What Aspects of Public Health Lead to the Perception that it primarily Functions for the Poor and Disadvantaged through Publicly Owned Hospitals and Clinics?

Even though the public health system performs a wide range of functions in the society, the common understanding of their roles through what they are commonly seen to be engaged with the public has contributed to the notion that they only function for the poor and the less fortunate individuals in the society. Some of the commonly known roles of the public health officers which have led to the propagation of this notion are offering childhood immunization in public places, inspection of restaurants and testing of the public drinking water. Apparently, we can, therefore, attribute the general notion that the public health system works mainly for the poor and less fortunate individuals in the society in the public places to the inability of the people to understand the roles of public health officers and lack of information regarding the same.

Core Responsibilities of the State Health Departments

1. The implementation of the various prevention programs which are meant to help the public stay healthy by not victims of the existing diseases or virulent circumstances. Some of the prevention programs which are managed by the public health officers include disease surveillance, newborn screening programs, and tobacco quitlines.
2. Engaging the public with the professional healthcare services which require special skills such as food service inspection and disease outbreak inspection which requires a level of expertise which is not readily available, expensive to hire at the local level, or entails overseeing the functions of the local public health officers.
3. Administration of the public health licenses, controlling health care, health facilities and public food services.
4. Monitoring funds and resources which have been allocated for healthcare purposes to ensure that they are distributed equitably and used effectively within the community.
5. They are collecting and analyzing important statistics within the state such as health indicators and morbidity data for specified threats to public health such as cancer and other diseases.
6. Offering essential community health services throughout the state irrespective of the capacities or available resources within the local health departments.
7. Investigating the arising cases of disease outbreaks, potential environmental risks such as oil spillages and other health emergencies within the public domain.
8. Carrying out the statewide health evaluation, improvement, and planning.

The Responsibility Differences between the State Public Health Officers and the Local Public Health Officers.

The local public health officers complete the following roles within the local areas

1. Elucidation of specific health issues within the community as well as how the social, environmental, economic, physical and behavioral conditions affect them.
2. Conducting investigations on existing health threats and health problems.
3. Minimizes prevents and contains the extreme health issues which ranges from communicable diseases, outbreak of diseases which originates from chronic disease, unsafe food or water, risky health practices, injuries and health hazards.
4. Take the lead in developing the planning initiatives which are meant to respond to the existing public health emergencies.
5. Conducts the health promotion initiatives.
6. Make efforts to engage the community in addressing the threatening public health issues
7. Acts as an essential resource for the local authorities in the formulation of updated health policies and laws.
8. Offers scientific, cultural and timely competitive health information and health-related alerts to the community and the local media.

In the contrary, the state’s public health officers undertake the following responsibilities on the entire states

1. Assessing the health needs in the entire state by relying on the available statewide data.
2. Giving assurance on the adequacy of the state statutory base of health activities
3. Creation of the statewide health obligatory, delegation of power to the local public health officers and holding them accountable.
4. Giving support to the local public health services, especially when there is disparity in the ability of the local public health authority to raise funds.
5. Giving assurance to the public on the most appropriate health incentives organized by the state to create and maintain important personal, environmental and educational health; enabling of access to the mandatory health services and giving solutions to the health related problems within the state.

How the Funding of Public Health Services at both the State and Local Levels

The ensure continuity in the running of all their operations and functions, both the state and local public health agencies receive financial capacitation from various sources. The largest funding source of both the local and state public health agencies is the federal government which makes about 46% of the funds coming into these organizations. The federal government is followed by the state government which makes about 22% of the total funds coming into the agencies. Other finances into these organizations come from the state and territorial funds which comprises of the restricted funds, tobacco master settlement agreement and this makes about 16 percent of the funding.

What is Fiscal Federalism? What are the Consequences of Restructuring the Public Health Financing as Per the Fiscal Federalism Framework?

The fiscal federalism refers to the type of relationship between the various units of governments in a federal type of governance. It entails the distribution of the governmental roles and financial association between the different levels of government. According to this financing framework, the responsibilities of certain functions are delegated to the local and state governments while proper financial mechanisms are put in place to help in the completion of such functions. Some of the positive consequences that can be attributed to the fiscal federalism are:

1. Since each of the state and local government has got unique public health characteristics and requirements, the fiscal federalism enables the government to understand such conditions and finance them accordingly. This is because, all the grass root-level problems can be pin pointed and addressed effectively.
2. It stimulates a positive competition. In order to realize good performance, there is need to engage both the state and local governments to compete in terms of better service delivery and this can impact positively on the citizens.
3. The fiscal federalism enhances smooth distribution of funds to the grass root levels hence enhancing equity in the distribution of resources.

