Public Policy in the United States Federal System

Public Policy in the United States Federal System
Apparently, Comprehensive knowledge on public policy is important for effective citizens and public administrators. Public policies govern all economic sectors that drive a country forward. They include education, trade, and healthcare. Hence, adequate information on public policy allows administrators and citizens to identify policy-gaps that can affect their livelihoods in terms of their physical and emotional well-being, finances, academics, and employment opportunities. According to Portz (2011), public policy in the United States is related to federalism, which is the allocation of powers and responsibilities to
different arms of the federal government. They include the local, state, and national governments. Hence, the interactions between these arms and the distinct economic sectors in a country make public policy processes complex. This paper discusses the U.S. healthcare policy where the national arm has the primary responsibility while the states perform secondary but also significant roles. In the U.S. federal system, policymaking has both merits and demerits.
According to the National Health Council (NHC) (2016), healthcare policy makers and stakeholders have failed to involve patients during policy discussions. An effective healthcare policy ought to put patient needs first before looking at other stakeholders such as nurses and physicians. As a result, the NHC is fighting for effective changes in the policy area, such as A a faster development of new medicines, more comprehensive health research, and equal access to quality and affordable medical care for all citizens. Evidently, these changes represent the gaps in the current healthcare public policies.
The main work of federal governments is to formulate public policies (Portz, 2011). In this case, a policy is a series of activities by public officials with the intention of achieving desired outcomes and dealing with matters of concern. Healthcare is one area of American public life where government officials have engaged in several discussions and activities to create laws and to design programs that address perceived needs. Hence, it is normal for policymaking to be contentious and complex since government bureaucrats and policymakers from the local, state, and national levels often have distinct perspectives and interests regarding the formulation and implementation of particular policies. For instance, in the U.S healthcare sector, state governments rejected the latest national health reform act by claiming that it conditioned citizens to contribute more to medical care costs.
However, since the U.S. Constitution gives the national government the power to make supreme laws over the other levels of government, the states have to adhere to the health reform act even if they do not want to (Portz, 2011). Apparently, the Constitution fails to give specific responsibilities or power to state governments. However, the 10th Amendment reserves the powers that have not been delegated to the national government to the states and the local people. Nevertheless, since healthcare and education are not mentioned in the Constitution, it is not clear which arm of government should be responsible for the two policy areas fully. Similarly, local governments, such as school districts and municipalities, are not mentioned anywhere in the American Constitution.
As a result, there is an ineffective distribution of constitutional power in the U.S healthcare sector. As a policy area, the sector is shared among all three intergovernmental arms, although the state and national levels share the major responsibilities: the quality of medical care, healthcare costs, and healthcare access to all Americans. Correspondingly, this creates a high level of interdependence among the governmental arms concerning the formulation and implementation of healthcare policies. Thus, even though national policymakers have the biggest role of creating a specific policy, they have to rely on state and local governments for the final service delivery. However, this interdependence can fail to be beneficial when competition and conflicts play a part. Therefore, the American Constitution should make clear directives about public healthcare policies and people’s rights in the sector to provide distinctive roles to the three arms of government.      Is it not clear already in that it is the role of the states and not the federal government?  



















References
National Health Council (NHC). (2016). Public Policy. Retrieved 13 May 2016, from http://www.nationalhealthcouncil.org/public-policy
Portz, John. (2011). Policymaking in a Federal System: The U.S. Experience in Education and Health Care. Boston, Massachusetts: Northeastern University Press.