Indima kahulumeni kahulumeni empilweni yomphakathi iyinto eshukumisayo futhi evame ukuphikisana, esekelwe eMthethweni womthetho-sisekelo wase-U.S. futhi ebunjwe amakhulu eminyaka wokuziphendukela kwemvelo. Nakuba ngokwesiko isho ukuthi amandla amaphoyisa abanzi ukuze avikele impilo, ukulondeka, nenhlalakahle yezakhamuzi, uhulumeni usungule indima ebalulekile nebalulekile ngokuhlukanisa amandla anjengezentengiselwano zezentengiselwano, ukukhokha intela nokuphatha inzuzo yezenhlalakahle evamile, kanye nokuqhuba ubuhlobo bangaphandle. Lokhu kuhlanganisa igunya likahulumeni ne-Hulumente ne-gest kudala isimiso esiyinkimbinkimbi lapho ukubambisana kwesizwe kunokwenzeka, kodwa ngaphandle kokuxabana. Ukuqonda umthetho - ngokomthetho kuyanikeza, izinhlangano eziwasebenzisa, kanye nezinzuzo zangempela zezenzo zomphakathi zempilo, abafundi, nanoma yimuphi umfundi, nanoma yimuphi umphakathi wezwe namuhla.

Amandla Kahulumeni Kahulumeni Ophethe Empilweni Yomphakathi

Igunya likahulumeni kahulumeni ukuba uthathe isinyathelo empilweni yomphakathi ngokuyinhloko livela kuMthetho-sisekelo wase-U.S., nakuba lencwadi ingakhulumi ngokuqondile “impilo yomphakathi.” Kunalokho, iSishaya-mthetho negatsha eliphethe liye lachaza izigaba eziningana ukuze kuxhase imizamo yempilo efinyelela kude. Lamandla akhishwa ngezinhlangano zikahulumeni, izimiso zezimali, kanye neziphathimandla zezimo eziphuthumayo.

Ezentengiselwano Zesifunda Samazwe Esihlangene

ISiphakamiso I, Ingxenye ye-8, u-Claus 3 yoMthetho-sisekelo unikeza uKhomishane amandla “okulawula noma yini ethinta ibhizinisi nezizwe zakwamanye amazwe, naphakathi kwezizwe eziningana, naphakathi kwezizwe zaseNdiya.” Lokhu kubekwa kuyisisekelo esingokomthetho semithetho eminingi yezompilo. Incazelo ebanzi yeNkantolo ePhakamileyo, ikakhulukazi kusukela enkathini yeNkathi Entsha, ivumela uhulumeni ukuba ulawule noma yini ethinta kakhulu ezentengiselwano zezentengiselwano, kuhlanganise nokuphepha kokudla, ukukhiqiza izidakamizwa, nokulawula izifo ezithathelwanayo. Isibonelo, i-FOLD, i-FOLD, i-D, i-Drigi, ne-Chonatic Act incike ku-Classiccolaus ukuze iqinisekise ukuthi imikhiqizo ehambayo ezindaweni ezisemfaya.

Ukukhokha Intela Nokusebenzisa Amandla Emali

ISiphakamiso I, iSiqeshana se-Scomponee 8, u-Classias 1 unikeza uMkhandlu amandla “okwenza nokuqoqa izintela, imisebenzi, izikhokhiso, ukukhokha izikweletu nokunikeza inhlalakahle yempilo ehlangene nenhlalakahle ye-United States.” Lokhu“ kunikeza u-Clauskase” elinye lamathuluzi anamandla kakhulu ethonya lezempilo yomphakathi. Ngokufaka izimo zokunikeza izintela, uhulumeni ungenza izimo zokwamukela imithetho ethile yempilo. Ngokwesibonelo, uMedicaid, uhlelo lwe-omganote yezempilo oluhlangene olunikeza ukuhlotshiswa kwe-R242222,2; kusho ukuthi ukwamukela izimali zikahulumeni kumelwe kuhlangabezane nezimfuneko ezithile ngokuphathelene, izinzuzo, nezingalo. Ngokufanayo, [FL:0][EF.C][FFFF]

Izinkonzo Zomphakathi Negunya Lazo Lokubusa

ISishaya - mthetho siye sanika izinhlangano eziphethe amagatsha igunya lokumisa nokumisa imithetho yempilo yomphakathi.

