When a regulatory agency prioritizes the interests of the industries it regulates over the public interest.
Deeper Dive
Regulatory capture can be subtle and difficult to define, but it’s often cited as a problem in health care, where industry holds significant sway in how complex regulations are formulated and enforced. The starkest example is the U.S. Food and Drug Administration (FDA), where controversial product approvals, such as the Alzheimer’s drug Aduhelm (aducanumab), have raised questions about the agency’s independence.
One factor is the “revolving door” in which regulators move from industry to government and back again, compromising their ability to be effective watchdogs. A 2023 study in Health Affairs found that 32% of HHS employees went to industry after leaving government, with highest rates in the Centers for Disease Control and Prevention, the Office of the Deputy Secretary, the Centers for Medicare and Medicaid Services (which regulates Medicare, Medicaid and the Children’s Health Insurance Program) and the FDA. Departing staff went to not only biopharmaceutical and device manufacturers but also insurers, technology firms, real estate firms with medical property portfolios, and consulting firms, the authors reported.
At the FDA user fees also play a role, according to watchdog group Public Citizen. Since 1992 and 2002 respectively, drugmakers and device manufacturers have paid fees for review and oversight of their products. User fees are reauthorized by Congress every five years, giving industry lobbyists an opportunity to negotiate for weaker standards and leading the FDA to treat the companies it regulates like partners or customers.Connecting the dots between industry influence and the harms of lax regulation — dangerous medical devices that are allowed to linger on the market, health plans that record big profits while denying essential care, physicians who continue to practice despite numerous instances of malpractice — makes for great journalism. Reporters can also hold to account politicians who promise to “shut the revolving door,” such as (newly appointed as of this writing) HHS Secretary Robert F. Kennedy Jr.