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Government Responsibility in Balancing Public and Private Healthcare

Government Responsibility in Balancing Public and Private Healthcare

The medical system of the USA still needs to be more effective compared with developed countries of Europe, such as Great Britain. The legislation, policies, and monitoring of the government strictly coordinate it. The US state authorities have a weak system of prevention and intervention in the national healthcare system, which is divided into two hostile sides – private and public. The access to assistance is quite weak, the quality is comparably poor, and the costs are high. The misbalance in the medical system is the highest responsibility of the national governmental institutions. Unrelated public and private healthcare systems initiated a political and financial war, putting pressure on each other and increasing a misbalance in the social insurance system. Thus, the state authorities are responsible for national Medicare, as it can reduce the tension between private and public medicine, making them work as a single unit, decreasing medical errors, and improving social and medical insurance, including costs, quality, and quality access.

Public versus Private

To begin with, there is a significant lack of understanding between two brunches of medicine – public and private; both work to complement each other serving the needs of American society. The relations between both institutions are quite weak. The public healthcare system works to improve the health of the citizens, while the mission of private medicine is the financial outcome of the individuals. The problem is rooted in these systems’ main programs and goals. Thus, the aim of the public system is directed to improve the medical status of the entire population, advocate vaccination, work to reduce the risk of preventable diseases, infections, and disabilities, as well as assist disabled people and a variety of other issues, as the public healthcare work in its wide scale for entire American society, while the private medicine is focused on a particular case. Public efforts are directed to reduce problems in the entire population of the state, stop epidemics, and minimize contact diseases and other risky situations, while private healthcare is aimed at assisting personally regarding every single case individually. If the goals and principles of the approach are significantly different, the common way, cooperation, and even understanding are impossible.

However, the problem is much bigger than it seems, as public and private medicine work separately and have a significant collision of interests. Furthermore, the contradiction of the interests increases the tension, thus leading to an invisible political battle. Inequality is in terms of health, outcome, and availability. The problem concerns the need for more single standards recognizing equality in medicine. The situation in public and private medicine in America is one of the most complicated compared to the other developed countries. For instance, Great Britain has the most public healthcare system. The private and public medicine sector is functionally organized and combined, thus working together as a single effective system. The country has quite a high expenditure of the public on healthcare.

Nevertheless, direct consumer payment is the lowest, as the private insurance industry has a small particle in the sector. Thus, direct governmental financial assistance plays the biggest effective role. Therefore, the role of the government in state healthcare transformed a medical system into an effective single unit of the private and public sectors.

Governmental Monitoring the Medical Errors

Medical error is one of national healthcare’s most debatable and critical problems. Therefore, there is a serious dilemma about whether the government should take an active part in monitoring and controlling healthcare providers or should not. The published report from the IOM in 1999 summarized alarming information concerning the increased mortality rates related to medical errors. It also mentioned the risky situations, potential reasons for errors, and the methods to reduce the issue. The biggest rate of medical mistakes has a place in surgery, and it is one of the prevailing cases of death in the USA. The situation is complicated, as the problem still needs to be solved. The major death cases are still unresolved due to weak control and irresponsibility. It is also necessary to conclude that the weak participation and control of the governmental institutions lead to such cases since the errors are not related to poor quality or medical assistance delivery but rather to poor performance and irresponsible attitudes of some separate healthcare providers. The reports confirm that the medical system of Tallinn, Estonia is one of the best examples in the world of systematic governmental monitoring of the cooperation of the healthcare providers and their effectiveness level. The state’s medical system is an example of full coordination of work and responsibility under strict governmental control, which initiated the program to control the progress in medicine. President Clinton made some attempts to reduce medical errors by initiating specific coordination agencies. Nevertheless, it did not have a significant effect.

Therefore, increasing national awareness about medical safety is highly recommended. Such national efforts must be coordinated on the federal level. The government should create a mandatory and voluntary specific reporting system to gather information about the errors. The providers would be able to learn from the mistakes to omit them in the future. The government must also create a delivery-level safety system within healthcare providers. Innovations and new technologies mostly concern business, while medical sources inform about treatment and medications. A reporting system should inform about technological innovations. Thus, the government should have the highest responsibility for medical errors, thus controlling the medicine and improving it on a policy-making and legislative level.

Legislative Attempts

Social, and medical security includes a strong system in the form of a triangle, which includes quality, costs, and access. An effective medical system should work as a single unit with the appropriate status of these three parts of the triangle. Nevertheless, the legislative attempts to improve one element of the triangle lead to inevitable negative consequences, thus decreasing the effectiveness of the other two. The parts of this system are closely related and mutually dependable since the costs, quality, and access depend on each other. The costs must be affordable, as it makes the healthcare system available and accessible for all the population. The quality depends on the costs and the accessibility. Congress passed the concept of the triangle, but the work of the triangle still needs to be more effective, as the government does not work mutually in three directions. It is necessary for the improvement of Medicare but assists a separate part of the triangle, thus worsening the situation of other segments of it. The government is working on a program to reduce healthcare delivery costs. The medicine can be sufficiently cheaper. However, such an attempt is only possible if the government reduces the quality or access. Therefore, if one part of the triangle is improved, the other two parts should be sacrificed. It is a price for enhancing one of the triangle’s sides. If the government raises healthcare assistance costs, most patients would not be able to pay for it, and access would be reduced while the quality could be improved. Thus, the Affordable Care Act of President Obama was one of the most effective ways to improve the system. The Affordable Care Act became a sign of hope for those unable to afford expensive insurance. Therefore, it was one of many government attempts to state the balance within the triangle. The Act is a well-organized legislation that controls the costs, thus increasing access to Medicare and controlling medical quality standards.


The governmental institutions may affect the healthcare industry, as they can reduce medical errors, increase public-private medicine cooperation, and control the balance within the social medical security triangle. The public and private medical sectors do not work mutually in close cooperation due to differences in attitudes and principles. The role of the government is to coordinate mutual cooperation, thus increasing public medicine effectiveness on the example of medical systems in Great Britain and Europe. The government can also improve the mortality rate related to medical errors. It is necessary to initiate a new program of control and coordination, thus encouraging the providers to learn from their mistakes and omit them in the future. The legislative attempts of the government to improve medicine still need to be more effective, as the institutions do not regard the social, medical security triangle. Therefore, by addressing one issue, the other two become worse. The government aims to identify a balance within the triangle by making the costs stable, hence increasing access and quality.

📎 References

1. Marshall, M., & Bindman, A. (2016). The role of government in health care reform in the United States and England. JAMA Internal Medicine, 176(1), 9.
2. Schulman, K., & Kim, J. (2000). Medical errors: How the US government is addressing the problem. Current Controlled Trials in Cardiovascular Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC59595/
3. Sultz, H., & Young, K. (2018). Health care USA. Burlington, MA: Jones & Bartlett Learning.
4. World Health Organization. (2014). Health systems for health and wealth in the context of Health 2020: Follow-up to the 2008 Tallinn Charter. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0005/254732/64wd09e_TallinnHealthSys_140462.pdf