Public health can be achieved only through collective action, not through individual endeavor. Collective goods are essential conditions for health, but can be secured only through a well-regulated society. Yet, successive governments have eroded health and safety protections, with serious consequences. Think about the death of miners, lead in children’s toys, industrial solvents in toothpaste, salmonella in peanut butter, e-coli in spinach, and unsafe or ineffective pharmaceuticals such as COX-2 inhibitors or non-statin cholesterol medications.
Conservatives have waged a campaign against the administrative state that has created and reinforced deep-seated concerns about over-bearing government, particularly at the national level. The political dialogue used to describe agency action is pejorative and effective: “big government,” “centralized top-down,” “bureaucratic,” “command and control.” This anti-government narrative has set the terms of the debate about the role of government in protecting the public from market excesses and failures. It has quietly led to pervasive deregulation, allowing the market to dictate business and consumer behavior.
The “Deregulatory State” takes many subtle forms, including self-policing, so that industry discloses and corrects its own safety violations; incapacitating, so that agencies are starved of expertise and resources; devolving, so that residual regulation is focused at the local level; preempting, so that the federal government denies states the authority to protect its citizens; and privatizing so that government functions are conducted by “for profit” or voluntary entities. In this column, I will focus on two broad categories of deregulation: federal preemption and privatization.
Gostin, Lawrence O., "The Deregulatory State" (2008). O'Neill Institute Papers. 11.