Tuesday, June 17, 2014

On de facto industry regulation of industry - nowhere to run, nowhere to hide...and no indication that you should be running

Whether you like it or not, deadly pathogens are traveling all around the world. And if we're not going to combat them (per my previous post on Boston's opposition to research on Biosafety Level 4 agents), then the only thing that we can do is to warn people when they show up, so that people can kinda sorta take precautions. I say "kinda sorta" because I don't write sometimes good, and also because in such situations, you can only hope that you are able to avoid the pathogen.

But what if you're never warned that the deadly pathogen is out there?

Antibiotic-resistant germs continue to plague hospitals across the United States. In Florida, several hospitals handled antibiotic-resistant germ outbreaks without alerting the public. A Palm Beach Post investigation found that since 2008, twelve outbreaks have affected at least 490 people statewide, and the Florida Department of Health (FDH) did little to inform the public....

FDH has not released the name of hospitals involved in the twelve CRE outbreaks, and state lawyers have denied public disclosure requests, pointing to an exemption in the open-records law for epidemiological investigations. Hospitals themselves are not motivated to publish that they have highly resistant germs in their facilities, and the state law which requires outbreaks of any germ to be reported have been enforced loosely. In the past five years, Florida’s Agency for Healthcare Administration, which licenses and inspects hospitals, has cited only one hospital for failing to report an outbreak, said agency spokeswoman Shelisha Coleman.

Obviously part of the issue is that regulators are not motivated to regulate. William Sanjour explains the problem from his perspective as a 30-year employee of the U.S. Environmental Protection Agency:

After some catastrophe or new technology, Congress creates a new regulatory agency in a wave of enthusiasm, giving it money and following the same pattern of broad, vague discretionary authority to control the richest and most politically savvy forces on Earth. But the interest of Congress, the press and the public can only be maintained for a few months or years. There are a lot of other things going on. But there is one group whose interest never wanes or wavers. The life, the existence, the future of the regulated industry depends on the pressure it can exert on the regulatory agency. At least that’s what the special interests believe.

The regulated community constantly deals with regulatory agencies through congressional committees, the courts, and meetings with top government officials. This is what the public sees, but it does not stop there. Industry also constantly interacts with individual agency employees at every level, working directly with the field inspectors and permit writers responsible for making regulatory decisions.

What kind of, um, "interacting" takes place?

[T]he inspector general of the Minerals Management Service concluded that officials in the agency had frequently consumed alcohol at industry functions, had used cocaine and marijuana, and had sexual relationships with oil and gas company representatives.

But this case isn't about oil, but about hospitals. As noted above, hospital inspections in Florida are performed by the Agency for Healthcare Administration. This agency is headed by Elizabeth Dudek. She was appointed to her position by the Governor of Florida; while this ensures that she is in alignment with the Governor's views, critics could argue that political appointees may not always have the best interests of their agencies at heart.

Dudek actually worked within the Agency for Healthcare Administration prior to heading it, and at one point was "a registered lobbyist providing testimony before the Legislature on behalf of the Agency." Yes, you read that right - the government had an official lobbyist to lobby the government.

Before this, did Dudek acquire the necessary experience to regulate hospitals? Well...

Ms. Dudek has over thirty years of health care experience; ranging from direct care work with developmentally disabled individuals in a state institution to testifying for the Agency as an expert in health planning.

Yup...she came right out of the industry that she is mandated to regulate.

On the other hand, critics would argue, you need to have people from the industry to regulate the industry, because people from outside the industry wouldn't understand the issues involved.

And therein lies the problem.


I intentionally began this post with the words "whether you like it or not," and wanted to find an appropriate link to Gavin Newsom's original comments. Well, I found this link:

San Francisco Mayor Gavin Newsom may have sealed the fate of marriage equality in California with his triumphant — and misjudged — cry celebrating the legality of gay and lesbian family rights “whether you like it or not,” writes John Diaz, the editor for the San Francisco Chronicle’s editorial page.

Wrote Diaz in an Oct. 14 story that appeared in the Chronicle, “Like it or not, Mayor Gavin Newsom is proving to be the gift that keeps on giving for the campaign to deprive same-sex couples of their right to marry.”

Californians will recall that Newsom's quote was played, over and over, by opponents of gay marriage. Kilian Melloy was convinced that this would be disastrous for gay marriage proponents.

Those TV spots, paid for by a torrent of money that has rushed into Calif. –l argely from Mormons and Catholics nationwide, whose church leaders have instructed them to promote the anti-gay legislation — are fueling a ballot initiative to rewrite California law from the ground up in a way that will build discrimination against gay and lesbian families into the vary fabric of law.

Of course, we know what happened after that - opponents of gay marriage DID win the proposition battle, gay marriage was outlawed in California, Gavin Newsom was reduced to obscurity, and Brendan Eich led Mozilla out of its terrible financial state.

Well, the position of Lieutenant Governor of California is relatively obscure...
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