Michelle Malkin » Inside the monstrous Obamacare bureaucracy

Inside the monstrous Obamacare bureaucracy

By Michelle Malkin • July 17, 2009 09:35 AM

My column today delves into the Byzantine world of the Democrats’ government-run health care takeover. I filed it before the latest CBO budget analysis assailing the costs of Obamacare — a predictable outcome which simply bolsters my point. I linked the other day to the incredible flow chart created by the GOP team at the Joint Economic Committee. It deserves far and wide dissemination. This will be the future if taxpayers sit by and do nothing. (And check this out: The nutroots did not like the chart. Update: Some people are misunderstanding me and CrabbyCon’s chart. The point is that none of the lefties wanted the chart’s info to get to the viewing public.)

Latest legislative machinations:

On the House side, Ways and Means helped Obamacare clear another hurdle.

The House Ways and Means Committee approved legislation early Friday to overhaul the health care system and expand insurance coverage after a marathon session in which Democrats easily turned back Republican efforts to amend the bill.

The 23-to-18 vote came just hours after the director of the Congressional Budget Office, Douglas W. Elmendorf, shook up the political landscape by suggesting that none of the major health care bills would significantly slow the growth of health spending…Two other House panels, the Energy and Commerce Committee and the Education and Labor Committee, are working on the legislation.

Democrats said the actions in the Senate and in the Ways and Means Committee created momentum for passage of the legislation, President Obama’s top domestic priority. But in both committees, the votes generally followed party lines, indicating the lack of consensus on how to finance coverage for the uninsured.

Kimberley Strassel says on the Senate side, Sen. Charles Grassley is the key.

***

Inside the monstrous Obamacare bureaucracy
by Michelle Malkin
Creators Syndicate
Copyright 2009

If you think government is too big and too costly, wait until Obamacare kicks in. The Congressional Budget Office put the price tag of the House Democrats’ health care takeover plans at $1.5 trillion over 10 years. But the CBO’s fine print included a tell-tale caveat:

“We have not yet estimated the administrative costs to the federal government of implementing the specified policies, nor have we accounted for all of the proposal’s likely effects on spending for other federal programs.”

You don’t need an accounting degree or clairvoyant powers. The administrative costs and spillover spending effects will be astronomical. Look at existing federal programs. In 1966, the Office of Management and Budget put the total taxpayer costs for Medicare at $64 million. In 2011, Medicare costs are expected to balloon to nearly $500 billion. Medicaid cost $770 million in 1966. By 2011, that program will cost taxpayers an estimated $264 billion. The Virginia-based Council for Affordable Health Insurance estimated that the administrative expenses of both programs last decade were 66% higher than those of private sector health insurance companies.

And we ain’t seen nothing yet. House Republicans on the Joint Economic Committee sifted through their opponents’ 1,018-page health care bill and released a dizzying flow chart detailing the Byzantine bureaucracy Obamacare would create. Washington would become the home of at least 31 new federal programs, agencies, and commissions to oversee the government-run health insurance regime.

Because 32 “czars” isn’t enough, the Democrat plan would add another overlord to the Obama administration. The new “Health Choices Commissioner” would helm the new “Health Choices Administration” (Section 141 of the bill) – separate from the already existing Department of Health and Human Services, Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration), the Veterans Health Administration, and the Indian Health Service.

Because the government has done such a boffo job managing the near-bankrupt Social Security and Medicare Trust Funds, the Democrats have proposed creating a “Public Health Investment Fund” and a “Health Insurance Exchange Trust Fund.” The latter would create a “transparent and functional marketplace for individuals and small employers to comparison shop among private and public insurers.”

No matter that state insurance departments already operate such systems. Health care must be “fixed.” The federal cure is redundancy.

The Obamacare bill also creates a new “Bureau of Health Information” (not to be confused with the already existing National Center for Health Statistics) within the department of Health and Human Services. The BHI will be led by a new “Assistant Secretary for Health Information.” The new assistant secretary will coordinate with the recently-created “National Coordinator for Health Information Technology” – who is responsible for monitoring the $19.5 billion in the stimulus law to implement “a nationwide interoperable, privacy-protected health information technology infrastructure.”

New bureaucracies always have old special interests to appease. The Bureau of Health Information will house its own “Office of Civil Rights” and “Office of Minority Health.” The information czar will be required to collect health statistics in the “primary language” of ethnic minorities – and thus, the need for a new “language demonstration program” to showcase their efforts. Obamacare will also ensure “cultural and linguistics competence training” and establish “a youth public health program to expose and recruit high school students into public health careers.” The government health care juggernaut must be fed and staffed, after all.

