Doctoral Dissertation Research: Elected Politicians and Unelected Bureaucrats: Agency Rulemaking and Medicare Physician Payment Reform

9409300奥尔德里奇这个博士论文研究支持项目考察了国会对联邦官僚机构的监督。它旨在回答几个问题，包括：国会议员自己在多大程度上参与了对官僚行为的监督，而不是将监督权授予受机关决策影响的利益集团？在限制机关自由裁量权方面，各种形式的监督有多有效？该项目的核心假设是，政治对官僚行为的影响最普遍和最有效，不是通过国会小组委员会听证会等正式机制，而是通过非正式渠道，如官僚和受机构规则影响的利益集团之间的会议。该项目通过关注一个主要的医疗保健问题来检验这一理论命题：医疗保险计划支付给治疗用药患者的医生的费用。1989年，国会授权制定收费明细表，这是一种前瞻性地设定Medicate为所有医生服务支付的金额的支付机制。通过一系列回归方程，该项目评估了各种形式的正式和非正式监督对确定支付水平的影响。这些结果意义重大，因为它们代表了对国会监督的首批经验性检验之一，并为医疗保健改革的政治提供了洞察。

9409300 Aldrich This Doctoral dissertation Research Support project examines congressional oversight of federal bureaucratic agencies. It aims to answer several questions, including: To what extent do members of Congress engage in supervision of bureaucratic behavior themselves, as opposed to delegating oversight authority to interest groups affected by agency decisions? How effective are various forms of oversight in constraining agency discretion? The project's central hypothesis is that political influence on bureaucratic behavior is most prevalent and effective not through formal mechanisms such as congressional subcommittee hearings, but through informal channels such as meetings between bureaucrats and interest groups affected by agency rules. The project tests this theoretical proposition by focusing on a major health care issue: payments by the Medicare program to physicians treating Medicate patients. In 1989, Congress mandated the development of a fee schedule, a payment mechanism which prospectively sets the amounts that Medicate pays for all physician services. Through a series of regression equations, this project assesses the impact of various types of formal and informal oversight on the setting of payment levels. These results are significant in that they represent one of the first empirical examinations of congressional oversight and provide insight into the politics of health care reform.