However, fiscal federalism in public health may also be attributed to a number of negative consequences to the citizens. They include:

1. Unhealthy competition between the states and the local governments. The state public health agencies might decide to engage into certain unfair practices as a way of ensuring that they are considered to be good performers and this can disrupt the national harmony.
2. The fiscal federalism funding framework can also encourage the governments to resort to unequal distribution of the public health resources and funding and this can lead to disparity between the states.
3. In some cases, the fiscal federalism can degenerate into many chaos as it works on the framework of too many programs and policies.

An Example Tragedy Of The Commons In Context Of Public Health And What Should Be Done to Respond to this?

Tragedy of commons refers to an occurrence in a shared resource system where specific individuals act in ways that serve their own-self-interest by behaving in ways that are contradicting to the common benefit of all the users through spoiling or depleting the resources. An example of a common tragedy in the public health situation is where a public health officer who is charged with the duty of distributing specific drugs to the public against a given disease or offering free treatments. Decides to sale the drugs or charge the patients for the services offered. This way, the officer hopes gain financially from such exercise, however, this is against the service code as he/she is expected to give such services for free.

In order to respond to this, the public health professionals should report such an officer to the relevant authorities for such an act of extortion. The correspondent officer should be relieved of his services and his certificate of practice be withdrawn because the act of charging the public for free services is against the code of conduct which are outlined by the public health officers governing council. To avoid such incidences in the future, the public should be informed adequately on the nature of such services and what is expected from them.

Public Health as a Public Good

Working as a public health officer entails offering curative or preventive medical services to the public with the aim of ensuring that the public safety is maintained. The public health service is considered to be a public good because of the nature of this service and what it entails. Firstly, all the public health officers are expected to help in ensuring that healthy safety of all the individuals are maintained by either warning against the outbreak, giving information on how to prevent the occurrence of epidemic’s, offering treatments in case there are people who are already affected and conducting research on the existing diseases. Secondly, most of the public health officers renders their services to all the people in the society without reducing the availability of such services to any person. Moreover, most of the public health services which are offered in the society are given for free as they are funded by the government as a sign of goodwill to the citizens who faithfully pay taxes. Even though the public health initiatives are funded by money collected from the citizens through taxes, the availability of such services are not denied to those who don’t pay the taxes directly or indirectly. Public health should therefore be considered as an act of public good as is directed towards the wellbeing of the general society.

How Can the Maintenance of the US Public Health Infrastructure Be Achieved In an Era of Fiscal Restraint

During an era of fiscal restraint, the US government will be able to reduce its expenses while at the same time raising taxes to maximize the government income. Through this policy the government will be able to conserve much of its resources which are usually wasted in facilitating unnecessary programs. After saving adequate money through the implementation of the fiscal policy, the US government will be in a position finance the maintenance of all the public health infrastructures.

How the CDC’s Research and Development Initiative Changed in Recent Decades and Factors Driving This Change?

The CDC’s research and development initiatives have changed over the years because many of the state and public health organizations have been accustomed to the practice of obtaining information and data from the CDC’s surveillance systems to identify the health needs of the public within the places and analyze their impacts. Additionally, many of the policy analysts and researchers have also adopted the practice of acquiring their data from the CDC’s national health surveys to conduct scientific investigations on health behaviors, health status and health delivery to come up with new findings. For these reasons CDC has been relieved of the need to research the health status in each and every place of their operation.

Some of the factors that have accelerated the CDC’s initiative change include the growing technology which has made it easier for states and public health organizations to carry out research on the areas of their operations without over-relying on the CDC’s equipment. The increased access to information has also made it easier for the public health officers to learn about the prevention measures concerning certain health threats. Through the access to information, CDC has been able to avail ad share their data to other researchers and the public.

Example of the Policy Marketplace in Action

The nation is an example of a policy market place this is because it comprises of both the demanders and the suppliers of the health policies. The supplies of health policy in this market place comprises of the politicians, physicians, researchers and all the health stakeholders who are involved in the formulation of the policies. On the other hand, the demanders comprises of the public, the public health officers and the authorities who implements the policies.