To understand the current state of the U.S. health system is to understand sovereign power and the check and balances on a state level. Federalism is the relationship between the country and the state in an agreement to work together. It is a balance between the two so that power is not overrun by one entity. Thinking of it as a tiered system where each entity serves a purpose. The federal level provides most of the services to the largest portion of the population. The state level provides more specialized care to individuals who may have specific needs. When you get down to the local level care tends to be dispersed by class depending on the location you live in.
While all levels play a significant role in health care services, the federal government provides 11 divisions to support the population. They also account for 42.5% of overall health expenditures as of 2017. While classism can play a role in health care services the federal government plays a huge role in supporting The Department of Veteran Affairs on a state level.1
Throughout chapter 5, Government and Healthcare Systems, the importance of federal programs and their impact was stressed. One program that has a large bandwidth is the Department of Veteran Affairs. According the VA.gov, “The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,298 health care facilities, including 171 medical centers and 1,113 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.” These numbers and bandwidth are extremely impressive and the research they are conducting has made great strides.
Part of what I have learned so far in this class is that the United States is a leader in technology and research innovations. Within the VA’s they are playing their role in research outcomes by studying topics like Covid, Alzheimer’s, Dementia, and drugs for blood pressure medicine. One study that stuck out to me is research that shared insight on dementia and African American genealogy. They used data from the VA Million Veteran Program (MVP) where they were able to isolate genetic structures that can be linked to dementia. Since most past studies have been with those of European genes, the results expanded resources to a new part of the population. According to their data, “The results showed an association between dementia risk and variants in six different genes, including APOE. While many of these genes have been linked to dementia in past genetic studies of people with European ancestry, only two of them had been identified as significant risk factors in people with African ancestry.”2 The impact that research and data have on patient care results is becoming more important. You can see the impact the Federal government funding has on those who serve our country and that is extremely powerful.
By reading the chapter in Jonas and through different programs on Va.gov, I learned more about the impact federal funding has on the community. The power of research in the U.S. is a force in the United States and research that the VA is working on is providing better care. This is important because research opens more opportunities for patients and veterans to be better cared for.
- Goldsteen, R. L., Goldsteen, K., & Goldsteen, B. (2021). “The People Who Provide Health Care.” In Jonas’ introduction to the U.S. health care system (pp. 150-167). essay, Springer Publishing Company, LLC.
- Horrom, Tristan. “We’re Here Anytime, Day or Night – 24/7.” VA Study Reveals Dementia Risks Unique to People with African Ancestry, VA.gov, 22 Dec. 2022, www.research.va.gov/currents/1222-VA-study-reveals-dementia-risks-unique-to-people-with-African-ancestry.cfm.