Providing more stimulus for taxpayer-funded jobs, the Democrats’ bill would add a new “Senior Advisor for Health Care Fraud” and require the Attorney General to appoint a “Senior Counsel for Health Care Fraud Enforcement.” There’s already a national Health Care Fraud and Abuse Control Program, but who’s counting?

To coordinate all the new bureaucrats, Obamacare would create a new “Health Care Program Integrity Coordinating Council” to “to coordinate strategic planning among federal agencies involved in health care integrity and oversight.”

To make sure all the existing local and state environmental public health agencies don’t feel lonely, the Democrats’ plan creates a new “Coordinated Environmental Public Health Network” to “build upon and coordinate among existing nvironmental and health data collection systems and create state environmental public health networks.”

A new “National Health Care Workforce Commission” will be “tasked with reviewing health care workforce and projected workforce needs.” New funding will be available for a “demonstration program to improve immunization coverage” that would enable government busybodies to send reminders or recalls for patients or providers, or home visits.”

Who’ll be looking out for you? The House bill creates a “public plan ombudsman” and a “special health insurance exchange inspector general” to police spending and guard against waste, fraud, and abuse. Given the sad fate of aggressive watchdogs in the age of Obama, however, these positions will end up like every other new agency, commission, task force, and office created to serve the federal health care beast: black holes.

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#747793

On July 17th, 2009 at 2:52 pm, palologirl said:

Thank you Michele for the talking points.I made my calls to my Senator’s Warner and Webb. I will keep track of them on this issue.
#747806

On July 17th, 2009 at 3:00 pm, libertybelle said:

I guess I’ll stick around until the 2010 elections and fight for change. But if the electorate chooses to continue down this road, then it will be time to go Galt BIGTIME!

Exactly! We nourish and provide for these beastly programs. What if we all just give up and “Go Galt?” I would love to see how they would handle that. And if you haven’t read Atlas Shrugged yet, you MUST. It will freak you out.
#747833

On July 17th, 2009 at 3:12 pm, T-Bone said:

On July 17th, 2009 at 1:40 pm, jjmurphy said:
T-Bone, Call me cynical but I think Obama and the other collectivists give a rat’s rear-end about the health of the poor. They are solely concerned with their power. If they can get more power by making false promises to the useful idiots in the USA, then they will do it.

Thats what I meant to imply and they do it here under the false pretense of helping the little guy, who is uninsured, to get health care. They don’t talk about how much liquor the guy drinks or how much he gambles away instead of buying health insurance, or whether he is legally here in the US. I guess I could see them having some empathy for others but they don’t let that get in the way of their real quest for power and control. Useful idiots is right.
#747858

On July 17th, 2009 at 3:25 pm, Misscheryl said:

Rags said: The way is clear. It is only a question of individual commitment.

I agree but personally, I don’t see it happening. The same inertness that has kept us in our lazy boys watching the boob tube is the same thing that will keep us doing nothing and they know it.
#747875

On July 17th, 2009 at 3:34 pm, The Ugly American said:

On the plus side, Obamacare will create lots of new shovel-ready jobs
#747880

On July 17th, 2009 at 3:36 pm, Ragspierre said:

I agree but personally, I don’t see it happening. The same inertness that has kept us in our lazy boys watching the boob tube is the same thing that will keep us doing nothing and they know it.

There is a tipping point. We are rushing toward it every day.

If not for ourselves, for our children and grandchildren.
#747881

On July 17th, 2009 at 3:37 pm, Ragspierre said:

And if you haven’t read Atlas Shrugged yet, you MUST. It will freak you out.

You might also enjoy http://www.amazon.com/Joe-Shrugged-Modest-Reprise-Atlas/dp/1442110155/ref=sr_1_1?ie=UTF8&s=books&qid=1247859213&sr=1-1
#747897

On July 17th, 2009 at 3:48 pm, AlohaGuy said:

The public just doesn’t care. Neither does Congress. We’re screwed.

Fortunately your pets will still receive fine care. Get to know your local veterinarian…
#747899

On July 17th, 2009 at 3:49 pm, AlohaGuy said:

Birth certificate, passport applications and college apps please.
#747902

On July 17th, 2009 at 3:53 pm, Misscheryl said:

Those who support a global economy know this will result in 3rd world standard of living increasing and industrial countries standard of living decreasing (that means us). As long as we can hook up the boat, eat steak once a week and have a comfortable place to sleep – nothing changes. When our comforts start to diminish, we’ll take action. I don’t want to be pessimistic. I prefer to call it realistic.