  • Abangenisi bezifo zokulawula nokuvimbela (CDC): Inhlangano yempilo yezwe egxile ekuqapheni izifo, ekuhloleni, ekuhlolweni, nasekuvimbeleni izinhlelo. Indima yokulawula ilinganiselwe, kodwa ithonya layo ngokuqoqa ukwaziswa nokuxhasa imali likhulu.
  • Food and Drug Administration (FDA): Isibopho sokuqinisekisa ukuphepha, ukusebenza, nokulondeka kwemithi yabantu nezilwane, imikhiqizo yamagciwane, imishini yezokwelapha, ukutholakala kokudla kwesizwe, izimonyo, nemikhiqizo ekhipha imisebe.
  • Inhlangano yesizwe yezempilo (NIH): inkampani eyinhloko kahulumeni eqondisa futhi isekele ukucwaninga kwezokwelapha, kuhlanganise nokuhlolwa kwezifo ezingamahlalakhona, amasu athathelwanayo, nokwehluka kwempilo.
  • [[NTL:0] IHealth Resources and Service Administration (HRSA): ithuthukisa ukutholakala kokunakekelwa kwempilo kubantu abangabodwa, abangavikelekile, noma abangavikelekile ngokwezokwelapha.
  • Ukusetshenziswa kabi kwezidakamizwa nokuphathwa kwezifo zengqondo (SAMHSA):[ kuholela imizamo yezempilo yomphakathi ukuze kuncishiswe ithonya lokusebenzisa kabi izidakamizwa nokugula ngengqondo.

Amandla Aphuthumayo Nokulungiselelwa Kwempilo Yomphakathi

Uhulumeni uhulumeni onomthetho oqondile owenzelwe ukuthatha izinyathelo zokuvimbela ukuthuthwa, ukudluliswa kwezifo ezithathelwanayo zempilo yomphakathi. UMthetho wezempilo we-Public Health Service (42 U.S.C. 76 264) ugunyaza unobhala wezempilo nezezinkonzo zabantu ukuba athathe izinyathelo zokuvimbela ukuthuthwa, ukudluliswa, nokusakazeka kwezifo ezithathelwanayo ezivela kwamanye amazwe zingene eUnited States noma phakathi kwezifundazwe. Lokhu kuhlanganisa amandla okubamba, ukuvimbela, noma ukukhulula abantu ngokwezimo okukholelwa ukuthi bangenwe yisifo esingangenwa yi-active. I-Stanford Act neNational Emer Act Act inikeza ezinye izicio zemali ezisemfazandleni zomphakathi phakathi nezinhlekelele zempilo. Phakathi no-2001 nyaka ka-2014, lezi ziphathimandla zasekela futhi zale mibuso.

Izibonelo Zezwe Langempela Zokuhileleka Empilweni Yomphakathi

Ukuhlola izibonelo ezithile zendlela igunya likahulumeni elisetshenziswa ngayo, izinzuzo elizinikezayo, nezimpikiswano elizibangelayo ngezinye izikhathi kufakazela izenzo zikahulumeni ezihilela ukubhekana nezinkinga ezinkulu nezinselele zempilo eziqhubekayo.

I - COVOID 16) I - Pandemic

Ubhadane lwe - COVID 16) lwaluwukusabela okukhulu kwempilo yomphakathi kusukela ngobhadane lomkhuhlane wango - 1918. Uhulumeni kahulumeni wathatha indima eyinhloko, wasebenzisa izinhlobonhlobo zezinhlangano eziphuthumayo, izimali nokusekela okusebenzayo.

