HA 199 Assignment2JohnsonGRADED.docx - BEFORE I BEGIN I...

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BEFORE I BEGIN, I LIKE TO FIRST PASTE IN ITS ENTIRETY THE BEST SET OF ANSWERS I HAV READ TO THIS ASSIGNMENT. THIS YOU MIGHT CALL THE “GOLDEN STANDARD” AS FAR AS GRADING GOES: Assignment 2 (covers chapter 6-9) Essentials of Health Policy and the Law The Difference between entitlement program and a block program For many years the federal government has created more and more entitlements program. Some of these programs are “cooperative arrangements with the states, e.g. AFDC and Medicaid, but they are not very cooperative. Indeed, the general image of an entitlement program seems to be a federal statute that imposes detailed and rigid standards of beneficiary eligibility in return for a federal contribution to state financing of transfers of cash, goods, or services. These programs are distinguished in terms of beneficiary’s capacity to enforce their interest in the state’s fulfillment of programmatic promises. The issue here is the degree to which statutory standards give administrator’s discretion to determine a beneficiary’s access to cash, goods, or services and the extent to which those decisions are constrained by legal remedies. Block grants fall somewhere between the most general and flexible form of federal support of state activities, general revenue sharing, and the most confined and targeted form of project by project support. Block grants emphasize state discretion in comparison with more targeted categorical grants. But as we shall see, the difference is more of degree than of kind. To differentiate between an entitlement program and a block program, here are some other key features to consider: Entitlement program can be defined as a governmental mechanism where public funds are given to people because they meet some kind of requirement . One commonly known American example of entitlement program would be the federal food stamp program, which allows people without sufficient funds to buy food. On the other hand, block grant funding is capped. It is pre-set by amount or formula and not based on actual or current costs needs. In terms of coverage or services, entitlement program eligible people are guaranteed coverage because the federal government will fully share in all costs. It allows the program to guarantee coverage for all eligible people, waiting lists and enrollment caps are not allowed. In contrast, with block grant , there is no federal guarantee of coverage . Since states are not guaranteed full federal participation in costs, block grants do not guarantee coverage for eligible people; waiting lists and enrollment freezes permitted. Also with block grant, there is less accountability and information available at the federal level with respect to how funds are spent, which can reduce support for funding over time. Moreover, the state matching payment with block grant may or may not be required . If no state spending or less state spending is required, overall level of funding for coverage could be reduced. A state spending requirement, however, may discourage a state from drawing down its full federal allotment.
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