The power of the purse, only less girlie

A recent letter to the editor in our local paper asked the question, "since when does the President have the authority to tell hospital administrators what their policies should be."

The answer, apparently, is when the hospital accepts funds from the Federal government.

To explain. President Obama has signed an order to the effect that hospitals that accept Medicare funds need to have policies more friendly to non-married people. This means no keeping significant others away from the gravely ill even if they aren't, technically, next of kin. It also means accepting the patient's stated (or apparent) wishes on who should have authority to make medical decisions on his/her/its behalf.

Under other circumstances, the President would have no authority to just order a private institution like a hospital to change its policies. The President could cajole, or advise, or yell at, and this might be cause the institution to reconsider - but couldn't order. But in this case, the institution relies heavily on Federal funds. The government has the right to declare which organizations it will do business with and which it won't. Presumably, the President has the authority to base those decisions on a number of factors, including the institutions policies (though I expect that this will go to the courts for a real determination). So the President - by the power of the purse - is using non-legislative means to achieve an end.

Now, I assume hospitals have their reasons for the policies they've adopted. They may even be good reasons from some point of view. However, I applaud President Obama for this action.