laws are applicable within villages, townships and municipalities of various states. Examples of local laws include rent laws and domestic safety. The federal government focuses on the issues that affect a country as a whole. In contrast, the state governments major on the problems which affect the population within their states.
The Role of Federal, State and Local Governments in Health and Nursing
For a long time, the discussion on the role of government in healthcare and nursing has been full of controversy. All the same, the government has a responsibility of advancing and protecting the citizen’s social interests and amongst them includes the delivery of high-quality care. The three levels of government (federal, state and local governments) are responsible for the provision of universal healthcare (Cherry & Jacob, 2016). Majorly, the federal government participates more in healthcare funding and provides support to States and medical occupations. Through Medicare, the federal government subsidizes the primary care providers via the Pharmaceutical Benefits Scheme (PBS), provision of funds for states services and through the Medicare Benefits Scheme (MBS). To a more considerable extent, the state governments are responsible for the services in public hospitals, community health services, mental healthcare as well as ambulance services (Blake & Trano, 2019). In addition to the funding provided by the federal government, state governments contribute extra cash for the running of healthcare services within respective states. On the part of Australian local governments, for instance, they actively participate in immunization and other preventive healthcare programs and oversee the delivery of community health services. Also, it is the role of the local governments to regulate the standards of food.
The significant function of federal and state legislation in the nursing practice is the protection of public health, safety and welfare of the citizens. It is the role of the federal government to provide regulations in support of nursing evolution in meeting the needs of the society. On the state government, the state legislations offer management and control of the healthcare standards of practice by stipulating boundaries of the acceptable practice. For the overall improvement in the healthcare sector, the federal government plays a significant role in shaping all healthcare aspects. Reliable policies and practices across all government health care functions and programs, coupled with strong federal leadership, are essential in the provision of quality care (Cherry & Jacob, 2016). Amongst the significant roles of the federal government in the American healthcare arena include the role of a regulator, purchaser and provider of healthcare services and the role of a sponsor of applied research and training programs for medical experts.
Through the federal government regulatory role, healthcare beneficiaries get protected from unqualified and inadequately trained practitioners and from institutions of care which do to meet the minimal standards of care. Traditionally, federal regulatory requirements focused more on quality assurance. However, at present, the regulatory requirements entail quality improvement approaches which concentrate more on showing improvement in processes of care as well as patient outcomes. In its purchaser role, the government rewards the providers of care who attain high levels of quality. The government also uses the strategy of publicly releasing comparative quality data on providers of care to draw attention on the best practices of care and encourage various providers of care to adopt them (Cherry & Jacob, 2016). Since the consumers can use the publicly released comparative quality data in making healthcare choices, the providers of care are forced to improve the standard of their services to create more demand for them.
The purchasing government role also has a close relationship with payment based on performance. In this case, the federal government can decide to participate in selective contracts with the highest quality providers. In appreciation of a work well-done, the government might choose to provide the highest quality providers with bonuses; diagnosis-related group (DRG) payments, as well as capitation rates. On the part of the government as a sponsor of applied healthcare services research, the federal government offers aid for knowledge development and creation of the tools required for the provision of care. Again, the federal government provides support in the education and training of healthcare professionals such as nurses (Salmond & Echevarria, 2017). For instance, the Medicare program, which is government-funded spends close to twenty billion annually in the education of medical persons such as nurses, dentists and physicians.
Additionally, through the tax policy, both federal and state governments offer support in the field of healthcare by excluding employers from contributions to health insurance from taxable income for employees. Again, the federal and state governments grant tax exemptions for various institutions of care and offer individual tax deductions for many expenditures in the field of healthcare. Also, the federal government ensures that all people irrespective of their provinces attain free medical services and plays the role of handling various health concerns in society. For instance, the federal government sponsors campaigns which focus on health concerns like obesity and use of alcohol amongst the American populace. The main aim of government healthcare campaigns is to raise awareness of the harmful effects of alcohol and unhealthy nutrition on people’s health. Through mandatory health insurance (MHI), the federal government regulates healthcare financing and oversees public health initiatives (Salmond & Echevarria, 2017). To sum it up, the federal, state and local legislatures play a crucial role in the enhancement of the health of the populace through provision funds, authority and direction on public health and agencies of social welfare.
References
Blake, C., & Trano, G. (2019). Public and Nonpublic School Nurses: Common Practice, Common Goals. NASN School Nurse, 34(2), 83-85.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.
Katz, R., Attal-Juncqua, A., & Fischer, J. E. (2017). Funding public health emergency preparedness in the United States. American journal of public health, 107(S2), S148-S152.
Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopaedic Nursing, 36(1), 12.