Describe and explain why the USA health system is considered to be neither a centralized or de-centralized system and what is the impact of healthcare reform of the combined federal-state responsibility with substantial federal oversight and funding, imbued with state innovation and implementation.

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Describe and explain why the USA health system is considered to be neither a centralized or de-centralized system and what is the impact of healthcare reform of the combined federal-state responsibility with substantial federal oversight and funding, imbued with state innovation and implementation. Also, discuss what are the functions of the Agency of Healthcare Research and Quality and how can its nationwide and worldwide mission mandates influence healthcare reform?
 

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