The agency in the United States that is responsible for public healthcare is the Department of Health and Human Services. It has two major units, the United States Public Health Service and the Health Care Financing Administration. The leadership of the Department consists of the Secretary of Health and Human Services, the Assistant Secretary (Head of the Public Health Service), and the Surgeon General, all appointed by the President.
The Public Health Service consists of sub-agencies, including the CDC, NIH, FDA, Health Resources and Services Administration, and others. These various offices are responsible for the management of health policy, research, statistics, health promotion, intergovernmental aspects, and planning and evaluation (Centers for Disease Control and Prevention, 2015).
Agencies within the Department of Health and Human Services often engage in collaboration and synergy since most national health initiatives require the different components that each office can offer to be successful. This is even outlined in the legislature in section 403A(a) of the Public Health Service Act, 42 U.S.C passed by Congress, requiring annual reports to increase interagency collaboration (NIH, 2018). With over 560 annual collaborations, the complexity of health efforts focuses on everything ranging from assessment and screening of public health to disease prevention and enabling effective health policy. The Department believes that sophisticated strategic planning is vital to coordinating initiatives in federal healthcare-related projects.
The Department of Health and Human Services has a dedicated human resources (HR) office and system. It claims to focus on establishing a foundation for workforce cohesiveness and labor functionality as well as utilizing technology to make informed data-driven decisions. The HR office consists of customer care, executive support, analytics, program management office, and operations and maintenance (HHS.gov, 2016).
Overall, this is a positive aspect for the organization since the objectives of the department are oriented at inherently human services, and it is important that the HR office takes a comprehensive and systematic approach to management that increases labor functionality. Dedicated offices focusing on program management, resource management, and operations are vital to supporting the role that the Department plays in managing the national healthcare system. Furthermore, the complex technological approach taken by HR to manage department-wide analysis and provide key solutions is necessary to the adoption of new initiatives and providing funding for expansions of the healthcare-related initiatives.
Each year, the Department of Health and Human Services finalizes its budget plan and submits it to Congress for approval and budget allocation as any federal agency. Each sub-agency in the Department develops its own budget based on the programs it runs or plans to develop as well as performance measures which are used as justification for the budget and required by the Government Performance and Results Act of 1993.
For example, the Centers for Medicare and Medicaid Services (CMS), which as the title suggests, oversees the large Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) as well as the Exchanges where the public can purchase insurance plans (Department of Health and Human Services, 2019).
The budgeting of the organization is positive for the issue of expanding universal public healthcare. The primary concern for universal healthcare is that it will cost exuberant amounts of money, and it is neither clear where it will come from nor how it will be distributed. Analyzing the tedious, highly detailed budgeting methodology of the Department of Health and Human Services alleviates such concerns. The agency follows specific guidelines in detailing its expenditures as well as organizes its financing based on planned objectives to achieve in the spheres of public health and access. A universal healthcare system will require a significant revamping of budgetary parameters and funding, but the existing foundation is beneficial to promoting transparency and accountability for the expenditures.
Healthcare is a highly politicized aspect in the United States and remains one of the most controversial issues on how to proceed forward with the system. Healthcare is closely tied with socioeconomics which is potentially why it is so political on a large scale. The relationship between politics and healthcare is complex, ultimately reducing the passage of relevant legislation and policy to a matter of ideology and partisan voting majority rather than collaboration for the benefit of the public.
A prominent example was the nearly decade-long political struggle surrounding Obamacare. It delivered healthcare reform which significantly improved standards of care, access, and financial security among my other aspects of management and funding for medical organizations. Nevertheless, despite evident showings of benefit for the country, it continues to experience partisan and special interest opposition attempting to derail it instead of building upon it (Obama, 2016).
This political nature of healthcare creates significant barriers to its management and implementation of good public policy. The first challenge that is experienced comes in terms of funding. As described, the Department of Health and Human Services is reliant on Congress approving and providing its budget. In addition to traditional budgetary constraints, the politics of it can result in slashed funding to certain programs as political parties disagree on the extent of welfare benefits and other social issues.
The management of the agency is forced to consider these political realities when formulating the budget to avoid provoking further cuts and, through this, limit the healthcare outreach to the public. A second challenge comes in terms of policy and legislation that politically guides and regulates the health departments. Although management is appointed by the President, it must adhere to Congress legislation, or it may not agree with policy approaches. Political adherence and loyalty is also a challenge that must be navigated by upper management when leading the agency and developing new programs.
References
Centers for Disease Control and Prevention. (2015). Components of the public health system description. Web.
Department of Health and Human Services. (2019). Fiscal year 2020 Justification of Estimates for Appropriations Committees. Web.
HHS.gov. (2016). HR solutions. Web.
NIH. (2018). Report on NIH collaborations with other HHS agencies for fiscal year 2018. Web.
Obama, B. (2016). United States health care reform: Progress to date and next steps. JAMA, 316(5), 525-532. Web.