Effects of Federal Mandates on Intergovernmental Relations Essay

existence Policy making is a rudimentary task of the Government. There has been concerns regarding the make up ones mind federal mandate on intergovernmental relations. In order to understand and quantify these influences we will discuss the influence of the intergovernmental lobby over the Medicaid program. We will besides analyze the importance of interest alignment amongst the federal and nar strides Governments and size uping enhancer in order to ensure smooth working of these national programs. Medicaid is the wellness insurance program that is administered by the expresss and funded jointly by federal and state governments (Weissert 1992).The Medicaid has an important place in the history of medical treatment in the U. S. An organisation noble in conception has ii dimensions to put up with. The dual dimension challenges are to cope up with the changing inevitably of patient ofs with ever increasing greets due to advances in medical knowledge, medicines and techno logy. From the early(a) side the pressure is to find solutions in the restricted bud render and to take the changing political pressures. From its beginning the Medicaid gone through legion(predicate) reforms. Researchers fix identified few challenges facing Medicaid in order to cater the necessitate of the patients.They are keeping it clear to engage service users in decisions or engaging the wider usual. Secondly to develop a link between the public and the health system. Third, Quick solutions through open discussions. The fourth is to take a long run at this. Finally, achieving above goals and much more from the Medicaid by engaging users and patients in the decision making a barely. The last few decades support seen a major multifariousness in the Primary care requirements, enlarge in the ageing population, widespread of chronic diseases, increase in the patients awareness, and greater accountability due to increased exposure (Coote, 2005).This has created a paradigm shift in the requirements of patients. The increasing trend of client centred go has made it important for the Medicaid to find ways to provide rapid and clean to access primary care to the patients. According to the Department of Health change plan the vision of change in Medicaid should be directed towards the ineluctably of the patients rather than the service providers. In order to undertake the change process effectively the professional type of the NHS staff should withal be transformed.These steps towards modernisation were indicated ) Adoption of change by the Medicaid staff. 2) Governments role in getting rid of barriers in the way to change. 3) The method for gentility and training should also be restructured. Since the Medicaid program is undertaken with the combine efforts of the federal and state governments it can clearly provide the picture of the influence of states in intergovernmental relations. The cheek of the Medicaid program provides the state governme nts with experience, management abilities and the information of the important aspects of effectiveness of much(prenominal) programs for low-income group.Both the federal and state governments fund the Program. It is often the case that there is vast difference in the goals of both state and federal governments. In order to justify the expenses it is mandatory for the federal government to undertake audit programs (Anton 1997). The process of testifying Medicaid program has always remained controversial as it has been noticed many times that state agency faces lesser criticism while warranting on the Medicaid program.This has remained a moot issue between the state and federal governments as often conflict arises on the same issue between the two government levels. A lack of collective action has been felt between both the federal and state level governments. The situation seems to threaten the federalism. allege governments have the expertise to undertake analysis and suggest im provement measures but these expertise are not used to promote intergovernmental relations so adversely effecting the potential program improvements. Both the state and federal governments at a set rate fund the cost for the Medicaid program.It has been observed that the governments of opposite states keep on experimenting with dissimilar payments mechanisms mostly aimed at reducing their cost through transfereering their the cost of the program to the federal treasury (Weissert and Weissert 2006). The states use different funding processes in order to draw down funds from the central government without spending their own funds. One such way is to increase the payment rate for the eligibility of public care providers. This higher payment rate in turn gives rise to the share of the federal government.The state governments get back the portion of the surplus through tax imposition or voluntary contributions. Although many states use this surplus amount in the render of other publ ic facilities to the people but still there has been doubts regarding the victorian and transparent use of these funds. States use two such programs Under disproportional share hospital payments (DSH payments) program the state governments provides higher amounts of funds to public hospitals and community health centers which serve people from low income group.Through the fastness payment limits (UPL) states reimburse some of these providers up to the highest Medicaid reimbursement rate (Weissert and Weissert 2006 267). These programs are implemented to cover the costs of care provision to low-income Medicaid and uninsured patients. The states use intergovernmental transfers (IGTs) to transfer back the funds at the different levels of government. The reliability of these (IGTs) as the shew of payment recycling is suspicious.Although it is through the federalism the possibilities for acquiring information regarding the policies increases because of the improved chances of experim ent due to decentralization but on the other hand it is also federalism which acts as a constraint to undertake measures according to that information. The higher tip of discord between the federal and state level governments results in turn of the wastage of the state potential which can be used for the well cosmos of the nation at federal level. This is what we call the failure of federalism, where the state level expertise are not acknowledge in national policymaking.