Electrifying public accountability of US Congressional Committees
The U.S. Senate and House committees and subcommittees should not operate at the leisure of lawmakers; they should operate with accountability to the US. public.
The U.S. Senate and House committees and subcommittees are a self-contained operation. This set-up is silly at best, and it is a blatant failure to protect the public from the gross, pompous DC political culture.
The House and Senate determine their committees and the makeup [1,2], including all Congresspersons assigned. There is little understanding and clouded transparency on these committees. If, how and when committees work together is unknown. There is also no evaluation of the committees: whether or not they are effective, how success is defined, how attendance and time-lines are accounted for. And there is no evaluation around how legislation is assigned to, analyzed and decided upon by these committees. There is no evaluation of the Subcommittees, either.
Importantly, there is little public ability to influence operations, yet there is great influence from these committees on the public’s health.
The committee and subcommittee work should be much more accountable to the public.
To an outside observer (and in a democratic country, the existence of a citizen outsider suggests a systematic failure), the House and Senate Committees are set up to operate for the exclusive benefit of the Congressperson. There is no public decision-making on committees, and there is no public accountability of the committee work. If the legislative work is divided for subject matter expertise efficiency, there also appears to be no accounting of the so-called experts.
We should shape up the House and Senate Committee structures. Because healthcare is inherently tied to governing, because healthcare is a primary priority for our lives, and because healthcare reaches every facet of major government, healthcare committee work should lead the way.
The sheer amount of work necessary to shape up the decrepit, exclusive elitist committee system is daunting. Decades of Congressional ineptitude have indirectly cried out for a systematic overhaul, the work must get done one way or another, and we needn’t feel intimidated.
We can work point by point to clean up, and electrify, the committee structure of the U.S. Congress.
Some steps:
Rewrite the committee rules to reflect evidence-basis, common sense and public input.
Require written rationales for committees and subcommittees. Require rationale for the number of Congresspersons assigned, as well as rationale for frequency of meetings based on type and vote. Support this criteria with evaluation data.
Require specific time-frames for re-establishment or retirement of the committees. This is especially true with an evolving healthcare agenda under our democracy.
Be specific in detailing committee and subcommittee influence on U.S. healthcare. Be specific on direct influence [3]. What have the committees on health assured on an ongoing basis, what has the patient outcome trajectory seen, what has the GDP and household healthcare expenditure trajectory been? Be specific on indirect [4] healthcare influence. What have the committees on agriculture, labor and/or environment contributed to patient outcome trajectories, public health trajectories of proper nutrition, occupational health and wellness changes, or asthma and respiratory management?
Evaluate the health-related committees and subcommittee personnel. How much work is being done? How is this work being defined? How is the work productivity and attendance of the Congress persons? What training and continuing education has been offered and taken by those tasked to become subject matter experts? How has noncompliance to committee rules been violated by the Congressperson? Because limitless financial donors in a limitless campaign funding cycle are not an evaluation, create an evaluation structure.
Evaluate the committees and subcommittees. Where are there duplicate healthcare responsibilities? What public health priorities are not being addressed under any committee? How many of these committees are assigned healthcare legislation related to children? What are the committees not assigned “healthcare” yet directly responsible for funding cognitive, physical and mental impairment social care, and how do they work alongside the others? Which committees directly influence oral health and dental reimbursement? How do these committees work with one another to create efficiency in healthcare legislation and oversight?
Require written criteria for establishment and retirement of committees. Support this criteria with evaluation data. If, for example, attendance is extremely low and a committee tasked with health-related legislation rarely meets, evaluation should steer the course. Criteria should be specific, as well. A criterion that requires a committee to be retired if <25% of pending legislation has been addressed, for example, should be accompanied by a specific timeframe.
Determine qualifications for committee member assignments, including ongoing education on the health issues assigned. Clarify qualifications for the assignments. If a Congressperson refuses basic and ongoing education related to the subject, why should the public settle?
Determine criteria for removal from a committee, including removal for conflicts of interest, removal for financial conflicts, removal for corporate and lobbyist grey areas, removal for lack of attendance, removal for lack of productivity, removal for lack of transparency, removal for continued behavioral or noncompliance issues during committee sessions and removal for falsification of expert qualifications. This should not be a subjective whim of party leadership; the criteria should be written and binding.
Monitor the introduced legislation for these individuals. How have the opportunities to advance been addressed? What are the criteria for committee assignment to the legislation with respect to party colleagues and others? If the Congressperson has avoided decision-making, rejection or advancement of health-related laws, what has been done to address their performance? And, if the person who introduced the legislation is deliberate in inaction or alternative action, what is being done?
Require committees to undergo ongoing performance improvement. Select third party assistance to oversee the quality assurance.
Require committees to address ongoing population health metrics, outcomes and harms related to the pending status of their work. If the metrics remain unaddressed, write this incompetence into the evaluations.
Clearly outline processes for committees to work together, processes to form pathways across populations and health, and processes to be accountable to one another. When assigned a committee assignment, working together across party lines shouldn’t be hailed as a spectacular achievement. Teamwork is an expectation of most employed tax-payers and Congresspersons are no different. Create expectations of teamwork, not participation trophies for the decades-old and new lawmakers.
Assign risk to the committees and subcommittees. Fund this assignment at the level of the healthcare policy think tanks. How much is each committee at risk for DC lobbyist and political party manipulation to healthcare legislation? Which committees are at risk for agenda greasing, and how much resource would the public need to match the selfish agenda contributions? What is the estimated equitable catch up to ensure health protection? What is the risk to public and population health with each political and antidemocratic vulnerability?
Rather than get intimidated, let’s choose confidence. We can shape the U.S. Congressional committee system up.
The public is neglected and harmed when the U.S. Congress operates without public disclosure and transparency. The public is also neglected and harmed with the U.S. Congress writes its own managerial operations as it remains accountable to no one. Committee and subcommittee work is a ripe to be transformed, and it is a primary opportunity. The way they’ve always done it is unacceptable to our democracy. Neglect and harm is a failure of democracy and should be remedied without delay, treated as an immediate jeopardy finding.
With healthcare leading the way, we can electrify the U.S. Congressional Committee structure.
References
1.https://www.house.gov/committees
2.https://www.senate.gov/committees/index.htm
4.https://www.senate.gov/committees/committees_faq.htm
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