The map representing the Pittsburg Metropolitan Statistical Area (MSA) found on page 460 of our textbook provides some idea of inherent problems associated with urbanization and its encroachment upon the differing jurisdictions existing within all MSAs. While each local government may have specific issues that differ from other districts within an MSA, they also share problems as well. Noted on the map is that the Pittsburg MSA abuts the state of Ohio, however, what is not pointed out by the authors is that both the Wheeling and Steubenville-Weirton MSAs, located in the southeastern portion of Ohio and southwestern border of Pennsylvania, segue into West Virginia (Ohio Metropolitan Statistical Areas). This may give some idea concerning inherent problems, such as the example provided in the text related to Tennessee’s Memphis Regional Medical Center (“The Med”), where there exists no contingency for Medicaid reimbursements for healthcare services provided to residents living in Arkansas who are part of the same MSA (Smith, Greenblatt and Mariani 459). The problem described at the end of the paragraph above appears to be inherent to MSAs “Because these metropolitan areas span not just county but also state and even national borders, it is incredibly difficult to exercise any form of centralized planning over their growth and operation.” (Smith, Greenblatt and Mariani 462). Precedent appears to remain none existent to address the dilemma faced by The Med, where Medicaid reimbursements across state borders continue to be a contentious issue; and the proposition of incorporating those areas in Arkansas served by the hospital remains untenable because MSAs, as regions sharing essential services in this case, are not constitutionally... ... middle of paper ... ... today, it would be highly improbable that any movement attempting to consolidate geographic and political boundaries, as well as public services within those boundaries would be met with earnest bipartisan consideration, or by those having a vested interest in maintaining the status quo. Works Cited Bovbjerg, Randall R., Joshua M. Weiner and Michael Houseman. "State and Federal Roles in Healthcare: Rationales for Allocating Responsibilities." Federalism and Health Policy. Eds. John Holahan, Alan Weil and Joshua M. Weiner. Washington D.C.: Urban Institute, 2003. 25-57. Print. Smith, Kevin B., Alan Greenblatt, and Michele Mariani. Governing States and Localities. Third ed. Washington, D.C.: CQ, 2011. Print. "Ohio Metropolitan Statistical Areas (MSAs)." Workforce Development. Stark County. Web. 02 May 2012. .
Healthcare in the United States is an extremely often discussed topic on whether it is morally a right or just a charity to those who cannot afford it. Plenty claim that health care is too expensive and not affordable so they demand aid from the government. On the other hand, the rest presume that the state is not morally accountable to take this type of action, since not every citizen and human being is equally eligible to receive the same healthcare.
...re inevitable considering the vast difference between the scopes of the federal constitution and those of local states.
A Democratic Party long ruled by moderates and conservatives succeeded in stunting what seemed like the natural growth of a successful Republican Party until the 1990s. Since then, various forces have contributed to the growth of the Republicans, and in the end, to an altering of the core membership of each party. Most recently, the state has seen the development of a dominant Republican Party that doesn't yet hold quite the dominion the Democrats enjoyed through most of the twentieth century. The Republican Party has certainly benefited from the defection of former Democrats, the arrival of Republicans and independents from out of state, and organizational difficulties in the Democratic Party. Thus, Republican officials dominate state government, and Democrats find themselves reduced, for the present, to the status of an embattled minority party seeking to recreate themselves among their voting and financial constituencies. This is showing that the newfound Republican dominance can be the beginning of a new strong party system, or if we are in a state of transition in which the terms of political competition are still in change. If it is a new party system, I don’t think it will be very durable or last too long for that matter. Now, it seems that Republican dominance of state government will
To define the terminology of federalism to a simplistic way is the sharing of sovereignty between the national government and the local government. It is often described as the dual sovereignty of governments between the national and the local to exert power in the political system. In the US it is often been justified as one of the first to introduce federalism by the ‘founding fathers’ which were developed in order to escape from the overpowered central government. However, federalism in the United States is hitherto uncertain where the power lies in the contemporary political system. In this essay I will outline and explain how power relationship alternates between states and federal government. Moreover I will also discuss my perspective by weighing the evidence based upon resources. Based on these resources, it will aid me to evaluate the recent development in the federal-state relationship.
Longest Jr., B.B (2009) Health Policy making in the United States (5th Edition). Chicago, IL: HAP/AUPHA.
Since the initiation of the Affordable Care Act in 2010, Americans have been put back in charge of their individual health care. Under this new law, a health insurance marketplace provides a haven for individuals without insurance to gain coverage. Just this year, citizens found out early whether they qualified for Medicare or the CHIP formally known as the Children’s Health Insurance Program. So much is to be learned about the Affordable Care act and this paper provides the roles of the different governmental branches, along with other important factors associated with this law.
Discussion surrounding the role of the government in health care has become an American past time. The government is responsible for improving health care quality and safety in the United States which should enhance access to care. Many goals have been sought after since the enactment of the Patient Protection and Affordable Care Act (PPACA). Little achievement has been made in regards to which level of government is ultimately responsible for the continued support of health care. This essay will discuss both the state and federal level of government in health care, along with insight into the current happenings of both levels.
Niles, N. J. (2011). Basics of the U.S. health care system. Sudbury, MA: Jones and Bartlett.
Burns, James MacGregor, J.W Peltason, Thomas E. Cronin, and David B. Magleby. Government By The People. 01-02 Edition ed. New Jersey: Prentice Hall, 2002
The United States of America is one of the most powerful nation-states in the world today. The framers of the American Constitution spent a great deal of time and effort into making sure this power wasn’t too centralized in one aspect of the government. They created three branches of government to help maintain a checks and balance system. In this paper I will discuss these three branches, the legislative, the executive, and the judicial, for both the state and federal level.
Medicaid is a broken system that is largely failing to serve its beneficiary’s needs. Despite its chronic failures to deliver quality health care, Medicaid is seemingly running up a gigantic tab for tax payers (Frogue, 2003). Medicaid’s budget woes are secondary to its insignificant structure, leaving its beneficiaries with limited choices, when arranging for their own health care. Instead, regulations are set in order to drive costs down; instead of allowing Medicaid beneficiaries free rein to choose whom they will seek care from (Frogue, 2003)
The state is responsible for the overall regulatory, supervisory and fiscal functions as well as for quality monitoring and planning of the distribution of medical specialties at the hospital level (Schäfer et al., 2010). The 5 regions are responsible for hospitals and for self-employed health care professionals, whereas the municipalities are responsible for disease prevention and health promotion rel...
Kevin B. Smith, Alan Greenblatt, and John Buntin, Governing states and localities: First Edition (Washington, D.C.: CQ Press), 2005, 95.
Barton, P.L. (2010). Understanding the U.S. health services system. (4th ed). Chicago, IL: Health Administration Press.
...to. The notion is rather consistent to the already established idea that all local governments’ functions are and should be provided by either a municipal government or a county government. Without the procedures for city-initiated annexation and annexation powers, most of the urban services desired by and required for citizens would have to be provided by Guilford County. Lastly, as the local level of government in North Carolina, almost all governmental responsibilities have been vested in municipalities and county governments’ which are two types of general-purpose government units. Expenditures of local government units in North Carolina are made through cities and counties, whereas in many other states special districts are much more important. The result from this is that North Carolina’s urban areas do not have the likelihood of overlapping units elsewhere.