What main roles does the government play in the US health services system?
The government is a major financier of healthcare delivery through the Medicare, Medicaid, and S-CHIP programs. The government determines eligibility criteria as to who can receive services under these programs; it also determines the reimbursement rates that providers will receive for rendering services to Medicaid and Medicare patients.
In order to render services to Medicaid and Medicare patients, healthcare facilities must be certified. These organizations must comply with the standards of participation formulated by the government. The government also regulates the healthcare industry through licensing of personnel and healthcare establishments. Under ACA, the government's role is expanding further by mandating that individuals have to get insurance or pay a penalty.