We certainly have seen regulations upon regulations appear for health care over the past several years, and this letter to the editor of the Wall Street Journal (1 June 2011) from the Commissioner of the Consumer Product Safety Commission, Nancy Nord, should cause us all to pause:
As a commissioner at the U.S. Consumer Product Safety Commission (CPSC), I can attest that no such (regulatory reform) activity is happening at this agency. We certainly have not combed through our regulations to eliminate those that are "out-of-date, unnecessary, [or] excessively burdensome," as he suggests is being done across the government. Instead, we are regulating at an unprecedented pace and have pretty much abandoned any efforts to weigh societal benefits from regulations with the costs imposed on the public.
In health care, we have seen an unprecedented rise in regulations for in-hospital MRSA screening while little data have been forthcoming about its patient benefits. Doctors are under increased administrative burdens to complete Pay for Performance questionnaires without any evidence of their benefit to patients. Burdensome and costly re-credentialing programs have never been shown to improve health care quality. In fact, we’re seeing so many regulations on how we provide care foist upon us without any clear indication that patient outcomes have benefited that we have to wonder if, like the CPSC, common-sense regulation will even get a head nod as well.
How doctors will work to free themselves of these administrative burdens while maintaining the clinical care volumes in the years ahead now that they are increasingly beholden to a larger health care management organizations remains to be seen, but I suspect once patients encounter problems with access to their own care, there might be a chance for effective reappraisal of which regulations really are in their best interest.
Until then, with more centralized control of health care, look for more and more regulations heaped on providers to control costs, safety and improve efficiencies "just because."