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, and it is a practice of taking out some Americans from free healthcare services by the federal government. Instead, our federal government should cooperate with the states to create a universal system that benefit all Americans equally without excluding them.
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). This is a clear evidence that our federal and state governments are not improving healthcare for American people. The complexity of the federalism is one of the obstacles that block universal healthcare in AMERICA because many states want to use the federal funds to create a program like single-payer, but the federal force them to distribute the money into diverse programs such as Medicaid, Medicare, and OTHERS.
HERE IS A SOURCE THAT EMPHASIZES THE POOR MANAGEMENT THAT OUR FEDERAL GOVERNMENT HAS IMPLEMENTED IN THE FUNDING DISTRIBUTIONS
"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).
The inefficiency to provide a change in the 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. Also, we need to elect the right representatives that work for our interest. Therefore, we need to vote for the right person. Moreover, Federalism is a system that will never end because it keeps the whole country running in a system called balance of powers on which none of the governments has more power than other. So our option is to vote for the right representatives that can change our current healthcare system which is in poor management.