Running Headhead: FEDERAL GOVERNMENT IN HEALTH CARE 1 FEDERAL GOVERNMENT IN HEALTH CARE 12 Federal Government in Health Care Alexander Ludena Saint Joseph’s University Health Care Organization HAD 553 Instructor: Dr. Charl Mattheus 12/10/2017 Abstract The federal government plays an important role in influencing all facets of health care through its different roles in the American health care sector. This paper will discuss the involvement of the federal government in the health care system through its various roles and how that contributes to health care access, affordability, and quality. This includes its role in purchasing health care services, regulation of healthcare, provider of health care services, sponsor of learning and training programs and in health care research. Through its role as purchaser, the government is involved in buying health care insurance for millions of Americans. This is accomplished through programs including Medicare and Medicaid. In its role as regulator, the government is involved in establishing safety and quality standards aimed at ensuring that patients receive appropriate care. It is also involved in reforming healthcare to ensure it’s affordable, contains value and is accessible to all. This paper will also discuss the involvement of the federal government as provider of health services. As provider, the federal government is involved in the ownership and management of various health care institutions. At this particular capacity, it’s involved in employment of healthcare professionals and as operator of health care delivery systems. This paper will discuss how the federal government is involved in providing health care to diverse population through various federal agencies such as the VHA and the HIS. The federal government has a key role in shaping research in health care through its role as sponsor of applied health care services. It’ll be further discussed government involvement as it plays an imperative role in supporting the development of knowledge and creation of tools required to augment the government in carryings its various roles. This include government sponsorship of research through various agencies including the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH). Federal Government in Health Care The provision of health care services to America’s diverse population represents one of the largest segments of the American economy. The federal government is involved in all aspects of the health care sector. Its role and mandate in the healthcare system areis defined by the constitution. It plays somea number of different roles in the American health care field, including the regulation of the medical industry, purchasing health care, health care services provision, sponsorship of education and training programs for health care professionals as well health care services research. The federal government is majorly involved in healthcare .

1. Running Headhead: FEDERAL GOVERNMENT IN HEALTH
CARE 1
FEDERAL GOVERNMENT IN HEALTH CARE 12
Federal Government in Health Care
Alexander Ludena
Saint Joseph’s University
Health Care Organization
HAD 553
Instructor: Dr. Charl Mattheus
12/10/2017
Abstract
The federal government plays an important role in influencing
all facets of health care through its different roles in the
American health care sector. This paper will discuss the
involvement of the federal government in the health care system
through its various roles and how that contributes to health care
access, affordability, and quality. This includes its role in
purchasing health care services, regulation of healthcare,
provider of health care services, sponsor of learning and
training programs and in health care research. Through its role
as purchaser, the government is involved in buying health care
insurance for millions of Americans. This is accomplished
through programs including Medicare and Medicaid. In its role
as regulator, the government is involved in establishing safety
and quality standards aimed at ensuring that patients receive

2. appropriate care. It is also involved in reforming healthcare to
ensure it’s affordable, contains value and is accessible to all.
This paper will also discuss the involvement of the federal
government as provider of health services. As provider, the
federal government is involved in the ownership and
management of various health care institutions. At this
particular capacity, it’s involved in employment of healthcare
professionals and as operator of health care delivery systems.
This paper will discuss how the federal government is involved
in providing health care to diverse population through various
federal agencies such as the VHA and the HIS. The federal
government has a key role in shaping research in health care
through its role as sponsor of applied health care services. It’ll
be further discussed government involvement as it plays an
imperative role in supporting the development of knowledge and
creation of tools required to augment the government in
carryings its various roles. This include government
sponsorship of research through various agencies including the
Agency for Healthcare Research and Quality (AHRQ) and the
National Institutes of Health (NIH).
Federal Government in Health Care
The provision of health care services to America’s diverse
population represents one of the largest segments of the
American economy. The federal government is involved in all
aspects of the health care sector. Its role and mandate in the
healthcare system areis defined by the constitution. It plays
somea number of different roles in the American health care
field, including the regulation of the medical industry,
purchasing health care, health care services provision,
sponsorship of education and training programs for health care
professionals as well health care services research.
The federal government is majorly involved in healthcare
through its role as healthcare purchaser. It contributes directly
to medical benefits for various groups of people such as the
elderly, veterans and financially challenged individuals. This
follows the enactment of the Affordable Care Act that

