The delivery of healthcare in the United States is largely an outcome of the policy framework that emerges from the combined efforts at the local, state and federal levels. Although their objective is common, different paths lead to discussions on framing healthcare policy. The state leaders have identified five goals. The requirement to connect people with services that they need; increased integration and coordination in the system; ensuring better care for people with complex needs; a result-oriented healthcare system and better efficiency of delivered healthcare (Weil & Scheppach, 2010).
At the state level, public health delivery is managed by the state health agency. One major concern for local, state and federal governments is the rising number of uninsured. One of the major objectives of healthcare reform in 2010 was to reduce the number of uninsured, the insurance of this population was to be done without increasing the budget deficit, bring down healthcare costs and increase the efficiency of healthcare delivery. The principle objectives of the federal government are, the provision of good healthcare for all Americans, to protect communities from preventable diseases and to propagate the idea of addressing one's own health issues. For example, when dealing with the public health issue of obesity, deciding upon a law requires the systematic approach for framing a legislation, adopting regulations and framing policy at the local, state and federal levels so that the multitude of factors that cause obesity. The prevention and control of the problem of obesity will require legal approaches that need to be developed and implemented and subsequently evaluated for their efficacy (Dietz, Benken, & Hunter, 2009).
The public health departments are funded by the local government. Public health needs of the community are assessed by the public health department that may number about 3000. The departments develop policies in accordance with the needs and deliver primary healthcare. Delivery of preventive health care is also the responsibility of the public health departments. Long-term care provision for the growing number of senior citizens is a priority for policy makers. The rising cost of healthcare and reorganisation of the mechanism of healthcare delivery are problems that policy makers at all levels are grappling with.
At the state level, the medicaid services need rapid expansion. Insurance exchanges have to be set up to settle medical insurance claims. The widening of the insurance network will pose a new set of problems at the state and federal levels (Kovner, Nickman, & Jonas, 2011).
Dietz, W., Benken, D., & Hunter, A. (2009). Public Health Law and the Prevention and Control of Obesity. The Milbank Quarterly, 87(1), 215–227.
Kovner, A. R., Nickman, J., & Jonas, S. (2011). Jonas and Kovner's Health Care Delivery in the United States, Tenth Edition. Springer Publishing Company.
Weil, A., & Scheppach, R. (2010). New Roles For States In Health Reform Implementation. HealthAffairs, 29(6), 1178-1182. Retrieved from