Federal agencies are part of the Executive Branch and headed by a secretary. The secretary is a member of the president's cabinet, the body that advises the president on national matters. The Department of Health and Human Services (HHS) has jursidiction over most healthcare issues in the country. This section provides background information on this department and the various agencies that fall under HHS' umbrella, as they relate to cancer.
The Department of Health and Human Services (HHS) is the United States government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. The Cabinet-level Department of Health, Education and Welfare was created under President Eisenhower, officially coming into existence April 11, 1953. In 1979, the Department of Education Organization Act was signed into law, providing for a separate Department of Education. HEW became the Department of Health and Human Services, officially arriving on May 4, 1980. The Department includes more than 300 programs, covering a wide spectrum of activities. Some highlights include: Health and social science research, assuring food and drug safety, Medicare and Medicaid, and health information technology.
HHS represents almost a quarter of all federal outlays, and it administers more grant dollars than all other federal agencies combined. HHS' Medicare program is the nation's largest health insurer, handling more than 1 billion claims per year. Medicare and Medicaid together provide health care insurance for one in four Americans.
HHS works closely with state and local governments, and many HHS-funded services are provided at the local level by state or county agencies, or through private sector grantees. The Department's programs are administered by 11 operating divisions, including eight agencies in the U.S. Public Health Service and three human services agencies. In addition to the services they deliver, the HHS programs provide for equitable treatment of beneficiaries nationwide, and they enable the collection of national health and other data.
There are three agencies that deal with oncology and that fall under HHS’ jurisdiction. They are the Centers for Medicare & Medicaid Services, the Food & Drug Administration and the National Institutes of Health. This and more information about the Department of Health and Human Services can be found on the agency’s website at www.hhs.gov.
The Centers for Medicare & Medicaid Services (CMS) administers the Medicare program and works in partnership with the States to administer Medicaid, the State Children’s Health Insurance Program (SCHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in health care facilities through its survey and certification activity, and clinical laboratory quality standards.
About 83 million beneficiaries, or more then 1 in 4 Americans, receive health care coverage through Medicare, Medicaid, and SCHIP. Medicare covers almost 42 million people, and about 43 million are covered by Medicaid (including approximately 6 million who are dually eligible for Medicare and Medicaid). Additionally, more than 6 million children are covered by SCHIP through separate programs or Medicaid-based expansions.
CMS spends 20 percent of the Federal Government’s dollars. In FY 2005, CMS will spend about $519 billion; 63 percent for Medicare, 35 percent for Medicaid and Medicaid administration, 1 percent for SCHIP, and 1 percent for other administrative costs. Including State spending, these programs spend about 45 percent of the Nation’s health care dollars.
All of this information and more can be found at CMS’ website at www.cms.gov.
The Food and Drug Administration (FDA) is responsible for protecting the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, and products that emit radiation. The FDA is also responsible for advancing the public health by helping to speed innovations that make medicines and foods more effective, safer, and more affordable; and helping the public get the accurate, science-based information they need to use medicines and foods to improve their health.
FDA is a team of over 9,000 dedicated public health employees that includes physicians, nurses, consumer safety officers, lawyers, and scientists, with specialties ranging from biomaterials engineering to pharmacology. About one-third of the agency's employees are stationed outside of the Washington, D. C. area, staffing over 150 field offices and laboratories, including five regional offices and 20 district offices. Investigators and inspectors visit more than 16,000 facilities a year, and arrange with state governments to help increase the number of facilities checked. Decisions made by FDA affect every American every day. In 2000, consumers spent $1 trillion—more than 20 percent of their income—on hundreds of thousands of products whose safety and effectiveness is our responsibility.
All of this information and more can be found on the FDA’s website at www.fda.gov.
The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research. Helping to lead the way toward important medical discoveries that improve people’s health and save lives, NIH scientists investigate ways to prevent disease as well as the causes, treatments, and even cures for common and rare diseases. NIH is the nation's medical research agency – making important medical discoveries that improve health and save lives. Its mission is science in pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability.
Composed of 27 Institutes and Centers, the NIH provides leadership and financial support to researchers in every state and throughout the world. For over a century, the National Institutes of Health has played an important role in improving the health of the nation. The NIH traces its roots to 1887 with the creation of the Laboratory of Hygiene at the Marine Hospital in Staten Island, NY.
This information and more can be found on the NIH website at www.nih.gov.
The National Cancer Institute (NCI) is a component of the National Institutes of Health (NIH), one of eight agencies that compose the Public Health Service (PHS) in the Department of Health and Human Services (DHHS). The NCI, established under the National Cancer Act of 1937, is the Federal Government's principal agency for cancer research and training. The National Cancer Act of 1971 broadened the scope and responsibilities of the NCI and created the National Cancer Program. Over the years, legislative amendments have maintained the NCI authorities and responsibilities and added new information dissemination mandates as well as a requirement to assess the incorporation of state-of-the-art cancer treatments into clinical practice. The NCI coordinates the National Cancer Program, which conducts and supports research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients. Specifically, the Institute: supports and coordinates research projects conducted by universities, hospitals, research foundations, and businesses throughout this country and abroad through research grants and cooperative agreements.
Since the passage of the National Cancer Act, the nation has made great progress in reducing the burden of cancer. While there is much more to learn about this complex disease, the increased understanding of cancer at the genetic, molecular, and cellular levels is opening up enormous opportunity to interrupt the initiation and progression of the disease. Over the course of the 20th century, the primary strategy for treating cancer was "seek and destroy." Now, in an effort to preserve healthy cells and improve outcomes, there are increasing efforts to "target and control" cancer by modulating and altering the behavior of the disease. Someday, cancer will be eliminated, but for today our immediate goal is to eliminate the suffering and death due to cancer.
This information and more can be found on the NCI website at www.cancer.gov.