  • Izimemezelo eziqinile nezingagunyaziwe: ngoJanuwari 31, 2020, iHHS yamemezela i-Public Health Emergency, ilandelwa yisimo esiphuthumayo sesizwe ngaphansi koMthetho weStafford ngoMashicelele. Lezi zimemezelo zokuxhasa okungacaciwe, zavumela i-FDA ukuba inciphe i-Emergency Uservations (UMbuso) ukuze ihlolwe ukuhlolwa, ukwelashwa, nemijovo, futhi zanika iCDC ukuba ifake i-modarium kahulumeni (empela yahlaselwa yiNkanto ephakeme).
  • Ijubane lokwehla kwe-Warp: Ubudlelwane bomphakathi obala obusheshisa ukusungulwa, ukukhiqizwa, nokusakazwa komjovo we-COVOID 16). Uhulumeni wezwe wabiza imali engaphezu ko-R34,000 000 000 ekwakhekeni komjovo nesilinganiso sangaphambi kuka-93purchase, okwenza ukuba izigodlo zokuqala zigunyazwe cishe ngonyaka.
  • I-Guidance kanye nokusikisela: I-CDC yakhishwa futhi yahlelwa kaningi ngokuqondisa kokufihla imbonakalo, ukuxega kwezenhlalo, ukuhlola, ukuzihlukanisa, nokuhlukaniswa nabantu. Nakuba lokhu kwakungagunyaziwe, babethonya kakhulu izimiso zikahulumeni, izivalo zesikole, nemisebenzi yomsebenzi. Inhlangano yalawula futhi ukuhanjiswa kwesizwe kwemijovo yokugoma nge COVOVID .
  • Ukusekela kwezezimali kweminyango yokwelapha no-Avelm: I-Act ye-Carect nempahla yosizo ezalandela yanikeza izibhedlela, iminyango yezempilo yomphakathi, nabantu ngabanye ngokukhokhela impoqo, ukuthuthukisa izinzuzo zokungasebenzi, nezimali zosizo.

Ukusetshenziswa Kokudla Nezidakamizwa (FDA) Kokuvuselela Ukudla Nezidakamizwa

Inqubo yangaphambi kwe-FDA yokugunyaza imilaliso emisha kanye nokuqondisa kwayo ukutholakala kokudla yizibonelo eziyinhloko zomthetho wezempilo kahulumeni. Imisebenzi engundoqo ihlanganisa:

  • Imvumelo ne-Safety Monitor: Izinkampani zomkhakha-khakha-khakha kumele zithumele ukwaziswa okuningi komzabalazo ukuze zibonise ukuphepha nokusebenza. I-FDA ihlola lomniningo futhi, uma ivunyelwe, iyaqhubeka ihlola izenzakalo ezimbi kakhulu nge- FDA Menassiere Factoring Proving System (FALT). Ukuvunyelwa kwababulali bezinhlungu-mizwano phakathi ko-1990 kanye nokungafanelekile kokubekwa kuqala okungafanele kwaleligunya.
  • Imithetho yoKhuseleko Lokudla: IFDA iphoqelela i-Food Safety Modertiation Act (FSMA), eyasusa ukubheka ukusabela ekuqubukeni ukuze ivimbele. Inhlangano ihlola, iqophe, ibeke izimpawu zokuphepha, i-aldergen ibalap, kanye nokudla okuthengiselwa kwamanye amazwe. I-2018 yomaine etwece E. i-coli, eyabangela ukuba abantu abangaphezu kuka-200, iveze izimfuneko zokulandelelwa.
  • Ukuhlanganisa ukuvinjelwa kogwayi onambithekayo: Kusukela lapho kudlula khona uMthetho wokunqanda Ukubhema nowokulawula komkhaya ngo-2009, i-FDA iye yalawula ukwenziwa, ukusakazwa, nokuthengiswa kwemikhiqizo kagwayi. Lokhu kuhlanganisa ukuvinjelwa kukagwayi onambithekayo (ngaphandle kwe-manthol), okudinga izixwayiso zempilo, nokubukeza imikhiqizo emisha enjenge-ekhagargarettes. Ngo-2022, i-FDA yasungula umthetho wokuvimbela ugwayithi, i-speactal trans, iveza ukulimala okungahluziwe kwemiphakathi yabaNsundu.

Izinyathelo Zokuqala Zokulawula Nezokuvimbela Izifo EC (CDC)

I - CDC ithinta cishe zonke izici zempilo yomphakathi, kusukela ekunqandeni izifo ezithathelwanayo kuya ekuvimbeleni izifo ezingapheli.

