The report documented many instances of the administration’s misrepresentation or suppression of scientific information and stacking of scientific advisory committees to obscure the fact that policy decisions were based on its political agenda, which usually favored rightwing constituencies and large corporations.
The Medicaid program, which has grown enormously expensive since it was established, has also been a target of Congress, which for some time threatened, without success, to hand it over to the states entirely. These police powers of governments are basic to public health, and are the reason why public health must ultimately be government’s responsibility. Police powers are invoked for three reasons: to prevent a person from harming others; to defend the interests of incompetent persons such as children or the mentally retarded; and, in some cases, to protect a person from harming himself or herself.
As an example of the interplay of legislation, agency rule making, and the role of the courts, consider the Occupational Safety and Health Act, passed by Congress in 1970. The legislation stated that “personal injuries and illnesses arising out of work situations impose a substantial burden upon interstate commerce,” and thus used the federal government’s authority over interstate commerce to pass a public health statute.