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Michigan healthcare freedom community forum
So, you understand the constitutional framework and safeguards for freedom. You're involved in elections, but they have little impact on local healthcare. What's next?
For any citizen trying to do good oversight, government health policy can be daunting. State, federal, and local are massive and intertwined.
Three branches of government are enough for anyone to keep up with, but what about the fourth branch? Also called the Administrative State or Deep State, it has a literal, identifiable meaning.
And for people who miss personal control of healthcare, it explains a lot.
Jun 12, 2023
The federal government has threatened to withhold Medicare, Medicaid and CHIP funds from a Catholic hospital in Oklahoma because the staff keeps one small candle burning in its chapel. It’s tiny, encased in glass, and kept far away from medical equipment, but the feds insist it’s a safety risk.It’s absurd, but not surprising. Absurdities are a feature of administrative rule.
What is administrative rule? It’s a system of government where nearly every aspect of citizens’ lives is regulated by obnoxious laws that nobody voted on enforced by pedantic bureaucrats who nobody voted for.
The candle is just one example. There are many.
Federal water regulators are fighting a 16-year-long battle to prevent the owners of a dry plot of land from building a home, under the theory that the land contains "navigable waters" because it is connected by a road to a marsh, by marsh to a ditch, by ditch to a creek, and by creek to a river.
And state governments have ticketed and fined children for running lemonade stands without the proper food and beverage licenses.
Administrative rule is America’s system of government. We were a republic once, but our representatives didn’t like the pressure of governing, so they foisted the responsibility onto a massive bureaucracy.
How massive? Nobody knows exactly how many agencies there are. And nobody has a clue how many rules and regulations they administer.
We know that there are hundreds of thousands of pages of laws and regulations. We know that our administrative agencies publish thousands more every year. But nobody knows how many rules they contain. Neither the smartest lawyer, nor the most learned judge has the slightest clue what the law, in total, is.
And that’s just the federal law. State legislatures have followed Congress’ bad example and foisted their jobs onto state agencies.
This is a problem. None of us voted for or has any ability to vote against any of these laws. And nobody, short of our buck-passing congressmen, can fire the bureaucrats who make them. Self-government is more faded memory than reality.
What’s more, nobody can possibly comply with the law because nobody can know it. And where, as in America, the law regulates nearly everything a citizen does, a citizen’s life is full of invisible legal traps. Losing federal funding is the risk posed by some of these traps. But others will strip a citizen of his business, his job or his freedom.
Even the most lawful and conscientious citizen can fall into jail by tripping over some arcane regulation about recycling bottles or packaging lobsters.
It’s bad enough that bureaucrats fuss over the little details of our lives. But where things go from bad to worse is when bias creeps in.
Some bureaucrats are doubtless well-intentioned, albeit in the overbearing way that nannies supervising unruly children are. But some are not. Some of them are power-trippers. Others are discriminators. Some are both and enjoy using their power to harm people they don’t like.
In the case of the candle in the hospital chapel, it could be that the hospital’s regulator just loves rules for rules’ sake. The finger-wagging type: "Well, technically the law does say all flames must be supervised at all times."
Or perhaps the regulator hates religious organizations and people.
It would be easy to rummage through the hundreds of thousands of laws to find one or two to throw at religious people or any other group of people a regulator dislikes.
There are too many rules for people to know, so they cannot conform their behavior to them. And there are too many rules for bureaucrats to enforce equally, so bureaucrats are free to pick and choose their targets.
This is the greatest problem of a system of administrative laws: it tends to become a system of no laws at all. It replaces the rule of laws—general, equal and knowable – with the rule of men who enforce unknowable decrees unequally and with absolute discretion. And so 10,000 little rules become 10,000 little tyrannies.
If there is to be any hope for self-government and for the rule of law, America must abolish administrative rule.
GianCarlo is a Senior Legal Fellow in The Heritage Foundation’s Edwin Meese III Center for Legal and Judicial Studies.
Knowing the cost/benefit of current regulations is important to understanding real-world healthcare problems. This work gives hard numbers, history, and a framework for reforms.
Health Care Regulation: A $169 Billion Hidden Tax - Cato Institute Policy Analysis No. 527 October 4, 2004by Christopher J. Conover
Students of regulation have known for decades that the burden of regulation on the U.S.economy is sizable, with the latest figures suggesting this cost may approach $1 trillion in 2004. Surprisingly, given that the health industry is often viewed as among the most heavily regulated sectors of the U.S. economy, previous estimates generally have ignored the cost of regulating health care services.
Using a “top-down” approach, one can arrive at a “back-of-the-envelope” estimate that health services regulation imposes an annual cost of $256 billion per year (with a range of $28 billion to $657 billion), suggesting that health services regulations could increase estimates of overall regulatory costs by more than 25 percent.
A far more accurate “bottom-up” approach suggests that the total cost of health services regulation exceeds $339.2 billion. This figure takes into account regulation of health facilities, health professionals, health insurance, drugs and medical devices, and the medical tort system, including the costs of defensive medicine. Moreover, this approach allows for a calculation of some important tangible benefits of regulation.
Yet even after subtracting $170.1 billion in benefits, the net burden of health services regulation is considerable, amounting to $169.1 billion annually. In other words, the costs of health services regulation outweigh benefits by two-to-one and cost the average household over $1,500 per year. The high cost of health services regulation is responsible for more than seven million Americans lacking health insurance, or one in six of the average daily uninsured. Moreover, 4,000 more Americans die every year from costs associated with health services regulation (22,000) than from lack of health insurance (18,000). The annual net cost of health services regulation dwarfs other costs imposed by government intervention in the health care sector.
Finding ways to reduce or eliminate this excess cost should be an urgent priority for policymakers. It would appear from this preliminary assessment that medical tort reform offers the most promising target for regulatory cost savings, followed by FDA reform, selected access-oriented health insurance regulations (e.g., mandated health benefits), and quality-oriented health facilities regulations (e.g., accreditation and licensure).
Christopher J. Conover is an assistant research professor with the Center for Health Policy, Law and Management in the Terry Sanford Institute of Public Policy at Duke University.
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