  • Uhlelo lwesizwe lokubuyisela: ICDC imisa uhlelo lwezikhathi zobuntwana nogoma abantu abadala olusekelwe ekutuseni kwe-Advisory Committee on Immunization Practices (ACIP). Ithenga nemijovo yokugoma abantwana abangaqiniswanga noma abahlolwayo ngohlelo lwe-Vaccine yezingane (VFC). Ukwehla okuphawulekayo kwezifo ezinjengesimungumungu, uvendle, neHPVPPPPP.
  • Ukulawula nokuvimbela iTobaco:[[FLT] Ihhovisi leCDC eliphathelene nokubhema nempilo liqhuba umkhankaso ophuma ku-Oxmours Shouters futhi linikeza izimali ezizweni zezinhlelo zokulawula ugwayi ezibanzi. Inhlangano ihlola ukusetshenziswa kukagwayi nge-National Health Conference Sur Survey kanye nemininingwane kahulumeni. Naphezu kwentuthuko, ugwayi uyaqhubeka uyimbangela ephambili yokufa okungagwemeki e-U.S.
  • Ukuvinjelwa kwezifo zeChronic Prevention: I-CDC’s Division of Population Health isekela izinhlelo zokuvimbela isifo senhliziyo, isifo sikashukela, unhlangothi, nomdlavuza. I-National Diabetes Prevention Program (National DP) uhlelo lwendlela yokuphila oluye lwatholwa ukuze kuncishiswe ingozi yokukhula kohlobo lwesibili lwesifo sikashukela. Inhlangano izimali nemizamo yendawo yokuthuthukisa umsebenzi womzimba, ukudla okunempilo, nokubhema.
  • Ukuvimbela kobudoda: Ekusabeleni kumqedazwe we-opioid, iCDC inikeze iziqondiso ezigunyaziwe kuma-opioid, ukuqashwa kwemininingwane esetshenziswa ngokweqile, kanye nezinhlelo zombuso ezixhaswe izimali kanye nezinhlelo zendawo zokuvimbela. Umsebenzi wale nhlangano uye wanezela ekuncipheni kwe-621dose opioid prese, nakuba ukufa okuhlobene ne-fentanylâne kuseyinkinga.

Impilo Ezungezile: Indima ye - Environmental Protection Agency (EPA)

Nakuba ingekho kuphela inxusa lezempilo yomphakathi, i-EPA imisa imithetho ethinta ngokuqondile imiphumela yempilo. I-Cease Air Act, Clean Water Act, ne-Toxic Substances Control Act inikeza igunya lokumisa i-EPA umthetho wokulawula izindinganiso zokungcolisa, ulawula amapayipi amanzi angenamagciwane, nokuhlola amakhemikhali ezimbonini. Ngokwesibonelo, umthetho we-EPA wokulawula umthofu kaphethi kuphethilo kaphethiloli nopende unciphise kakhulu ubuthi obusebuholayo owezingane. Ngo-2024, i-EPA yakhipha umthetho wokugcina odinga ukuba wonke amapayipi aho athathe indawo engcono phakathi neminyaka eyishumi, ibhekise emthonsweni omkhulu wemizwanotho.

Ukuxhasa Kwezikhungo Zezempilo Zomphakathi

I-Health Resources and Service Administration (HRSA) inikeza i-Heal Health Center Program, eyimali engaphezu kuka-400 ezikhungweni zezempilo zomphakathi ezisiza iziguli ezingaphezu kwezigidi ezingu-30 ngonyaka, kungakhathaliseki ukuthi zinezimo zomshuwalense. Lezi zikhungo zinikeza ukunakekela okuyinhloko, izinkonzo zamazinyo, ukunakekelwa kwengqondo, nokusetshenziswa kwemithi esetshenziswayo ezindaweni ezigciniwe. I-Federal inikeza imvume yokunikeza izilinganiso zemali ezisheshintshwayo nezinkonzo ezibanzi, ezizenza zibe isivikelo esibucayi esisemnyangweni sokunakekela impilo yaseMelika.

Izinselele Nezimpikiswano Endimeni Yezempilo Yomphakathi

Ukungezwani phakathi kokubambisana kwesizwe nobukhosi bombuso, imibuzo yegunya elingokomthetho nokuthemba umphakathi konke okunqumayo ukuthi inqubo kahulumeni ithathwa futhi isetshenziswe kanjani.

Ubumbano Nokulinganisela Kwamandla

ISichibiyelo seshumi esigciniwe kuhulumeni wezwe esingaphathiswanga imibuso engokomthetho. Phakathi nobhadane, lokhu kwaholela ekuhlukahlukanisweni okusobala kwempendulo kahulumeni: ezinye izifundazwe zimisa iziphakamiso eziqinile nezigunyaza ukuvala amajaji, kuyilapho ezinye zenqabela izinyathelo ezinjalo. Uhulumeni wezwe wazama ukuphoqelela i-moduratorium ukuba ikhululwe yi-costarium e- i-Alabama Association of Realtors v. Umnyango wezempilo ne-Hulumendments[[FFLT:] [20] [20], owawuthi i-CDC idlulise iziphathimandla zayo zomthetho. Ngokufanayo, umthetho wokugomela abaqashi abaningi wavinjwa yiNFL.[FFFOL] V[2]