3. established a shared responsibility between the government,
state government and the private sector in the healthcare
coverage for the Americans. Through the Centers for Medicare
and Medicaid Services (CMS), the federal government
administers Medicare and Medicaid. These are the leading
programs through which the government is involved in the
purchase of health care (Gaynor, 2014). Medicare is involved in
the purchase of healthcare for elderly Americans who are 65
years and older and those individuals with disabilities. Medicaid
is involved in purchasing healthcare coverage for the low-
income earners and poor Americans. Through the Children’s
Health Insurance Program (CHIP), government is also involved
in purchasing healthcare for families whose earnings disqualify
them from Medicaid.
The federal government has recently surpassed the private
buyers to become the nation’s biggest purchaser of health care.
This is particularly due to the expansion of the Medicaid
program. According to a report released by the CMS, healthcare
expenditure stood at $3.2 trillion in 2016. The federal
government’s spending grew at the fastest rate when compared
with other health care purchasers which reached $918.5 billion.
The government also purchases health care services through its
role as an employer. And is thus involved in healthcare as a
purchaser, a role that it will continue to be enforced in the
future.
Government is also involved in the rendering of health care
services. This is through the ownership of health care facilities
which employ medical professionals to deliver care and health
care services to the populations that required medical
assistance. The federal government, for instance, for instance
provides comprehensive care programs through the Veterans
Health Administration (VHA). The VHA is the leading
integrated health care system in America serving millions of
veterans. Through this system, the federal government serves
more than 9 million enrolled veterans annually. This is spread
across 1,243 health care facilities under agency management.

4. Some of the common services that are provided by the VHA
Medical Centers include surgical treatments, mental health
services, apothecary, and physical therapy. Some of the VHA
medical centers also provide advanced health services such as
organ transplants and cosmetic surgery. Presently at each of the
VHA facilities are patient advocates that address veteran’s
concerns regarding numerous features of their healthcare
experience. This approach ensures that such individuals in need
of medical assistance receive quality healthcare from the federal
government.
The government is also involved in the provision of health care
services through the Indian Health Service (HIS). The HIS is an
agency within the Department of Health and Human Services
hence part of the federal government. Through the HIS, the
federal government provides health services to the American
Indians and Alaska Natives. This includes both inpatient and
outpatient services such as pharmaceuticals, dental services,
inoculations, and optometry services. Through this agency, the
government provides comprehensive care to more than 2 million
Americans and ensures that their health status is elevated to the
highest possible standards.
As regulator, the federal government is involved in the
establishments of healthcare standards. The government is also
involved in establishing regulations that protect beneficiaries
from inept and incompetently trained medical practitioners as
well as healthcare organizations that lack the required means to
carry out quality medical care to consumers and patients in
need. However, it is vital that the federal government ensures
that it does not establish regulations that create superfluous
burden on healthcare professionals and providers.
As regulator, government agencies are in charge of the
supervision, safety, and efficacy of medical devices and drugs
which are made available to the public. Such agencies can
further leverage on their role in regulating and controlling big
pharmaceutical, insurance, and healthcare industry marketing
expenses in order to reduce the cost of healthcare making it

5. affordable to Americans. Studies by various organizations have
shown that a large amount that is spent on healthcare is
allocated towards administrative costs. This include expenses
such as advertising and other marketing expenditures. They also
include unnecessary administrative costs such as underwriting
as well as the costs for processing applicants that qualify for
reimbursements. The government meticulously attempts to
reduce costs in often unnecessary areas where funds can be
allocated and used more efficiently. The government is further
involved in regulating various players in the health market in
order to ensure that the rising costs are contained without
jeopardizing the integrity of medical services which are
provided to many consumers and patients.
Through its regulatory role, the federal government is also
involved in healthcare reform. This is comprised of creating
major policies and changes with regards to health care delivery
in the United States. The federal government involvement in
healthcare reform is typically intended to broaden populations
that are covered either through government programs or by the
private sector. The debate on health care reform in the country
typically revolves around concerns such as a right to health
care, access, equity, affordability and quality of care. The
United States currently spends more oin healthcare as a share of
GDP than other advanced economies which spend relatively less
and hold higher standards in healthcare. This has resulted in
concerns regarding the cost of such spending on the long term
health of the economy and the country’s competitiveness and
sustainability.
Reforms particularly in regards to cost containment and the
governance of health care is conducive for the federal
government in order to achieve reform. The federal government
cost of healthcare in the United States has in the past been
involved in health care reform through the enactment of the
ACA in 2010. This legislation was passed and signed into law
with the goals of increasing access, quality and the affordability
of health care. The federal government has also been involved

