BOX 2-1

Other Federal Departments with Major Health Programs

A number of other federal departments and agencies are responsible for important health-related activities:

  • The Department of Veterans Affairs has an undersecretary for health in charge of hospitals, clinics, and other health services for eligible military veterans.

  • The Department of Defense has an assistant secretary for health affairs and separate surgeons general for the Army, Navy, and Air Force, who oversee health care services for active military service members and their families, and a joint staff surgeon, who serves as medical advisor to the chairman of the Joint Chiefs of Staff.

  • The Department of Homeland Security has an assistant secretary for health affairs, who also serves as the department’s chief medical officer and is responsible for advising the DHS secretary and the Federal Emergency Management Agency administrator on health-related issues.

  • The Department of Labor oversees ERISA (the Employee Retirement Income Security Act), the statute that governs employer-sponsored health insurance.

  • The Office of Personnel Management manages the Federal Employees Health Benefits Program, which is often cited as a possible model for the expansion of health care coverage.

State involvement in setting priorities is crucial, because Medicaid, health care financing innovations, and most public health activities—such as disease control and surveillance, emergency preparedness, and public information campaigns about tobacco and obesity—are carried out not just at the federal level, but in states and communities, as well. Greater inclusion of states in HHS strategic planning would be an important step forward, as states, despite their vital role in implementing HHS programs, frequently perceive that they are treated as an “interest group just like any other” (Boufford and Lee, 2001).

Health care experts outside government—such as professional associations, researchers and scientists, care providers, product manufacturers, business and labor, insurers, and health care associations—also should be consulted, as should consumer groups and organizations representing people with chronic diseases and disabilities and their family caregivers.

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