Writing the regulations for health

The development of regulations in health is much more than a purely technical procedure. Rather, it involves decisionmaking and bargaining processes that engage a wide range of individuals and organizations with diverse interests and varied resources. Attempts at statutory precision and goal clarification may improve, but will not fundamentally alter the regulation writing experience. The dynamics of regulations development are revealed in three cases. The primary case, The Health Maintenance Organization Act of 1973, suggests that despite the efforts of the regulations writers themselves, there are limits to the extent to which basic interest conflicts and questions of health policy can be resolved in the process. Other cases examined are the Professional Standards Review Organization Act of 1972 and the National Health Planning and Resources Development Act of 1974.