The irrelevant increase of the inequality on the healthcare system has become a sign of federal and state government failed to eradicate the irregular healthcare that has been affecting Americans. The inefficient processes that our institutional systems are using to eliminate the inequality seem to be criticized by all Americans due to the absence of improvement results. However, we see that healthcare is a broken system that is receiving many funds but is not improving at all. As Americans, we have to understand and consider the central message of the question, why don’t we have universal healthcare in America? Many citizens believe that federalism is one of the main factors that impede the creation of universal healthcare on which all Americans will have the same opportunity to equal healthcare service. Our modern democracies created the federalism system to split the government’s power into two levels the federal and state. By dividing powers of administration, the united states formed an unpredictable and complex federalism system that increase the failure to generate high-efficiency management of the government on healthcare due to the limitation that another level government-imposed to secure their interests.

 

The box above shows the structure of federalism on which it describes the two levels of government, which are federal and state. By observing the graph, one can see that federalism means separation of power between the nation and a subnational government. Also, we infer that there will be a limitation of power from one to another, leading healthcare issues to be a debate between the different interest groups that form part of those governments. Eventually, it will cause poor management and arrangement to solve the healthcare problem because some groups will think that other objectives are more important than universal health. The federalism complexity of this system will create debates on whether universal healthcare is necessary or not postponing them for long times.

Our healthcare group decided to evaluate the prominent question, why we do not have universal care? Some of the most important factors that make it difficult and hard to introduce a reform of universal healthcare. We found data in our research that America has an influential individualist culture, limitation of power between levels of governments, the waste of spending, different interest groups from congress, and the federalism system that will maintain the order between all two government institutions. In my point of view, I find more important the federalism system because of their separation of power and obligation between federal and state levels. The division of power shows a more clear perspective to determinate why is universal healthcare not able and its effect on our current system.

The federal government uses grants to transfer money to the subnational government as a way to persuade them to work in cooperative federalism toward the selecting objectives, for example, healthcare or another area. However, those grants can become categorical grants, which limit the beneficiaries to use funds from the federal government by directing them to strict rules in order to obtain their benefits such as Medicaid, a program that excludes a large number of citizens that do not qualify with their income and family size, (Federal Govt, pg.90). Although we can infer that federalism is creating exclusions of the middle-class on our healthcare system, it is a practice of limitation over free healthcare services from the federal government. For some citizens, this decision is a symbol of the inefficiency of our government to fix the irregular healthcare and transform it into equal care services for everyone since we all pay the same percentage of taxes to our federal and state governments; therefore, we all should get the same benefits.

Other critical factors to emphasize are the governments’ actions and their funds for healthcare programs with inadequate management from federal and state levels throughout the last years. According to congressional research, a graph that focuses on the increase of the federal grants to state and local governments, reveals “The upward slope since the 1990s is primarily due to the increase in federal grant money going to Medicaid. Federally funded healthcare programs jumped from $43.8 billion in 1990 to $320 billion in 2014.44 Health-related grant programs such as Medicaid and the Children’s Health Insurance Program (CHIP) represented more than half of total federal grant expenses” (Federal Govt, pg.91). By evaluating the statistics from the congress research, we can determinate that our current healthcare is receiving more funds than any other area, but the crucial problem is why are there so many Americans uncover when our government is granting most of the funds to the healthcare. As Americans, we need to know that our governments are distributing those funds for healthcare into programs that are not for everyone; instead, they are for particular individuals. Therefore, we need to persuade our federal and state governments to validate the universal healthcare policy, which will cover all of us equally.

The waste of healthcare spending emphasizes how our federalism system is providing poor management to attain universal healthcare. According to a research paper, published in JAMA evaluating the waste of spending on healthcare, reveals, “as much as $265.6 billion is spent on what they refer to as administrative complexity… Another $230.7 billion to $240.5 billion of waste can be attributed to pricing failure… Some $102.4 billion to $165.7 billion is related to failure of care delivery… Fraud and abuse takes up a further $58.5 billion to $83.9 billion each year, while $75.7 billion to $101.2 billion is spent on overtreatment or low-value care” (Newsweek). The presented report emphasized the poor management that our current system is providing to healthcare throughout recent years. The author of the article describes our healthcare as the most expensive and unequal for the citizens because most of American decided to buy private insurance since Medicaid cover lower-income families. Therefore, we observe that our federalism system affect our goal of imposing universal healthcare in America because its complexity divides its power and limit us to proceed to our goal.

The inefficiency to provide a change in the competitive environment, funding, poor management, and waste of spending from our federal and state governments are the most fundamental reasons that decline the possibility of universal healthcare in American. As Americans, we need to know how to determinate and cooperate with our communities to spread the important value of universal healthcare for all of us. Healthcare should be equal for us because we all pay the same percentages of taxes. Therefore, we need to embrace a strong desired for the change that we want in our healthcare system and transmitted it to our federal and state governments so that they can fix and improve it for Americans.