6. in giving incentives to health care providers in order to
facilitate the adoption of new technology in the medical arena.
The implementation of technology in the medical field creates
transparency and expedites information across many
departments. The government recognizes the important role that
technology plays in improving the quality of care while
simultaneously upholding cost effectiveness. Through the
Health Information Technology for Economic and Clinical
Health Act (HITECH) of 2009, the federal government has
offered monetary incentives for the adoption of Electronic
Health Records (EHR) systems galvanizing medical providers.
Government agencies additionally safeguard that its citizens
have access to high-quality care. This is due to the fundamental
obligation to defend and advance the interests of the American
people as it relates to medical assistance. The private sector as
a stand-alone unit cannot ensure that all citizens have access to
quality care forcing the federal government to step in, in order
to uphold access and care. This can be through complementing
the market where there are gaps and amending the market where
there is inefficiency or lack of equality. Achieving quality
health care also involves strong collaboration between the
federal, state and local agencies as well as the private sector.
This is because all levels of government and the private sector
play key roles in specific actions that ensure the responsibility
and duties of the federal government.
The various roles of the government as regulator, health care
purchaser, provider of health care services, sponsor of
education and training programs for health care professionals
and applied health care services can also support the
advancement of high-quality care for its consumers and
patients. The government can leverage on regulatory processes
to establish clinical standards that ensure the quality of care.
Through its role in the purchase of health care, it can establish
conditions for disbursement to ensure that its citizens access
quality care.
The enactment of laws that affect various elements of the

7. healthcare sector has additionally created involvement by the
government. This is particularly achieved through Congress,
which is the legislative arm of government. The federal
government can leverage on its legislative role to manage the
healthcare aspects of access to care, cost containment or
affordability and quality of care (Stabile & Thomson, 2013).
An aspect of healthcare legislation that particularly remains
thorny is on the funding of healthcare. Changes to Medicaid
which is a federal-state program for low- income earners has
effectively created difficulty as policymakers grapple with
increasing healthcare cost which isare often financed by the
federal government. Congress for instance enacted the
Affordable Care Act to create a joint responsibility between the
government, employers, and individuals in ensuring that all
Americans have access to affordable and high- quality care.
Therefore, government can achieve various healthcare
objectives through laws which focal point is to increaseing
access to affordable and exceptional medical care. A repeal of
the 2010 Affordable Healthcare Act has the potential to reduce
federal spending but very easily leave behind millions of low-
income Americans without health care coverage.
The federal government is also involved in the sponsorship of
applied health care research. Robust evidence- based research is
a critical element of healthcare. Medical research significantly
contributes to the enhancement of health care practice
guidelines as it relates to health care professionals and
organizations in the delivery of medical care. The government
further ensures that achievement of various healthcare research
objectives through the provision of funding for health care
research are met (Whitsel, 2017). Funding to various
organizations such as the Agency for Healthcare Research and
Quality (AHRQ) that conducts applied research on various
aspects of health care are managed by the government.
In its role in sponsoring health care research services, the
federal government also supports the creation of knowledge and
tools required to effectively carry out its various roles as

