Discussion: Federalism’s Impact on Policy

The fragmentation of the U.S. health care system, with its differing modes of financing and service delivery, is a reflection of a dispersed government structure. Policy making is shared and distributed across various branches and levels of government. As a result, policy making processes can be slow to respond, manipulated towards personal interests, and often redundant. Consider, for example, the public entitlement programs such as Medicaid, Medicare, the State Children’s Health Insurance Program (SCHIPS), and the PPACA of 2010. Where is there overlap between these policies? How do they demonstrate a dispersed government structure?

This week, you will analyze the role of the federal government in health care policy making.

To prepare:

• Review this week’s Learning Resources focusing on the France article and the textbook readings.
• Identify two nursing or health care policies that address similar needs, one passed at the federal level and the other at another level of government (state or local).

By Day 3

Post a cohesive response that addresses the following:

• Provide an example of two policies that address similar needs, passed at two levels of government (i.e., federal, state, or local).
• What are the advantages and/or disadvantages of this duplication? How does this example reflect the implications of federalism? Provide support from the literature for your position.
• To what degree should the federal government get involved in health care policy making? Provide concrete examples to support your position.