- Gounder Gives Lowdown on Ebola, Peptides, and Colorectal Screenings
- ASCO: Pfizer one-ups J&J with Talzenna combo's broad castration-sensitive prostate cancer win
- ASCO: With bispecifics on its heels, Incyte positions Monjuvi combo for first-line DLBCL
- 6 dental technology updates in May
- From clinician to leader: Building confidence, capability and leadership in dentistry
- Operationalizing AI at scale: A practical framework for enterprise-scale success
- 3 key stats on the orthodontist workforce
- Meet the COOs of 10 specialty DSOs
- Data, cross-training, and pipeline development: How health systems are rethinking OR staffing
- How top health systems are redefining the digital patient experience
- ‘The most significant change in 20 years’: Cancer centers prepare for daraxonrasib demand
- A Smooth Handoff From Decision to Dollars: Connecting the Last Mile in Healthcare Payments
- Budget-Strapped Montana Will Stress-Test Trump’s Medicaid Work Rules
- How CEOs actually use hospital rankings — and when they don’t
- What OU Health’s founding CEO learned building a new health system
- Arkansas hospital CEO to step down after 11 years for new role
- The behavioral health workforce pipeline: Where it stands and where it’s headed
- 6 major investments in youth behavioral health
- Coalition for Health AI unveils governance playbook for systems
- 66 health systems ranked by long-term debt
- UnitedHealthcare drops some prior auth requirements for cardiology, orthopedic services
- 8 No Surprises Act shake-ups physicians need to know
- The ASC independence playbook: 3 leaders’ thoughts
- Dr. Rahimah Maina opens new dental practice
- GWU offloaded its $450M physician group problem — why the industry watching
- The gastroenterologist pay gap
- Texas surgery center to double in size, add 2 ORs
- What dental leaders told us in May
- Climate Change: Statement on Proposed Rescission of Climate-Related Disclosure Rules
- Kenyan Court Blocks Trump's Plan To Quarantine Ebola Patients
- What’s going on at the FTC? 3 notes for ASC leaders
- 8 DSOs making headlines
- The physician noncompete battle in 5 key figures
- The physician red flags that can predict a bad ASC partner
- Patient death draws renewed CMS scrutiny at HCA’s Mission Hospital
- Nearly 70% of US counties lack a GI: 13 concerning workforce stats
- Statement of Commissioner Mark T. Uyeda on the Rescission of Climate-Related Disclosure Rules
- A new behavioral health profession is born
- Keynote Remarks at the 2026 Reagan National Economic Forum
- Statement on Proposing Release for Rescission of Climate-Related Disclosure Rules
- Dentists’ pay climbed the most in these 10 states
- Mental Health Disorders Now No. 1 Cause of Disability Worldwide
- Massachusetts AG sues UnitedHealthcare over alleged Medicaid fraud
- UnitedHealthcare to nix nearly two thirds of pediatric prior auths
- Industry Voices—Patients are building a new healthcare system. The industry is finally catching up
- Weekly Rundown—Moffitt Cancer Center expands Reimagine Care's virtual oncology model; Tanner Health deploys AI workforce solution
- Study: LA Canine Outbreak Caused By Low Vaccination Rates, Crowded Boarding
- Ocrelizumab Effective In Slowing Progressive MS, Trial Shows
- Long COVID Might Be Twice As Common As Previously Thought
- In Vaccine-Skeptical California County, A Potential Playbook To Contain Measles
- Heavy Drinking Harms College Students' Brain Power, Study Finds
- A Trump Stronghold Grapples With Health Risks of ICE Detention Sites
- After Her Bout of Amnesia, a $59,000 Billing Dispute Wouldn’t Go Away
- Pharma urged to modernize patient support as young adult cancer rates rise
- Philips adds a spoonful of Disney sugar to ease kids’ MRI anxieties
- MannKind seeks long-awaited sales boost with inhaled insulin approval for kids
- Aetna to launch ‘on demand’ virtual mental health services in 2027
- U of Connecticut dental school reappoints dean for 2nd term
- Michigan dentist charged with Medicaid fraud
- Brand-name drug prices climb after launch in US, fall abroad amid MFN push: report
- ASCO: After Takeda’s defeat, Dizal picks up baton to take on J&J in EGFR lung cancer subtype
- Acadia in the headlines: 6 things to know
- 26 behavioral health executive moves to know
- AstraZeneca gains 2nd bladder cancer nod in key expansion for Imfinzi
- Advocate Health grows Q1 revenue by 10.8% amid higher volumes, greater efficiency
- Behavioral health hospital operator to pay $32M in Medicare fraud settlement
- Bangladesh Measles Surge Kills 500+ Children; Vaccine Delays Blamed
- Care navigation startup Garner Health banks $100M series E at $2.74B valuation
- HCA bolsters workforce pipeline with healthcare professional college acquisition
- Plant-Based Diet May Cut Obesity Risk For Women In Menopause
- Pharma leaders meet with PM Takaichi in push for Japan to retain R&D edge
- Penn Medicine, K Health partner to deploy AI clinical agents
- CVS restores coverage of Eli Lilly obesity med Zepbound, adds new pill Foundayo