8. regulator, purchaser and provider of health care. The federal
government supports applied health research to address the
financing and delivery issues essential for increasing access to
care, reducing expense and promoting an environment that
supports quality. The National Institute of Health (NIH) which
is an agency of the U.S Department of Health and Human
Services and therefore a federal agency is also engaged in
applied health care research. The federal agency offers far-
reaching support for clinical research aimed at expanding
scientific education and developing new medical technology.
The NIH also offers support for the training of researchers
through various mechanism which isare later discovered and
enhanced. By way of research, various approaches to medical
care are implemented in order to enhance patient to provider
experience.
The government provides in-depth support for education and
training programs forof healthcare professionals. This program
renders an opportunity to increase access to medical care while
considering the leading and future challenges that the healthcare
sector faces as it relates to the shortage of medical
practitioners. Various agencies within the Department of Health
and Human Services play a role in various healthcare
professionals training programs. Funding for programs that
generate the development of post-graduate training aimed at
improving the delivery of care is made available by government
agencies. Furthermore, sponsored training programs in areas
such as health information technology are made available.
Overall, the government has a responsibility in advancing the
interests of society through its involvement in the health care
system. Through its various roles, government plays a vital role
in ensuring that its citizens have access to affordable and high
quality care. The government ensures the preservation of the
interests and rights of Americans in regards to healthcare. This
includes policies to reduce medical errors and enhance patient
safety through regulations and incentives to healthcare
organizations as well as patient medical satisfaction. It further

9. plays a role in research and the acquisition of new knowledge
that can be used to inform health care decision and policy
makers. The federal government’s role in healthcare reform has
also ensured the reduction of expenses and increased health
insurance coverage for many Americans. TIn order to achieve
its ultimate goals in regards to healthcare, government agencies
additionally require the collaboration and partnership with other
levels of government and the private sector. All these
approaches come into play to ultimately benefit consumers and
patient medical needs.
References
Gaynor, M. (2014). Competition policy in healthcare markets:
navigating the enforcement and policy maze. Health Aff
(Milwood) 33(6), 1088-93. doi 10.1377/hlthaff.2014.0333.
Hoyt, R., & Yoshihashi, A. (2014). Health Informatics:
practical guide for healthcareand information technology
professionals, (6th ed.). Raleigh.
Marshall, M., & Bindman, A. (2016). The Role of Government
in Health Care Reform in the United States and England. JAMA
Intern Med. 176(1), 9-10.
doi: 10.1001/jamainternmed.2015.6054.
Scxhneider, M., & Schneider, H. (2017). Introduction to public

10. health, (5th ed.). Burlington, MA: Jones & Bartlett Learning.
Stabile, M., & Thomson, S. (2013). The Changing Role of
Government in Financing Health Care: an international
perspective. Cambridge, Massachussets: National Bureau of
Economic Research.
Stabile, M., & Thomson, S. (2014). The changing role of
government in financing health care: an
international perspective. Journal of Economic Literature,
52(2), 480-518.
doi:10.1257/jel.52.2.480
Whitsel, L. (2017). Government's rRole in pPromoting hHealth
lLiving. Prog Cardiovasc Dis. 59(5), 492-497. doi:
10.1016/j.pcad.2017.01.003.
Week 7 & 8: Assignment-3 Rubric
Due Date – Week-7 before Dec 10, 2017 @ midnight
Due Date – Week-8 before Dec 17, 2017 @ midnight
Possible
Points
Requirements
· Writer addressed all objectives of the selected topic of the
final research assignment.
· Writer stayed focused on the topic, shows clear evidence of
thorough research. The paper is well organized, concise,
complete, correlated to the research and provide information
beyond the course textbook content.
· The paper consists of 5-7 full pages of text writing, excluding
the Title page, Abstract Page and Reference pages
7.5/7.5
Critical Thinking
· Writer show critical thinking and analyzing skills.
· Writer addressed assignment using insights and new
applications.
· Writer interprets new knowledge and applies it properly.
3/3
Mechanics

11. · Grammar
· Spelling
· Word choice
· Punctuation
· Sentence structure
1.8/2
APA Formatting
· Correct: Title page, abstract and reference page
· Proper in-text citations Comment by Charl Mattheus: I did not
see all you references in the text as citations.
· Header is APA format
· Proper margins, indentions, and spacing (sentence and line)
· Font type and size
· Minimum of 4 references with at least 3 scholarly articles
from peer-reviewed journals were used as references and at
least cited once in the text.
· No direct quotes or paraphrasing – student used own words
· References in Reference list are in APA format with no active
hyperlinks
3.5/5
Total
15.8/17.5