Burdens of regulatory fat

After Hurricane Katrina, very few members of Congress have stepped forward with a meaningful plan for paying what’s already an astronomical tab, other than driving America deeper into the red. While the hurricane relief debt steadily climbs, only a few members have dared suggest this spending be offset by reducing ever so slightly some of the taxpayer billions spent on pork-barrel special interest programs.

When it comes to reasserting fiscal responsibility and sound economic policies, the administration has a golden opportunity to save hundreds of billions of dollars by little more than applying some common sense to the already oppressive burden of federal regulations. All too often, regulatory burden is overlooked, yet a recent study suggests regulations cost Americans more than $1.1 trillion in 2004 alone.

One glaring example of government bureaucracy at its worst that will significantly harm our nation’s hospitals is the HCAHPS — an exercise in regulatory overkill that expert after expert has indicated will actually hinder its supposed goal.

HCAHPS is a hospital-care survey dreamed up by Medicare and the Agency for Healthcare Research and Quality (AHRQ). Bureaucrats at these two departments have decided all hospitals participating in Medicare — virtually every one in the nation — should “voluntarily” post patient responses to a quality survey on the Medicare Web site.

Never mind that about 80 percent of our nation’s hospitals already survey a percentage of patients upon discharge. Hospitals spend a lot of money on surveys because they want to improve the care they provide. The results speak for themselves. All four hospitals awarded the federal government’s prestigious Malcolm Baldridge National Quality Award are aggressive users of the private sector survey products, and are outspoken advocates of quality initiatives.

Despite a well-functioning private sector, Medicare and AHRQ bureaucrats have spent three-plus years developing a list of ultraspecific questions, including a pair about bed pan usage.

The many versions of the HCAHPS questionnaire have ranged from 66 questions to 25; the present version has 27. During two separate comment periods, more than 1,900 hospital officials have recommended limiting HCAHPS questions to between eight and 10, a range that would enable hospitals to include the government-sponsored questions in their own surveys and collect results at less additional cost. Otherwise, existing data collection efforts will suffer and hospitals must engage in costly new practices — such as multiple mailings and telephone surveys — just to get enough feedback to satisfy federal regulators.

A shorter and simpler HCAHPS, however, just doesn’t cut it for the Washington bureaucrats being driven by the AARP and AFL-CIO to produce a government survey. What these folks are not considering is the tremendous burden it would be for hospitals to send and collect data from two separate surveys. One study by leading economists at Purdue University concluded a long HCAHPS could cost hospitals as much a $675 million over the next five years alone. Even more telling, when divided among each unnecessary question, the per-question cost comes to a staggering $84 million. Even Federal Emergency Management Agency officials should gasp at that one.

In addition to a colossal waste of money, an HCAHPS that reads like a shopping list rather than a short survey will actually hinder data collection and confuse consumers. Leading Stanford University researchers, who have studied this issue for years, have concluded consumers benefit most from feedback to a short list of overarching questions.

It may be too late for our federal government to patch up the gaping hole it managed to create in the levee guarding the Treasury. But the Bush administration has a chance to stand up for fiscal restraint and common sense by ensuring the federal hospital survey known as HCAHPS does no harm.

Matt Kibbe is president and chief executive officer of FreedomWorks.

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