Wednesday, March 18, 2020

COVID-19 policy: your costs will be ignored unless you speak up

It is a fact that, despite requirements to the contrary, Federal health professionals do not consider the costs of health-enhancing rules and regulations in their normal course of operations.  Jerry Ellig has documented this fact in his regulatory report cards where he shows that the cost-benefit analysis from HHS (the Federal department making health policy) consistently ranks as one of the worst agencies in terms of considering costs as part of its regulatory impact analysis.  (Using other Federal agencies as a benchmark is an incredibly low bar!).

This HHS tradition is not new (Ellig's latest report card was prepared in 20116), and continues even into the current administration, as I witnessed first hand.  For example, when HHS is of a mind to reduce the number of people uninsured, they impose any cost on taxpayers and consumers in pursuit of getting people signed up for insurance and furthermore pretend that those costs are so negligible as to be unworthy of counting.

We can safely assume that HHS continues this approach to COVID-19.  They want to minimize the rate of new infections.  It won't matter to them how much of our money that costs.  It won't matter how much human capital our children and young adults lose.

Although it was not true in the past with health insurance, opioids, and other matters, perhaps this time they are doing the right things.  If so, it is the blind squirrel story, because they are ignoring costs.

The only way for Federal health decisions to reflect costs is for YOU TO SPEAK UP.  HHS reports to elected officials, who can and often do listen to their constituents.  President Trump certainly does listen (I know that first hand).  But they will not hear unless PEOPLE SPEAK UP.

Cass Sunstein, whom I admire, has nonetheless made a big mistake by perpetuating the myth that "Technocrats have triumphed,” which is his way of asserting that Americans are now ruled over by nonpartisan career professionals who carefully balance costs and benefits.  This depiction of balancing costs and benefits is absurd, especially as regards to health policy, which is the single biggest area of Federal regulation.

What I never anticipated is that it would become so obvious to so many regular people how health policy is conducted without regard to the costs they bear.


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