Too Many Rules!

Two weeks ago, I attended a three day seminar for lawyers in Baltimore: The Institute on Medicare and Medicaid Payment Issues.  It was an excellent program in its content and quality – as are all seminars put on by the American Health Lawyers Association.  But non-lawyers tend to grimace when I tell them that’s where I was and can’t believe it could take three days to cover the regulations. The fact is, those three days only scratched the surface.

Many of the regulations sound like nonsense, adding cost and inefficiency to an already suffering health care system. For example, a physician wanted to know how to offer certain health services to his patients in a way that would be more convenient for them. The structure he was considering would comply with the substance of the regulations, so I told him the requirements for documenting it. He shook his head sadly.  “No offense to you,” he started. “But what you are telling me is that if I pay an attorney to write a contract showing how I will be providing these services then everything is fine; but if I provide the same services without having an attorney write it up, I’ve committed a federal crime?”

Sadly, the answer was “yes.”  I’m sure some people are scoffing that this was to be expected – the attorneys write laws to benefit themselves.  I’m not going to defend lawyers here, nor am I going to agree, other than to admit that I am part of the problem having made a living in that system for over twenty years.  But to dismiss the problem as merely lawyers being self-serving misses the bigger picture – one that is much more important, and more troubling.

The problem is us. We have attempted to regulate common sense. That is, we keep layering prohibition on prohibition thinking it will stop people from exercising bad judgment, and give quick and clear redress for even the slightest affronts.  Yet, America was founded on ideas of freedom and individuality, with laws existing to guide and extract punishment only for significant impingement of the rights of others. One of the fundamental concepts behind our judicial system was that setting a guilty man free was better than confining an innocent one. But that is no longer true.  Now regulations flourish to protect ourselves from our own stupidity – so that we don’t have the opportunity hurt either ourselves or others. Basically, so we don’t have to think and exercise judgment ourselves.

Over the weekend, I hiked on a nature trail, passing five signs that demanded I stay on the six foot wide, smooth packed, groomed path.  This wasn’t a nature hike; it felt more like a march down a street! My husband wondered what would happen if we followed the riverbed instead.  Would we be fined? Kicked out of the public park? Face criminal charges?  Publicly flogged?

I was reminded of Hector West, in John C. Brewer’s novel, Multiplayer, who is told to go outside to play, only to find there is nowhere he’s permitted to ride his bike, the soccer fields are off limits to non-team members, the school playground is closed, and he could be arrested for trespassing in the woods near his house. I fear for our children growing up in a world of such constant prohibitions.  How will they learn to make decisions?  How will they understand that there are consequences that you live with when you make mistakes? How will they ever think for themselves?

I don’t know the answers to those questions.  But I know that at this point, the only way to avoid regulations is for us all to sit at home, alone, in the dark.  By doing that, you will not violate any rules.  You will be safe and so will everyone else.  If you want to do that, I guess I can’t stop you.  But personally, I prefer personal freedom, even if it comes with a price.



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