Government's Role in Health Care & Poverty

ROLE OF GOVERNMENT IN HEALTH CARE AND POVERTY

This research paper discusses the involvement of different levels of government in addressing health care needs and the problem of poverty in the United States, the economic implications of that involvement and differing rationale for that involvement and the proper degree and nature thereof.

Role of Government in Addressing Health Care Needs

According to Cochran et al. (1996), "the traditional American health care system is a mix of public and private institutions with little central planning or coordination" (p. 250). Prior to the 1960s, health care was largely left to private health care providers. Many hospitals were owned by private charities. Local governments were responsible for providing garbage and sewage services, safe drinking water, insect and epidemic control and some free clinics. The federal government through the Food and Drug Administration regulated the purity and safety of food products and pharmaceuticals. According to Cochran et al., total R & D for public health (conducted mainly through the National Institute of Health and the National Science Foundation and the Public Health) rose from $160 million in 1950 to $11 billion in 1963 (p. 264). The Public Health Service established minimum standards for the control of certain communicable diseases. The federal government also financed 15 percent of postwar new hospital construction.

The role of the federal government increased dramatically

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uting caps and standardized reimbursement formulas, it has skyrocketed, from $1 billion in 1966 to $175 billion in 1995; and Medicaid costs have risen by similar proportions (Cochran et al., 1996, p. 269). The costs of public spending on health are not the only economic impacts. Kuttner pointed out that "social provision of basic public health is enlightened self-interest" without which general epidemics, malnutrition, lower productivity and widespread suffering would be much greater (p. 111). Conservatives argue that health care should be largely left to market forces and that greater consumer choice will rectify any social ills. Kuttner noted that health care is far from a perfectly competitive market and that the present system accentuates inflationary pressures, bureaucratic inefficiency and gross inequality of basic coverage. Liberals argue for universal health care coverage, but efforts since 1935 to achieve it have been frustrated by a combination of conservative forces. The Bill Clinton administration failed in its effort to achieve broader coverage and restraint of costs through its managed competition health reform proposal of 1993 which Kuttner said was difficult to understand because of its "Byzantine complexity" (p.

Category: Government - G