What is the healthcare infrastructure actually like? Who oversees the implementation of new healthcare legislation? How are infrastructure changes implemented? In the US, the Department of Health and Human Services (DHHS) has a simple mission statement: “Improving the health, safety, and well-being of America.” What exactly does this mean? How does the DHHS operate on a federal level and how is this different from how it operates on a local municipal level? What sort of position does it assume within the US government?
The Department of Health and Human Services is overseen by the Secretary of Health and Human Services, who is in turn appointed by the President. Several extremely large sub-agencies are included under the Secretary’s authority, including the Food and Drug Administration (FDA) the Centers for Disease Control and Prevention (CDC), and the Centers for Medicare and Medicaid Services. These agencies in turn include many smaller agencies that are more attuned to local demographics and municipal practices. Communication among sub-agencies is intended to be frequent to assure rapid implementation of policy changes.
The DHHS (as of 2013) is one of the largest components of the US national budget, with funds marked for a variety of causes: medical and health research, Medicare, food inspection, preventing disease (including immunization services at all most levels of state and local government), the Head Start education program, substance abuse treatment, and financial assistance for low-income families. There is also funding for medical preparedness in the event of a terrorist attack and comprehensive funding for Native American health services.
Recent major reform in the DHSS includes the Affordable Care Act of 2010 (also known as Obamacare or the ACA) which mandates that all small business employers with more than 50 full-time employees must provide health insurance coverage for their full-time staff. The long-term effects of the Affordable Care Act are (as of 2013) yet unknown, but many employers have attempted to circumvent the health insurance coverage mandate by shifting their workforce toward part-time labor. While employers who do not provide their full-time staff with health insurance coverage are penalized, there is currently no federal corporate penalty for the widespread shifts toward part-time labor. The DHHS established the Small Business Health Options Program (SHOP) in order to provide small business owners with an online marketplace for comparing public health insurance coverage plans for their employees. Whether more federal measures will be taken to address the part-time labor crisis remains to be seen.