Independent Agencies Under Attack: A Skeptical View of the Importance of the Debate

The 1980s have witnessed two related but distinct attacks on independent agencies. 1 One attack is grounded in constitutional theory. Some have argued that independent agencies, those strange amalgam[s] that blend the functions of all three branches but are the creatures of none, violate the separation of powers doctrine in the Constitution. 2 This approach has been labeled neoclassical 3 or the new formalism. 4 These terms suggest a rediscovery of fundamental constitutional principles. Another attack proceeds from an organizational perspective. Without clear lines of authority from one branch of government, independent agencies are politically unaccountable, and therefore vulnerable to regulatory inefficiency and external manipulation. 5 In essence, the independent agency form is organizationally dysfunctional. This functional critique is almost as old as independent agencies, yet the criticism continues unabated. These two lines of attack are distinct in several ways. One questions the constitutionality of a form, the other criticizes its function. The latter has a long history; the former reflects a reawakening and expansion of a traditional argument. They are related in one significant way. Both critiques present themselves as politically neutral, questioning the form of regulatory agencies rather than their political purpose or effect. Joined together, as they often are, these two themes have become the 1980s assault on the fundamental legitimacy of independent agencies. How can we explain the timing and intensity of the present debate on independent agency structure? After all, independent agencies have been around for one hundred years, 6 and have been created to ..

Beyond the Politics of Federalism: An Alternative Model

In Regulation and Federalism, C. Boyden Gray describes a theoretical framework for distributing regulatory authority in a federalist state. In this comment, I provide an alternative model that goes beyond Gray\u27s framework to establish specific criteria for allocating regulatory power between the states and the federal government

Managing the medical arms race: public policy and medical device innovation

The allure of medical innovation is powerful - it holds out the promise of perfect health, the end of pain, the deferral of death. Our insatiable appetite for costly new technologies, fed by a profusion of innovations and the profits they generate, has led to what has been dubbed the medical arms race. During the last several decades government has been called upon to manage the escalation of this race.Foote has written the first comprehensive examination of the profound influence of government policies on medical innovation. She explains how these policies have proliferated to affect every stage of the innovative process in medical device technology - from the first research idea to the patient's bedside. Drawing on case studies of technologies as diverse as lasers, cardiac pacemakers, CT scanners, and IUDs, she traces the interaction between the industry and government institutions, including the National Institutes of Health, the FDA, and the Medicare and Medicaid programs.Public policies during the 1950s and 1960s, Foote discovers, tended to promote innovation, while the regulation and cost controls of the 1970s and 1980s began to inhibit it. For the 1990s and beyond she proposes incremental policy improvements that will rationalize and streamline government intervention. She cautions that we must recognize the limits of medical technology and public policy to cure all ills.Medical innovation is a crucial part of health care reform, a subject of increasing complexity and controversy. Written clearly and accessibly, Managing the Medical Arms Race is an invaluable source for medical, industry, and policy professionals, but it also has much to say to anybody concerned with how we as a society choose to take care of our health