TED'S TAKE: THE GUY WITH THE GOLD MAKES UP THE RULES

There was a time when traffic safety and traffic engineering was the bedrock of roadway design. Sadly, that does not seem to be the case today as diligent safety and engineering does not always yield the quick visible results regulators are seeking. The system now seems to create the illusion of traffic safety through creative enforcement mechanisms, when in fact federal transportation policy is shaped by a limited few in the federal bureaucracy.

I argue that there is different, bureaucratic golden rule at play– the guy with the gold makes up the rules.

Federal transportation funds are doled out by the Department of Transportation (DOT) and the agencies under DOT like the Federal Highway Administration and the National Highway Traffic Safety Administration. Unfortunately, this can create incentives that steer state and local agencies toward restrictions in traffic flow packaged as safety.

Local agencies respond rationally – to get money. Requests for federal funding are evaluated and reviewed competitively. Projects aligned with or responsive to federal priorities receive a higher score. Over time federal recommendations or policy priorities tend to be what moves forward, regardless of whether or not they are validly achieving the desired results.

The bureaucrats and regulators within the DOT who dole out the money induce desired behaviors (be they right or wrong, purposeful or not) on the part of applicants. Applicants respond to get the money (which lightens their local budgetary load) often placating federal priorities or objectives in order to be ones that receive the money.

The result? We get whatever the feds want because of the golden rule.

That’s why we have traffic cameras, roundabouts, narrower roads (regulators think that narrower roads will make people drive slower and that going slower will result in increased traffic safety which is incorrect) and as such that is what funding is being given for, whether or not it actually leads to safer roads. It results in something they can point to, indicating that they did something.  

Now lets look at how this might play out or extend to a different industry; the health care research arena.

Hypothetically, this new golden rule phenomenon could be the same when applied to medical research in the United States and how the National Institutes of Health (NIH) doles out its money. Within the agency, the people who have authority to allocate funding could have a select result in mind. For example, if they think or favor drug development to treat patients then they could induce this in how they fund projects, who they fund, and for what. In this way, they could be subsidizing the front-end development costs of the pharmaceutical companies. They can do this through what they request proposals about (which could vary by type of research) and what the research is for. Those with the power to dole out funds can influence and achieve their intended goals through the scoring criteria they use to evaluative proposals, who they place on the review section panels and who they chose to use. Through these mechanisms, they could (and perhaps do) influence what and who gets selected.

This hypothetical application to allocating funding for medical research sure looks very similar to how the DOT works (which we know as fact). The DOT has moved away from the scientific establishment of traffic safety using sound engineering-based roadway design and speed limit establishment towards a heavier use or reliance on enforcement – a policy initiative, not a real-world desirable outcome.

The medical research world could similarly be moved towards drug development, rather than investing in true science which looks at how things work, understanding the functionally of body systems first and then pursuing a path forward from there, which could truly lead to scientific break throughs. Unfortunately, there does not seem to be immediate money available for investing in true science so they may not pay for that.

Interesting to ponder why we are where we are!