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5 Ways Government Influences Healthcare in the United States - Lewis Robinson - Blog

5 Ways Government Influences Healthcare in the United States

The United States spends more per capita on health care than any other nation in the world and yet achieves outcomes that are no better or sometimes even worse than other developed nations that spend less. The United States government has played a significant role in the state of healthcare in the United States. These are five ways the government influences healthcare.


  1. Dietary Guidelines

Most experts agree that nutrition is a critical component of overall health. Every five years, the United States Department of Health and Human Services and the Department of Agriculture release an updated version of the Dietary Guidelines for Americans. These are the guidelines behind the food pyramid many Americans were introduced to in grammar school. The guidelines are intended to assist healthcare professionals and policymakers with advising Americans on healthy nutrition choices.

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The USDA food guidelines have come under fire by nutrition experts, such as Gary Taubes and philanthropists, such as John Arnold, who have accused the guidelines of being based on bad science, influenced by the financial interests of food manufacturers and the meat and dairy industry. Because these guidelines are the foundation upon which much of U.S. healthcare policy making is based, they play a huge role in the nutritional aspect of healthcare in America.


  1. Medicare and Medicaid

The Medicare and Medicaid programs were introduced in 1965 to provide access to health insurance coverage for senior citizens, people with disabilities and people whose income is below a certain threshold. Because more than 50 million people are insured by these programs, their administration plays a huge impact on healthcare in the United States.


For example, though Medicare and Medicaid originally excluded preventative services from coverage, to reduce the cost of administering these programs, the U.S. government has added an increasing number of covered services over the years. This has promoted the use of certain preventive services, which has, in turn, increased the promotion of these services among private insurers and healthcare providers. This focus has also increased the public's recognition of how prevention efforts can reduce the occurrence of disease and improve healthcare outcomes.


  1. The Affordable Care Act

The Affordable Care Act, which was passed in March of 2010, is one of the most significant pieces of legislation to impact healthcare in the United States since the inception of Medicare and Medicaid. The ACA made it possible for many people who did not qualify for coverage on the standard insurance market due to pre-existing conditions or who could not afford the premiums to obtain coverage, either through private insurance or through Medicaid expansions. The ACA also placed a greater emphasis on disease prevention and health promotion as the foundation of healthcare reform. Other notable elements of the legislation included a ban on charging women more for healthcare services because of their gender and a requirement to offer coverage for maternity and newborn care.


  1. The Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services has been one of the most influential federal healthcare agencies due to their statutory authority to make changes that affect the U.S. healthcare system. CMS has the ability to use its authority to hasten prevention efforts, maximize value and improve patient-centered outcomes. CMS primarily relies upon its Quality Improvement Organization Program and End-Stage Renal Disease Network Program to implement improvements in healthcare quality. However, many critics believe CMS could be better utilized to make more sweeping healthcare changes.


  1. Regulations and Incentives

Government agencies, such as the Department of Health and Human Services, influence healthcare by setting quality standards, conditions for coverage and issuing compliance regulations. Additionally, they have the power to incentivize behavior by implementing payment incentives for hitting goals and penalties for non-compliance.

The government in the United States has a wide-reaching effect on the cost and quality of healthcare in America. These are just five of the many ways the government plays a role.

Publish Date: February 12, 2021 1:52 PM

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