Health Care Regulation in America

Abstract

This book is a guide to the regulatory maze that governs health care. Regulation shapes all aspects of America's fragmented health care system, from the flow of dollars to the communication between physicians and patients. It is the engine that translates public policy into action. While the health and lives of patients, and almost one-sixth of the national economy, depend on its effectiveness, health care regulation in America is bewilderingly complex. Government agencies at the federal, state, and local levels direct portions of the industry, but hundreds of private organizations do so as well. Some of these overseers compete with one another, some conflict, and others collaborate. Their interaction is as important to the provision of health care as are the laws and rules they implement. The book recaps the past and present conflicts that have guided the oversight of each industry segment over the past hundred years and explains the structure of regulation today. To make the system comprehensible, the book also presents the sweep of regulatory policy in the context of the interests, values, goals, and issues that guide it. Chapters cover the process of regulation and each key area of regulatory focus—professions, institutions, financing arrangements, drugs and devices, public health, business relationships, and research. The system thrives on confrontation between competing interests but survives by engendering compromise. The book shows that health care regulation is an inexorable force that has actually served to nurture the enterprise of American health care.