EC: Obamacare’s Bureaucracy Nightmare

Tait Trussell

We now see how the regulatory bureaucracy works—or probably can’t work– and how it “may well push us into the single-payer health care system,” Grace-Marie Turner astutely pointed out Aug. 26 in the Detroit News. Turner is president of the Galen Institute, a research organization focusing on health policy. Under a single-payer system, the federal government would be the paymaster making the medical decisions. hree influential House Democrats are now pushing for a public option (single-payer). ModernHealh.com reported July 22. Rep. Pete Stark (D-Calif), chairman of the House Ways and Means Health Subcommittee, is leading the movement. The “public option offers lower cost competition to private insurance companies,” added Rep. Lynn Woolsey (D-Calif ) co-chair of the Congressional Progressive Caucus. Rep. Jan Schakowsky (D-Il), is the third Member.

Even before a single-payer system could evolve, ObamaCare has the potential to topple from bureaucratic overload. Uncountable unelected and untested bureaucrats will be making life-affecting decisions. At this stage, not even experts who have pored over the 2,000-plus-word law know how many bureaucracies are hidden away in the ObamaCare statute. According to Politico no one can figure out exactly how many new agencies ObamaCare will spawn once it comes into full effect. Congress authorized a “self-perpetuating bureaucracy, one that can expand on its own and make determinations far outside of the boundaries Democrats promised during the ObamaCare debate.”

A Congressional Research Service Report, “New Entities Created Pursuant to the Patient Protection and Affordability Care Act (PPACA) is a dramatic eye-opener. Curtis W. Copeland earnestly attempted to compile and briefly explain the pieces and parts of the regulatory jungle in a 40-page report in July. In his summary section, author Copeland, described as a specialist in American National Government, writes:

Some of these new entities are offices within existing cabinet departments and agencies, and are assigned certain administrative or representational duties related to the legislation. Other entities are new boards and commissions with particular planning and reporting responsibilities. Still others are advisory bodies that were created to study particular issues, offer recommendations, or both. Although PPACA describes some of these new organizations and advisory bodies in detail, in many cases it is impossible to know how much influence they would ultimately have over the implementation of the legislation.

This report describes dozens of governmental organizations or advisory bodies that are mentioned in PPACA but does not include other types of entities…(e.g. various demonstration projects, grants, trust funds, programs, systems, formulas, guidelines, risk pools, websites, ratings areas, model agreements, or protocols)….The precise number of new entities that will ultimately be created…is unknowable….PPACA significantly increased the appointment responsibilities of the Controller General of the United States, and it is unclear how the Government Accountability Office (GAO) will be able to independently audit entities whose members are appointed by the head of GAO.

Seemingly always conscious of racial matters, an example of the minority health provision that the CRS analysis mentions “requires the heads of six separate agencies within Health and Human Services to each establish their own offices of minority health.”

This astonishingly frank description of the law’s provisions reminds one of Shakespeare’s Act 3, Scene 4 when Lady Macbeth says “You have displaced the mirth…with most admired disorder.” A law perhaps admired by some in Congress, but certainly in disorder.

The Center for Health Transformation (CHT), founded by former House Speaker Newt Gingrich, estimated 159 new offices, agencies, and programs created by the health law, Politico reported Aug. 3. “Even in the few cases in which the PPACA set explicit creation dates for organizations, the consequences for missing these deadlines remain unknown.” The law’s provisions “vary dramatically in specificity.” It states a lot about some provisions, but a little about many other provisions. “Some have been authorized without any instructions on who is to appoint whom, when that might happen and who will pay.”