Local, state, and federal governments are inherently different in the scopes of their legal powers as well as limits on those powers (Payson, 2014). The existence of the layered approach to the limitation of the governmental powers hinges upon the implementation of federalism as a system of checks and balances that have been put in place to safeguard citizens of the US from excessive governmental corruption. Local governments are in a position to introduce value-driven services and control their implementation (“The role,” n.d.). However, the top-down approach of the federal government to state funding can impose significant budgetary limitations on the local healthcare delivery.
Rural communities fundamentally differ from urban ones because the limited scale of political maps of country areas allows their residents to better control the functioning of their municipalities. Therefore, it can be argued that rural local governments are more efficient in performing their key functions. For example, people residing in rural areas can effectively change the political leanings of their representatives. Furthermore, union members have a higher level of bargaining power granted by local legislatures than their urban counterparts.
It follows that local governments can impact the health of their residents by exercising their control over providers, which has positive connotations. However, they are unable to dissuade the federal government from cutting healthcare grants while simultaneously having to subsidize federal defense spending (Lav & Leachman, 2017).
References
Lav, I. J., & Leachman, M. (2017). At risk: Federal grants to state and local governments: Programs for low-and moderate-income families could bear the brunt of cuts. Web.
Payson, S. (2014). Public economics in the United States: How the Federal government analyzes and influences the economy (Vols. 1-3). California, CA: ABC-CLIO.
The role for states and local governments. (n.d.). Web.