Public Health Law Map - Beta 5 - Medical and Public Health Law Site

influence agency policy by cutting the funding for programs it does not like.
This power over agencies is proper because the agency’s power is derived from the
delegation of congressional power. Members of Congress should take an interest in
agency activities and provide a useful ombudsman function to ensure that
constituents in their district are treated properly by an agency. This congressional
casework might involve asking an agency to review a Social Security disability
claimant’s file more expeditiously, or to look into a matter that has been lost in the
agency bureaucracy. Congressional casework becomes improper interference when
the member of Congress tries to force the agency to make a decision that is against
agency policy. This becomes a particular problem when the casework is being done
by the members or chairperson of the subcommittee that governs the agency’s
budget. The subcommittee can threaten the agency’s future funding if it does not
change its policies to please the chairman or members of its appropriations
committee. The subcommittee can also call the agency director or other personnel
before it in congressional hearings and cross-examine them about agency policy.
Since adverse publicity in congressional hearing can end the career of agency
professionals, this gives the subcommittee considerable leverage over individuals.
This informal manipulation of agency policy violates the separate of powers, but
has, so far, been impossible to attack in the courts.
c) State and Local Control
In 1988 the Institute of Medicine published a study of public health in the United
States. [Institute of Medicine. The Future of Public Health. Washington, DC:
National Academy Press; 1988.] The report was scathing in its review of quality of
state and local public health agencies, describing them as “… a hodgepodge of
agencies, and well-intended but unbalanced appropriations—without coherent
direction by well- qualified professionals.” The lack of direction by well-qualified
professionals is because of the intense political pressure on state and local agency
personnel, especially directors of agencies. In many states and localities, agency
salaries are set well below market rates, and agency directors can be dismissed
without notice and with no severance pay. Thus a local health director who closes
the mayor’s brother’s restaurant for health code violations, or who objects to the
misuse of agency funds by the city administration, will be fired with no recourse.
This ensures that local agency personnel are selected for their willingness to
accommodate political pressure, rather than their expertise or commitment to the
public welfare. Although there are many dedicated professionals in state and local
agencies, they have only limited ability to resist improper political pressures.
B. Agency Procedure
Agencies provide an alternative to the courts for the resolution of disputes and the
enforcement of laws. The key values in administrative law are accuracy, fairness,
efficiency, and acceptability. In the court system, the judge is a referee and the jurors
are selected for impartiality, which usually includes not knowing anything about the
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