If you happen to pick up a copy of the Kansas legal code for the construction and administration of nursing homes — which, admittedly, you probably won’t — here are some of the rules:
— “The facility shall store each prepared food, dry or staple food, single service ware, sanitized equipment, or utensil at least six inches or 15 centimeters above the floor on clean surfaces. …
— “The facility shall provide living, dining, activity, and recreational areas in the special care section at the rate of 27 square feet per resident, except when residents are able to access living, dining, activity, and recreational areas in another section of the facility. …
— “Windowsill height shall not exceed three feet above the floor for at least 1/2 of the total window area. …
— “Wastebaskets shall be located at all lavatories. …
— “All eggs shall be cooked.”
OK, OK — I’ll stop (though, of course, the list goes on). I include these few samples for the same reason Philip K. Howard includes them in his deliberately infuriating new book, “The Rule of Nobody: Saving America From Dead Laws and Broken Government.” His point is that our country is drowning in laws so vast yet so persnickety that no one is allowed to use common sense.
Not only are professionals such as nurses and administrators treated like morons — “Don’t serve eggs raw!” — but also they are required to ignore the big picture of making sure the residents are happy and well-cared-for, in favor of obsessively ensuring that the home does not get cited for windowsills that are 3 feet 2 inches above the floor.
This kind of ridiculous regulating pops up in pretty much every public sector. In fact, in my neighborhood, right now, workers outside the apartment building next door are tearing down the beautiful wrought-iron fence that has been there for 60-plus years, because the city finally noticed (and cared) that it is 7 inches higher than allowed by local law.
What happens when we pile on laws that are excruciatingly precise but don’t make life any better for anyone?
Those who must comply are not only frustrated but also distracted from doing their jobs competently. How can they focus on providing a nice meal or satisfying day if they are busy worrying about the height of their utensil stations and all the other bogus benchmarks? Howard, a lawyer and founder of the nonprofit Common Good, cites one nursing home that wheeled its sleeping residents into “activities” so it would have the required number of people attending.
Fortunately — even amazingly — there is an alternative to this kind of bureaucratic lobotomy. As an example, Howard highlights what happened in Australia. There, in 1988, the government agreed to scrap hundreds of nursing home “input” regulations (regulations that detail exactly what an institution should do) in favor of 31 “output” regulations — ones that describe what the institutions’ goals should be. These include providing a “homelike environment” and honoring residents’ “privacy and dignity.”
Though some naysayers fretted this could result in across-theboard laziness or even patient maltreatment, the opposite occurred. Quality improved. Disagreements were less frequent. Once the workers were free to use their hearts and heads, their compassion and ingenuity flourished.
This approach is called “regulating by principles” rather than rules, and it doesn’t just work in nursing homes. Anyplace where bureaucracy seems to have replaced common sense, the switch to principles can be made without inviting chaos and corruption. These humans solve problems and stand responsible.
Imagine if we gave that kind of freedom to teachers, city workers and the folks at the DMV. They’d be less frustrated, and so would we. And I’m pretty sure that anyone charged with serving eggs would still cook them first.