A policymaker deciding whether to support a new action; a legislator deciding whether to vote for a new program; a regulator deciding whether to impose a stringent standard: each decisionmaker faces the question, What will be foregone if I decide to commit the resources for this activity? These constraints that arise from institutional contexts in which legislators and other policymakers address tradeoffs both limit alternatives that can usefully be considered, and tend to push decisionmakers to make up-or-down, case-by-case decisions rather than choosing among tradeoffs. While the President, Congress as a whole, each Chamber, and the full Committees on Budget and on Appropriations have the ability to view comprehensively funding priorities and consider tradeoffs, only in exceptional cases can those with comprehensive authority devote attention to the level of detail at which most environmental, health, and safety tradeoffs occur. The competition among alternatives is not just on the basis of relative costs and benefits: there is also political reality. For environmental, health, and safety statutes, tradeoffs are largely determined by the statutes/programs of the subcommittee/committee of jurisdiction. One result is that each act containing regulatory programs has its own criteria for decisions on setting standards, cleanup, etc. What seems clear is that even if state and local, corporate, or private investments in alternatives to pollution control mandates would contribute equally—or even more—to net national welfare, there is little reason to assume the alternatives would be selected from more cost-effective environmental, health, or safety programs such as immunization, education, or care for poor pregnant women. Weighing Tradeoffs: Where Does It Lead? In reality, the actual tradeoff faced by a policymaker at a particular time and place—subcommittee, committee, or the floor of Congress; or Commission or Agency—is effectively limited by institutional structures and rules and by the incommensurable criteria brought by different decisionmakers who would ultimately decide on the actual alternatives for spending any dollars the tradeoffs make available. There may be definite options, as when an appropriations subcommittee allocates dollars among programs in its jurisdiction; but in other cases the tradeoff may be between an intended outcome and the nebulous consequence of not opting for that outcome. The problem is depicted in Figure 1 : Putative tradeoffs among environmental, health, and safety expenditures presume that all programs are on the table , as shown in Figure 1 -A , each with a specified dollar amount per unit that gives one measure of potential cost-effectiveness; but the voting legislator typically has only a single program on the table at a time, the result of a deliberate, formal process of agenda setting, as shown in Figure 1 -B ; and the administrator(s) of diverse programs generally finds each program on a separate table , with the boundaries of each defined by a separate statute that gives little or no authority to an administrator to compare and reallocate resources across them, as illustrated in Figure 1 -C .
In the end, the underlying issue of environmental, health, and safety cost-effectiveness is how to foster decision processes and structures that enable tradeoffs that reflect the informed preferences of the citizenry. Evidence indicates that programs vary in cost-effectiveness.
A policymaker making a decision on approving a program may face the questions, What are the tradeoffs? What alternatives are foregone by committing resources to that program? This issue has been sharpened in environmental, health, and safety policy because studies indicate that some programs are more cost-effective than others, suggesting that redirecting resources from less efficient to more effective programs would increase overall national economic welfare.
Actually making implied tradeoffs has proved difficult, however. One reason is continuing controversy over methods for evaluating the risks, costs, and benefits of alternative programs—leaving uncertainty about exactly what would be gained and lost in a tradeoff. Other constraints affecting tradeoffs include variations in regulatory standards among environmental, health, and safety statutes and political responses to nonquantifiable values such as equity. Legislative efforts to revise the statutes or to establish more comprehensive reviews of tradeoffs have moved slowly.
Two further factors constrain the ability to make a tradeoff at a particular time and in a particular institutional context. One consists of institutional structures and procedures that impose limits on possible ranges of decisions within the legislative and executive branches. For example, an appropriations subcommittee typically weighs spending tradeoffs only among programs within its jurisdiction, but not tradeoffs with programs in the jurisdiction of other subcommittees even if the programs are related. Similarly, statutes authorizing environmental, health, and safety regulations may be written by separate committees, leading to variations in cost-effectiveness standards for protecting the public health and environment.
A second complicating factor occurs when a program's alternative(s) would require a shift in who can decide on the use of the resources involved, as when a regulatory program is considered in lieu of a tax-supported program. Deciding to regulate industrial air pollutants mandates spending by industry and consumers; choosing not to regulate leaves those monies available to the industry's executives and consumers, who can invest/spend them according to their own preferences. Having little control over alternative expenditures, a decisionmaker tends to focus on each program as self-contained, not to compare options.
The actual tradeoff faced by a legislator or policymaker at a particular time and place is constrained by institutional structure and rules, and by the fact that most decisions are up-or-down, not between program options. Many putative tradeoffs exist only in a theoretical sense: they are tradeoffs not then and there available to that policymaker. Making environmental, health, and safety tradeoffs on the basis of cost-benefit analyses implies restructuring decisionmaking processes, but such restructuring is very difficult in itself, and it is unclear whether the results would more accurately reflect the informed preferences of Congress—or the citizenry.