Question1
Traditionally, the federalism in the U.S. implied that the states had the power and authority аs sovereign nations (Feldstein, 2006). Therefore, healthcare regulation was a prerogative of the state level of government. The jurisdiction over physicians, nurses, and other health care professionals, as well as hospitals and clinics, and sanitation, disease surveillance, food safety and other general health matters has traditionally been granted to the state. The federal government, in terms of the health care, has the power to regulate two matters: commerce between the states – pharmaceutical drugs and medical devices that are traded between the states and abroad; and initiate programs which facilitate general welfare of Americans. Medicare and Medicaid are the examples of such programs. However, in fact, the U.S. health care system is too complex and ineffective and has been requiring reforms for decades. They happened on March 23, 2010, when President Barack Obama signed into "The Patient Protection and Affordable Care Act," known as ObamaCare. This federal law caused a lot of controversy, urging some states to nullify the federal legislation.
Florida rejected to enact the health care law and thereby had to return $4.5 million and decline $106 million allocated by the federal government on its implementation. Louisiana also opposed the health care reform. Both Florida and Louisiana governors hope “republicans will win the presidency and take control of Congress and repeal the health care overhaul”. Texas has joined other states challenging thee la in the court. Its governor Rick Perry says the state can “deliver health care more efficiently, more effectively and cheaper than the federal government can.”
Question 2
There is overwhelming consensus among scholars and health care practitioners that the U.S. health care system is enormously complex and ineffective being, at the same time, one of the most expensive in the world (Morone, Litman, and Robins, 2008). Therefore, some reforms are needed, and the question of who should take the lead in the health care policy, the state or the federal government, is the first in proceeding with the progress.
In my opinion, the states should become the flagmen in reforming health care, as Massachusetts did, rather than follow a one-size-fits-all system from dysfunctional Washington. It would allow for a federal partnership, but permit states to be more flexible in designing their own health care policy. In order to ensure the high quality of health care, it is important place a great deal of emphasize on refundable tax credits, high-risk pools and Medicaid reform, while providing coverage and reducing costs for people who have limited access to care.
There are two most important benefits of such a system. Firstly, the states can benchmark successful policy, while unsuccessful attempts can be abolished relatively easily without the need to transform the entire national healthcare system. Secondly, state officials are more aware of local problems and needs, than federal officials far away, thus, they can implement licensure and adopt laws more quickly and fairly. Some argue that the health policy problem is too big for the …