- CVS restores coverage of Eli Lilly obesity med Zepbound, adds new pill Foundayo
- CMS finalizes changes to No Surprises Act dispute resolution process
- Smartwatch App Accurately Detects Major Epileptic Seizures
- Racial Gap Exists For Asthma Inhaler Use
- New Colon Cancer Screening Guidelines Add Blood And At-Home Tests
- Fierce Pharma Asia—More China biotech hawkishness; Pfizer’s $10B Innovent deal; Astellas’ roadmap
- CVS expands partnership with Salesforce for greater call center personalization
- Nurse Convicted In Patient's Death Turns Fatal Drug Error Into Cautionary Tale
- Wearable Ultrasound Patch Monitors High-Risk Pregnancies In Real Time
- In a Vaccine-Skeptical California County, a Potential Playbook To Contain Measles
- Listen to the Latest ‘KFF Health News Minute’
- Teladoc Health inks partnership with Walmart to expand virtual care services
- PharmaEssentia taps Incyte alum Eric Vogel as it eyes Besremi expansion
- Kaléo speaks up on allergy awareness to amplify patient stories
- Privacy and PetShops: Remarks at the Regulatory PETshop Series: Cryptographic Technologies and Financial Services Regulation
- NYC Health + Hospitals adds 2nd behavioral health housing site
- Mindfulness isn’t a perk anymore — it’s a workforce strategy
- With Elahere building steam, AbbVie nets FDA nod for another ImmunoGen cancer asset
- Hospitals again ask FTC, DOJ for exemption from expanded premerger notification filings
- Coalition for Health AI unveils governance playbooks for responsible AI adoption
- Amazon taps Roy Schoenberg to lead healthcare business as Neil Lindsay plans to step down
- Viridian, awaiting FDA decision, taps WuXi Bio in eye drug supply deal
- U.S. To Keep Ebola-Exposed Citizens In Kenya Under New Policy
- CAT on a Hot Tin Roof
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- GoodRx launches subscription program for low-cost generic medications, telehealth services
- George Washington University locks deal to hand off debt-ridden physician practice to UHS
- Humana invests $83M in new Florida pharmacy distribution center
- As J&J separates from its orthopedics business, it's laying off 56 employees in New Jersey
- ASCO preview: With expectations jacked up, Akeso's ivonescimab to face scrutiny in high-stakes plenary
- An insider’s look at LillyDirect
- GLP-1 manufacturer CordenPharma strikes deal for peptide CDMO, lining up new production sites in US and China
- Weight-Loss Program Helps Women Battling Breast Cancer
- Younger U.S. Women of Color Face Rising Breast Cancer Deaths
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- Cheaper, Alternative Health Plans Are Having A Moment, But Critics Urge Caution
- Ultrafine Wildfire Smoke Particles May Pose Serious Health Risks
- Montana Hurries To Adopt Trump’s Medicaid Work Rules Amid Budget Woes
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- Nurse Convicted in Patient’s Death Turns Fatal Drug Error Into a Cautionary Tale
- Amid policy and pricing headwinds, US healthcare and life sci faces 'vast field of opportunity': survey
- Amid policy and pricing headwinds, US healthcare and life sci faces 'vast field of opportunity': survey
- Biogen investigated by Italian regulator over multiple sclerosis ‘market abuse’ claims
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- Remarks at the Stanford Rock Center for Corporate Governance
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- Outlook moves toward potential US nod for thrice-snubbed eye drug with FDA appeal win
- JD Power: Cost pressures worsen member experience with commercial plans
- Trump Admin Bars Key U.S. Researchers From Global Virus Response Talk
- Listen to the Latest ‘KFF Health News Minute’
- As calls for COINS Act expansion grow, will new rules sweep up China biotech licensing?
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- Dust Yields Clues to Viral Outbreaks, Study Finds
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- Quitting Smoking Might Lower Your Dementia Risk
- Severe Asthma Often Comes With Other Serious Health Problems
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- Common Food Preservatives Linked to Major Heart Problems
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- Nicotine Vapes Triple Smokers' Odds Of Quitting Tobacco
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- Fixing Eligibility at the Point of Care: The Missing Link in Medical Device Reimbursement Integrity
- Fixing Eligibility at the Point of Care: The Missing Link in Medical Device Reimbursement Integrity
- The failure of the ‘usual suspects’ approach to life science recruitment
- The failure of the ‘usual suspects’ approach to life science recruitment
- Statement on Novel Exchange-Traded Funds (ETFs)
- Value, Focus, and the Future of MedTech: M&A and Divestitures are Rewriting the Strategic Playbook.
- Value, Focus, and the Future of MedTech: M&A and Divestitures are Rewriting the Strategic Playbook.
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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