Ukwethenjwa Komphakathi Nokungaqondi

Ukuthembela ezinhlanganweni zempilo zikahulumeni kuye kwaphela eminyakeni yamuva, ikakhulukazi phakathi nobhadane lwe-COVOIDÍ19. Imiyalezo ephikisanayo ngezifihla - buso, imvelaphi yegciwane, kanye nesikhathi sokugoma kwandisa ukungaqiniseki. IMishproce yasakazeka ngokushesha kwezenhlalo zezokuhlalisana, ilulaza futhi ilandelana nezinyathelo zempilo zomphakathi. ICDC ne-FDA iye yazama ukuxhumana ngokucacile futhi yavuselela ukuthembeka, ikakhulukazi phakathi kwemiphakathi engokomlando okulinyazwe ukuhlola kwezokwelapha (umz., i-Tuskee Syphilis Stues Sy Study). Ukubuyisela ukuthemba kudinga ukuba kube nokukhanya, ukudluliswa kwemifela phambili, nokuboshelwa komphakathi okuqotho.

Ukulinganisela Nemithombo Yemvelo

Izimali ezixhaswa umphakathi zempilo yomphakathi ziyanda kakhulu kodwa azinakusakazwa ngokulinganayo. Izindawo zasemaphandleni, imiphakathi yezizwe, kanye nezinga eliphansi ezifikayo emadolobheni ngokuvamile zithola imithombo emincane kumuntu ngamunye kunezindawo ezicebile. Umqedazwe we-COVID 16) ogqamisa ukuhlukana ekuhlolweni, ukusakazwa komjovo, namandla empilo. Izinhlelo ze-Federal njenge Health Center Program neCDC's Medicial eComment eCommunity Health (INH) inhloso yokuvala lezindawo, kodwa ukuncitshiswa kwesimiso somphakathi embonini yempilo kuseyinse inselele inselele inselele. Ngokombiko ka-2021 we-Treaty of America’s Health, ukuxhasa kwezempilo yomphakathi eU.

Impikiswano Engokomthetho Neyobuhlanya Ngezindaba

Izimfuneko zomjovo we-Federal wezisebenzi zokwelapha, izisebenzi zempi, nezokukhankasela uhulumeni ziye zabangela izinselele zomthetho nezimpikiswano ezingokomthetho. Abasekeli baphikisa ngokuthi imiyalo iwumsebenzi ongokomthetho kahulumeni wokuvikela umphakathi, ikakhulukazi ezimisweni eziphakeme ze-"%risk. Abaphikisi baphikisa ngokuthi baphula inkululeko yomuntu ngamunye nenkululeko yezokwelapha. Izinkantolo ziye zasekela imiyalelo uma isekelwe egunyeni lomthetho elicacile futhi isetshenziswa emiphakathini ethile, kodwa ukunqandana kwezombangazwe kuye kwaba namandla amakhulu. Izimpikiswano ezifanayo zokuvikela umphakathi, izifihla - buso, kanye nenkongosi yemininingwane yempilo yomphakathi.

Isiphetho

Indima kahulumeni kahulumeni empilweni yomphakathi ayiyona eqinile futhi ayiphelele. Iwumkhiqizo wencazelo yomthetho-mthetho, ukuthatha imithetho yemithetho, ukuqondisa, nokuhlola kokwahlulela. Kusukela kuMabhizinisi ka Claus kuya ku-Pallas, izisekelo ezingokomthetho zibanzi kodwa ziphikiswa. Izibonelo zezwe ezingokomthetho zibanzi kodwa zinciphisana. Izibonelo ze-CHOVAD . Ukusukela ku-CFID . Ukuvukelwa kwezidakamizwa, kusukela ezimisweni zokugoma i-CDC kuya e-EPA ku-EPA imithetho ehlanzekile, − kugcizelela kokubili isidingo sokubambisana kwezimiso zombuso nokwenziwa kwazo okuqhubekayo. Njengoba kuvela izinsolo ezintsha zempilo nokwethemba umphakathi, ukulingana phakathi kwegunya elilawulayo ne-Oversal kuqhubeke kuyisicingqhinga esiyinhloko sempilo yaseMelika ebusa umphakathi. Abafundisi, baqonda lemiyadisi kanye nakuyiqonda kahle indlela engoko engokolwazini engokwempilo yamanje kuphela ukuzwa yizimiso zempilo eUnited States.