Watchdogs versus "Government Interference"

Think about this a minute. You maybe have a burglar alarm at your business site, or a watchdog at your home. Military installations routinely post sentries. And most of us are familiar with airport security inspections. None of these guardians are violating Constitutional rights. You may not like the inconvenience, but few would dispute the need. That's because there are occasional people out there, whether citizens or aliens is irrelevant, who do not respect your property or your life.

So why is a watchdog agency such as the Federal Aviation Authority, or the Federal Drug Administration, or the Securities and Exchange Commission, or any of dozens of other government groups considered "interfering" when they blow a whistle on the shenanigans of Wall Street, or lax safety inspection, or executive greed?

Someone does need to blow a whistle when a smelter lets clouds of unfiltered lead dust billow out of the smokestack. Or when a drunk takes the wheel of a car. Or when a bank or insurance company risks its customers' investments by loaning billions of dollars to high risk enterprises.

When an industry persuades Congress that deregulation of pharmaceuticals, or neglecting building codes, or cutting taxes are in the public interest, there is often a thin line between good business practice and corruption.

When a physician, called about a patient, doesn't see the patient but orders some medicine over the phone, and then charges the patient's insurance a fee for doing an exam, "because he is taking the responsibility," he's getting pretty close to fraud. That's a nasty word, but sometimes it has to be said, and it is another large factor in the rising cost of medical care.

There are trade-offs. If the government is to repair highways, it must find funds to pay for the workers, the material, and the equipment. If there is obvious waste in a program, it doesn't make sense to let the money continue to bleed away while the work stands idle. Nor does it make sense to continue to borrow endlessly and let hundreds of billions of dollars go to pay interest on the debt. And it doesn't make sense for a First World nation to leave 15% of its citizens medically uninsured. This makes the taxpayer or those with insurance pay the cost for the visits of the uninsured.

What Government Could Do Better: One of the tasks of Congress is to create laws for public benefit. To leave no doubt of what the law means, Congress adds regulatory clauses, often to the extent of a thousand pages or more. That length creates a lot of doubts of its own. For one thing, I doubt that many lawmakers or their aides have read the whole thousand pages carefully enough to grasp their full meaning.

How about a two or three-page summary stating concisely the purpose and actions required by the act, to which the other 997 pages must conform? And if any don't conform, they must be revised until they do.

The public wants action to produce a medical care act that reduces waste, increases efficiency, and addresses the problems of 45 million uninsured citizens. Instead, both houses of Congress, and many agencies besides, jockey for a political agenda rather than addressing the merits and flaws of the act they are trying to put together. Such delays cost money. Endless catch phrases and frank misstatements of meaning, on TV ads and talk shows, don't get the job done.

Congress can't expect to mandate new standards of care without funding them. It is hypocrisy to say "no new taxes," while cutting federal funding, leaving the states to finance new federal laws through state taxes. And cutting funding for watchdog agencies would be reckless negligence.


This blog post is adapted from my book, "Access to Medical Care, Common Sense for Doctors, Patients, and the Public," © 2009 by Keith Dahlberg, MD; iUniverse, publisher.