How can members of the public (including interest groups) have influence over the regulatory process?
(Note from me: you have already help with the main part of the assignment. The part that I want you to work on now is to help me responds to two post from to different colleagues. I have attached their post so read it and give a respond to their post. Just a page or less will be fine as long as it meets the discussion)
· As we have seen, the Executive branch and its agencies play a major role in shaping health care and health policy. But unlike members of the legislative branch (e.g., members of Congress and state legislatures), agency officials are not elected.
· So is it right for them to have so much power?
· How can members of the public (including interest groups) have influence over the regulatory process?
· Respond to at least (2) of your colleague’s postings over the course of the week to continue the dialogue.
Top of Form
Executive Branch Power
The US government is a representative democracy meaning that citizens elect officials to represent them and, hopefully, protect their interests. In the federal government, the Legislative branch (Congress) writes the laws, the Executive branch applies and enforces them, and the Judicial branch interprets them. Certain offices are elected in the general government, but the president administers laws through the executive branch with a whole bunch of people they appoint as agency officials, none of whom are directly elected by the people. They are, however, subject to approval by the Senate.
When Congress adopts a law, its administration is usually assigned to an agency within the executive branch. Federal agencies function as arms of the executive branch, and their officials are appointed because they are the way the administration carries out its policy. Agency officials who are appointed by the president do have significant power, but in a perfect world their actions should align with the president who appointed them (who should represent the interests of the people who elected them). There are limitations on the president’s appointing powers, namely a federal law that prevents federal officials from “appointing, promoting, or recommending for appointment or promotion any “relative” of the official to any agency or department over which the official exercises authority or control” (Committee on Ethics, n.d., para. 1). If agency officials were elected by the people, things might not run smoothly if interests of elected agency officials conflicted with the president’s platform, the party in charge, or the other federal agencies.
The system as it stands seems designed to function as a collective unit moving in the same direction and with shared goals and I think electing agency officials would introduce the risk of politicians running for positions purely to gain notoriety with the public. Ideally, appointed officials would have a background and experience that aligns with the agency to which they are appointed but in recent years that has not always been the case. Further, the actions of each agency and, by extension, appointed agency officials, are constrained by the laws adopted by Congress; they can’t simply make things up as they go along. In that sense, I don’t think it is technically wrong for appointed officials to have a lot of power because, under our system, if Congress adopted a law, they are charged with administering it and can’t just go rogue.
The way agencies interpret and enforce laws is another story. Since laws are often vague and can be up for some degree of interpretation when it comes to enforcing them, there are ways for agencies to overstep their bounds and for powerful entities or interest groups to influence proposed rules and regulations for personal gain. Fortunately, there are ways to check the power of the executive branch if they overstep, often in the form of lawsuits initiated by Congress, an individual, or a group of people who do not like the rule or regulation an agency puts forward. Our government is theoretically designed in such a way that powers are limited, actions must be grounded in adopted law, and power can be checked—even by regular citizens.
Members of the public have the power to shape the regulatory process through processes designed to allow every voice to be heard. If a federal agency wants to establish a rule, they are required to do so in line with the Administrative Procedure Act, which requires federal agencies to provide the public with a chance to participate in the rulemaking process (U.S. Department of Health and Human Services, n.d.). Part of the process involves the agency publishing notice in the Federal Register, after which a period of public comment begins. These comments can shape the final rule, and Health and Human Services include examples of times comments have shaped regulations on ther website (U.S. Department of Health and Human Services, n.d.). There is power in numbers, so joining national associations, professional organizations, unions like a hospital workers union, or trade association can help strengthen a collective voice of individual citizens. When people organize, they can fight a regulation or rule that they believe does not benefit them. At the same time, there is also power in money. While every citizen has a right to petition the government, people or entities with a lot of money can influence the government too much and outweigh the interests of others for personal gain.
Committee on Ethics. (n.d.). Nepotism. https://ethics.house.gov/staff-rights-and-duties/nepotism
U.S. Department of Health and Human Services. (n.d.). HHS regulations toolkit. https://www.hhs.gov/regulations/regulations-toolkit/index.html
Bottom of Form
The power vested in those in the executive branch of the government and its fifteen agencies is a double-edged sword. On one hand, we vote for the president, who then appoints the agency heads for each department. If the elected president is who we voted for and desired to be in office, one would hope that those selected to be members of his cabinet would align with our personal values. On the other hand, if the president that is elected is not who we voted for, there is a possibility that the president selects members whose beliefs do not match up with our own. It seems that this system relies solely on a win or lose situation. However, I think that by voting in the presidential election we are giving our consent that whoever is elected will have the ability to choose these agency officials. In doing so, we give the power to each cabinet member. It is important to note that their power is one of influence because Cabinet Secretaries do not write or enforce laws; they simply act as an advisory board for the president. That being said, the power that the Department of Health and Human Services (HHS) holds, for example, is a bit overwhelming, when grouped in one sentence. This individual agency oversees the, “…National Institutes of Health, the Food and Drug Administration, and the Centers for Disease Control” as well as Medicare and Medicaid (WH.Gov, 2019). Moreover, the heads of these organizations are also appointees and often wield enormous influence over policy decisions as they do not typically change with each newly installed president. For example, Dr. Anthony Fauci was appointed director of NIAID in 1984 and he has had enormous influence over public policy regarding the management of the COVID-19 pandemic in the United States.
Individuals and groups often try to shape public policy through education, advocacy, or mobilization of special interest groups. Hiring lobbyists or applying political pressure is another method of influencing public policy. Members of the public can have influence over the regulatory process during what is known as the comment period. This period allows, “…all people and organizations [to] submit their opinions or research on a specific rule” (PoliticoPro, 2019). In order to effect change, the public can write letters, make phone calls, or even protest to these agencies. For example, nurses can help shape health policy by joining with a larger more influential group like the American Nurses Association (ANA) so they are part of a larger voice. The ANA website states, “…nurses offer a unique, expert perspective on every aspect of the healthcare system, and have a key voice in ongoing efforts to improve public health. As the lead organization representing the interests of the nation’s 4 million registered nurses, ANA’s role is to articulate that voice at the highest levels in order to influence health policy” (American Nurses Association, n.d.). In order to impact policy, members of the public have an obligation to stay up to date on rulemakings.
The Essential Guide to the regulatory process. PoliticoPro. (2019). Retrieved from https://www.politicopro.com/blog/guide-to-regulatory-process#how_legislation_passed_senate
WH.Gov. (2021). The Executive Branch. The White House. Retrieved from https://www.whitehouse.gov/about-the-white-house/our-government/the-executive-branch/
Health policy – American Nurses Association (ANA).(n.d.) Retrieved January 30, 2022, from https://www.nursingworld.org/practice-policy/health-policy/