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Friday, August 21, 2009

Bureaucracy Expansion Act of 2009

As much attention as the draft health care restructuring bills have received, so much has been missed in the thousands of pages of proposed legislation. It is not an exaggeration to say that these proposals create numerous and layered levels of new bureaucracies, on top of the expansion of existing layers of government.

The draft bill proposed by the Senate HELP Committee creates the following new bureaucracies. This is just a sample, and is not a complete list:
Sec. 174. Negotiated Rulemaking Committee and Facilitator
Sec. 187. Commission on Key National Indicators
Sec. 211. Patient Safety Research Center
Sec. 212. Community-based Multidisciplinary, Interprofessional teams
Sec. 219. Center for Health Outcomes Research and Evaluation
Sec. 229. Office of Women's Health
Sec. 301. National Prevention, Health Promotion and Public Health Council
Sec. 411. National Health Care Workforce Commission
Sec. 430. Surgeon General Ready Reserve Corps
Sec. 511. Health Care Program Integrity Coordinating Council
Deep within the text there are innumerable new studies, rulemaking requirements, grants, programs, and other provisions which will expand existing bureaucracies. And this is just the Senate draft, which is barely half as long as the House version. Here are some examples (not a complete list) from the Senate draft of grants to fund private bureaucracies:
Sec. 212. Grants to establish community health teams to support a medical home model.
Sec. 213. Grants to implement medication management services in treatment of
chronic disease.
Sec. 321. Community transformation grants.
Sec. 412. State health care workforce development grants.
Sec. 426. Grants for State and local programs (to increase health care workers)
Sec. 436. Mental and behavioral health education and training grants.
Sec. 454. Workforce diversity grants.
And here are some new programs (again, just a sampling), which will require a combination of government and private staffing to administer:
Sec. 217. Program to facilitate shared decision-making.
Sec. 220. Demonstration program to integrate quality improvement and patient safety training into clinical education of health professionals.
Sec. 311. Right choices program.
Sec. 334. CDC and employer-based wellness programs.
Sec. 422. Nursing student loan program.
Sec. 423. Health care workforce loan repayment programs.
Sec. 424. Public health workforce recruitment and retention programs.
Sec. 425. Allied health workforce recruitment and retention programs.
Sec. 426. Grants for State and local programs.
Sec. 444. Youth public health program.
Sec. 455. Primary care extension program.
The Senate draft is titled the ‘‘Affordable Health Choices Act’.’ It should be titled the "Bureaucracy Expansion Act of 2009."

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Related Posts:
IRS The New Health Care Enforcer
Taxing Your Mere Existence
Health Care Tax Insanity Chronicles, Part 3 (IRS To Decide Amount of Taxation)

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Posted by William A. Jacobson at 10:23 AM

2 comments:

  1. Papa RayAugust 21, 2009 at 3:01 PM

    So, is the the National Jobs Program that will ensure millions of Americans will be hired.

    I'm sure that training and education for those millions will also recieve government assistance and guidence which will nessitate thousands of new instructors, teachers and professors.

    To complete this circle other groups will be needed to make this a self sustaining government policy and plan.

    One question I have is where are the literally trillions of dollars going to come from to fund this mega-headed monster?

    Two many other questions do I have now and that is without doing more than skimming several hundred pages of this....monster bill.

    Then I'm sure I would have dozens more questions.

    I don't think I will like the answers to these questions.

    Papa Ray
    West Texas

    ReplyDelete
  2. archer52August 21, 2009 at 6:13 PM

    I'm here to say this is one reason lawyers should never be allowed to hold public office. They get all wrapped up in their world of "process" and don't realize they have driven the car off the road in the real world.

    After over twenty years in law enforcement, I've seen good lawyers and bad, decent people and corrupt ones. But regardless of who they were they had one thing in common, an almost crack like addiction for the "process." Whether or not justice was done the giddy conversation surrounded who won the motion, who lost the case, which piece of law was used to persuade the judge to rule their way.

    In my early years I was that crazy cop who was walking around asking the outrageous question, "But what about justice?" It took years and many cross looks from senior attorneys for me to figure out what finally one admitted. She said, "Never confuse right and wrong, justice or injustice, with the law."

    They'll screw this whole thing up so bad we'll never understand it, but they will talk for years about the excellent process.

    ReplyDelete

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