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How did Congress try to address prescription drugs being expensive, and cheaper in other countries?
Medicine Equity and Drug Safety (MEDS) Act of 2000, allowed for importing drugs from specified industrialized countries
Issues with implementation of MEDS
Clinton and Bush opposed importing drugs, citing quality/security concerns, various resolutions on this, settled on allowing importing of certain drugs from Canada
Roles of the FDA
Evaluates/approves new drugs and meds, ensures safety of nation’s food, regulates medical devices, monitors compliance with regulations
Principal-Agent theory
A contract in which the principal engages the agent to perform some service on their behalf, which involves delegating some decision-making authority to the agent
Principal
entity delegating authority/assigning tasks
Agent
person/entity delegated authority from the principal to act on their behalf
When do principals delegate power?
The issue is salient or complex
Salience
how important, noticeable, or prominent an issue is
Saliency provides a motivation
to focus on a certain issue
High salience low complexity
Substantive controls
Low salience high or low complexity
Delegation
High salience high complexity
Procedural controls
Agency loss
the costs and inefficiencies that arise from the conflict of interest between the principal and the agent
Two ways disagreements might happen in the principal-agent relationship
Bureaucrats might have allies on the outside who can aid their careers, or an us vs them mentality-WH (inside), other agencies (outside)
Three ways to control agency loss
Institutional design, oversight of agent actions, executive compensation
Institutional design
Imposing internal controls to keep the agent’s self-serving behaviors
Oversight of agent actions
Identifying and redirecting agent behavior inconsistent with the principals’ objectives
Executive compensation schemes
Financial incentive schemes that provide rewards and punishments aimed to help alight principal-agent interests
Goal of politicization
replace career bureaucrats who have misaligned incentives/goals
How does the president control agency loss?
Positive hiring, firing, leaving positions vacant
Ideal bureaucrat selection process
Notifying the public about the open position, screen applications based on minimum standards, apply selection priorities like veterans’ preference, and assess relative competencies based on job-related criteria
Issues with politicization
Can limit range of opinions among bureaucrats, weaken objectivity of policy analysis at the president’s disposal
Politicization does what to agency loss?
Decreases it
Centralization
Presidential strategy of exerting political control over the bureaucracy by transferring administrative and oversight tasks from agencies to the EOP or WHO
Two ways to enhance centralization
Use czars or appoint acting or interim officials
What is a major negative affect of controlling bureaucracy?
Agencies that employ a greater proportion of political employees function much less effectively than others
Effectiveness
Ability of agency to draft rules and implement policies that are consistent with what they learn and know
Challenges with short-term political appointees
Aren’t there long enough to learn the culture of their agencies, decrease trust of their subordinates by making frequent policy changes, may erode agency’s institutional memory
Administrative Procedures Act of 1946
establishes procedures agencies must follow when changing rules
Examples of procedures governed by the APA
Publishing notice of rule in Federal Register, allowing for public comment on rule and including that in changes, allow for delay between publication of rule and effective date
What was FDR’s stance on control of the bureacracy?
Wanted more control (Brownlow committee)
Examples of political appointees intended to reduce role of agency
Watt and Norton, Secretaries of the Interior for Reagan and Bush, Anne Gorsuch EPA-Reagan, Trump Rick Perry DoE
How many appointments do presidents typically make?
3-4k
Excepted service
Roughly half of American civil servants in roles not governed by merit-based guidelines, often by giving managers more flexibility, “making it easier to circumvent rules in hiring and promotion.”
PAS
Presidential appointments with senate confirmation
SES
Senior executive service personnel, upper-level staff that work to implement the president’s agenda, no more than 10% of SES can be political appointees overall or 25% in a single agency
Schedule C
“political appointments to confidential or policy-setting positions,” below SES personnel
Presidential popularity and politicization
The more popular a president is, the less they need to politicize
Trade off in politicization
Responsiveness and competence
Political patronage
rewarding people for their past political support, can be a form of shoring up electoral support for the future of a party
Civil Service Reform Act of 1978
intended to provide presidents with more control over positions most relevant for the implementation of their agendas, established SES
1980 Foreign Service Act
states that contributions to campaigns shouldn’t be a factor in appointment, but presidents use 70/30 approach to ambassadorships
Four main components of the White House Office
Domestic policy council, National economic council, Office of legislative affairs, Office of public engagement
Office of public engagement
fosters relations with NGOs, interest groups, states
How many staffers work in the WHO?
200-400
Matthew Dickinson on presidential staff
concluded that presidents rely upon larger staff when the opposition party holds a greater number of seats within Congress, when the president’s popularity is low, and when the size of the press corps increases
Is there congressional oversight over policy czars?
No
Nixon used a ___ czar to ___
Drug, coordinate Office of National Drug Control Policy, FDA, DEA, CDC
When are presidents more likely to centralize?
when the policy consequences of forgoing expertise are less severe
9/11 Commission
recommended creation of the Office of the Director of National Intelligence to centralize
Bush centralization issues 9/11
had to choose between centralizing (he has direct info and can make quick decisions, but lacks the expertise of other agencies) or not (risk “falling asleep at the switch” in another attack)
Approximately how many new agencies were created between 1950 and 2000?
400
David Lewis-how politicization affects performance
More politicized agencies have a hard time functioning effectively, What presidents gain in ability to control is offset by a loss of expertise
What percent of career executives say they intend to leave their positions within a year according to a study?
25-often get offers from private sector (or retirement)
Harry Reid as senate majority leader
kept Senate in perpetual session to prevent Bush (2007) recess appointments
What did Obama try to use recess appointments for?
National Labor Relations Board and CFPB, ruled unconstitutional
Federal Vacancies Reform Act of 1998
president can appoint interim officials for 210 days, sometimes longer
What is a common problem with interim officials?
Substitute teacher problem-same powers, less sway
Teapot Dome scandal
Secretary of the Interior Albert B. Fall had secretly arranged for private oil companies to lease valuable federal oil reserves, including the Teapot Dome reserve, without competitive bidding. In return, Fall accepted hundreds of thousands of dollars in bribes, which he disguised as loans. Fall was sentenced to a year in jail and Harding’s legacy was tainted.
Patronage system
Prior to the assasination of James Garfield by Charles Guiteau, a time when staff were appointed based on support for the president, not merit
Is agency politicization increasing?
Yes
What can happen when there is too much politicization of an agency?
Loss of expertise/institutional memory, less employee morale, more corruption