The Administrative State and Healthcare

This book describes how federal agencies are attempting to gain full control over the healthcare system, and how such efforts can impair patient-physician relationships, the services that are delivered, and public support. This book indicates the struggle for control that is taking place today. First, a simplified way is developed to treat agencies and providers as organizations, in order to provide a foundation for the following discussions. Then, a detailed look is taken, step by step, at the ways in which agency pressures are impacting hospitals and integrated care networks, physician practices, Medicare and Medicaid, the use of fraud and abuse laws, antitrust laws and competition, medical devices and drugs, behavioral health programs, and digital networking. A potential game plan is presented for compromise solutions that may achieve a balance between agency regulations and independent healthcare operations. See also our web page at https://admin-state-and-healthcare.com for blog posts.

The last chapter of the book describes a potential game plan that may be applied to achieve balance between regulations and operations in healthcare. As noted, the only acceptable solution seems to be for agencies and operating businesses to learn to live together through a degree of compromise that combines the best of regulation and independence; of agency control and moderation; and of operating businesses that accept obligations to the public good combined with self-interests. However, many difficulties may be experienced in seeking any such mixed solution. As discussed in this volume, extremism is often the easiest path forward and compromises are more difficult to achieve. The approach taken in this book is to start with a foundation for discussion, then to apply this foundation to a wide range of healthcare settings. As demonstrated, any hopes for compromise solutions will require the adoption of new types of knowledge bases that are accepted by all organizations involved as unbiased and as establishing a reasonable basis for understanding healthcare today. There is an urgent need to re-balance agency controls and provider independence, in order to lower present stress and seek better strategies to meet the expectations of the public. See also our web page at https://admin-state-and-healthcare.com for blog posts.