The Cost -- and the Importance -- of Public Attention

We never tire of pointing out that FDA regulates products that represent about 20% of all consumer spending. It is a mark of FDA’s centrality to the economy, as well as to the public’s health and well-being. Indeed, last week we wrote about FDA exceptionalism: that there is no public health or regulatory agency with the same scope of mission or breadth of action. The agency is unique.Starting from that same premise, it is easy to see why: (1) FDA is constantly in the news; (2) Congress is always asking the agency questions; and (3) FDA is part of Washington’s alphabet soup that rarely needs to be explained to those outside the Beltway. I could go on with these -- it’s enough to say that everyone has heard about the FDA. Policymakers and the public demand that the agency be responsive.My question today: What price does the FDA pay for such intense and far-reaching public attention (probably more attention than any other federal regulatory agency)? Here are some thoughts:

• Accountability is expensive. Policymakers and the public hold FDA responsible for its action. Further, FDA needs to be a good steward for the money it receives. Robust, publicly-accountable decisionmaking is resource intensive. It’s hard to identify and add up the costs of quality controls, documentation of decisions, public outreach, etc., but we can be certain a lot of money is involved in assuring agency accountability.

• Scrutiny is time-consuming. No one is suggesting that Congress should write less often or that the media and public should ask fewer questions. Nonetheless, maintaining agency-wide staff for public outreach and Congressional liaison is necessary because of the sheer volume of time-consuming requests.

• Much of what the FDA does is undervalued. In an environment where government is widely perceived as “not working,” agency grades of C– are going to be common and A’s rare. FDA is one of the latter. The agency isn’t perfect by any means, but it tries hard and mostly succeeds; yet many would deny it the accomplishment. The Alliance is built in part on the observation that FDA doesn’t get the credit it deserves or the money it needs.

In sum, FDA’s job is made harder and more costly by the public attention the agency receives.However, public attention is built into the agency scope of work and must be accommodated regardless of cost. While we (and the agency) might wish for quieter days and less attention -- it would be hard for FDA to do its job if no one paid attention.Note: This week’s Analysis and Commentary was written by Steven Grossman, the deputy executive director of the Alliance for a Stronger FDA.