So, I thought that I would find a decrease, or no change, in the relevant regulatory pages. I focused only on Medicare and Medicaid, regulation of private health insurance, and regulation of providers. However, I did not address the regulation of drugs or medical devices for safety and efficacy.
The result was surprising: Overall, the federal regulatory burden on American health care has increased by more than one-half in the last ten years, as displayed in Table 1.
|Table 1: Number of Pages in Code of Federal Regulations
Addressing Medical Services & Health Insurance, 1998-1999 to 2008-2009
|Medicare and Medicaid||1,811||2,688||48%|
|Private Health Insurance (e.g. ERISA, COBRA & HIPAA)||96||183||91%|
|Provider Regulation (e.g. National Practitioner Database, HIPAA)||7||109||1,457%|
Source: Authors analysis of Code of Federal Regulations
With respect to private health insurance, there are only 183 pages of regulations: the current Labor Code includes 75 pages of regulations, and the Public Welfare Code also contains 108 pages of regulations on group and individual coverage. This might not look like much, but ten years earlier, the total was only 96: 36 in the Labor Code and 60 in the Public Welfare Code.
The Public Welfare Code contains 109 pages of rules governing providers. This includes rules governing the National Practitioners Database, HIPAA, as well as other administrative regulations. A mere ten years earlier, the number of pages was only seven!
So, even during a period of self-proclaimed regulatory restraint, the government was unable to prevent itself from adding more and more to the regulatory burden of American health care. The current government has the opposite bias, and the regulatory burden will surely accelerate at breakneck speed.
John R. Graham is director of Health Care Studies at the Pacific Research Institute.
This blog post originally appeared on National Review’s Critical Condition.