RT Journal
A1 Sessions SY, Detsky AS
T1 THe “shadow government” in health care
JF JAMA
JO JAMA
YR 2010
FD December 22
VO 304
IS 24
SP 2742
OP 2743
DO 10.1001/jama.2010.1873
UL http://dx.doi.org/10.1001/jama.2010.1873
AB 
Because of a combination of economic, social, and legal factors, considerable power over health care has effectively been delegated to medical societies, research organizations, and other institutions, enabling them to function in some respects like government rather than agents in a free market. In particular, the issuance of official statements setting the criteria for the diagnosis and treatment of disease can have much the same effect as the enactment of legislation or promulgation of regulations. In this Commentary, we describe how this “shadow government” evolved and discuss some of the implications of this phenomenon for health policy.