I work in academia and those I see still supportive of Obama are either black, 30 or younger or women. FYI
#747911

On July 17th, 2009 at 3:59 pm, mattymatt10 said:

Is there any way to tie voting rights to the requirement to pay taxes, i.e. if one pays no taxes then one has no vote.

The Constitution says Congressmen and women should be chosen by the people of the states, but it doesn’t say “all people” and there’s nothing in there (as I read it) that restricts putting requirements on people.

Back in the day, only property owners were allowed to vote cuz they were the only ones with “skin in the game,” as they say. Or have courts already decided on this in the last 230 years?
#747927

On July 17th, 2009 at 4:08 pm, purealchemy said:

On July 17th, 2009 at 3:49 pm, AlohaGuy said:
Birth certificate, passport applications and college apps please.</blockquote

That would be SSOOOO sweet if that would pan out. Supposedly, if it would be proven he’s not eligble, all legislation he’s signed would be nullified and he goes to jail for about 16 months. SSSQQQUUUUUUWEEEEEEE!!!!!
#747931

On July 17th, 2009 at 4:09 pm, AlohaGuy said:

mattymatt10 said:

Exactly. When voters outnumber tax payers…
#747938

On July 17th, 2009 at 4:12 pm, Misscheryl said:

more stuff (from “The Hill”:

Freshman Dems oppose Pelosi’s tax increase
By Mike Soraghan
Posted: 07/17/09 02:23 PM [ET]
Twenty-one freshman Democratic House members have signed a letter opposing their leadership’s plan to raise taxes to finance a healthcare overhaul.

Rep. Jared Polis (D-Colo.) circulated the letter, saying that the income surtax on the wealthy would place an undue burden on small businesses, some of which pay taxes in the same way as an individual. The letter had 22 signers, all freshmen except for Rep. Paul Hodes (D-N.H.), who is in his second term.
#747952

On July 17th, 2009 at 4:21 pm, Bogtrotter said:

NJ-Aviator said: “government workers that will do little work and get generous pay and benfits”

Never even thought of that. I would bet the cost for employee wages and benefits is one of the things they will spring on us later. Hate to say it, but it is beyond too late to stop this monster.
#747960

On July 17th, 2009 at 4:27 pm, purealchemy said:

On July 17th, 2009 at 3:53 pm, Misscheryl said:
Those who support a global economy know this will result in 3rd world standard of living increasing and industrial countries standard of living decreasing (that means us).

Obama had this planned all along. We eat too much, use too much energy, keep our air conditioning set too low.
Reminds me of a Quentin Crisp quote: “Don’t try to keep up the Joneses. Drag them down to your level.”

I work in academia and those I see still supportive of Obama are either black, 30 or younger or women. FYI

They will be getting all the good healthcare and the old people and baby-boomers about to hit Medicare will die off. That leaves their voting block.
#747963

On July 17th, 2009 at 4:29 pm, Misscheryl said:

Obama had this planned all along.

…and so did the family of Bush!
#747982

On July 17th, 2009 at 4:41 pm, purealchemy said:

…and so did the family of Bush!</blockquote

I think they wanted to lead us to one-world government but not to this healthcare thing.
#747997

On July 17th, 2009 at 4:55 pm, Lee Hazel said:

Redundancy, yup.

A “Senior Counsel for Health Care Fraud Enforcement”, what on earth for??

We have without a doubt the largest and most effective “Fraud Enforcement” agency in the history of the world.

It’s called The United States Congress as aided and abetted by the Administration, The Courts, and various “cozy” (fascist) arrangements between these and American Business interests, particularly financial.

It dwells in the Washington District of Corruption if there is anyone who does not know where to find it.

Incidentally, it has 52 subsidiary offices called States and literally thousands referred to as Cities, Towns and Counties.

PC is Thought Control
LEE
#748007

On July 17th, 2009 at 5:05 pm, Lee Hazel said:

BTW: there has been some rumblings about concerning Page 16 of this bill.

It is said that there is language there that effectively “outlaws”, as in makes illegal, private health insurance.

It would seem that if you have existing health care coverage the day this bill is made law you may keep it.

BUT, if you should lose that coverage by whatever means it is “against the law” for you to seek other private coverage, YOU MUST GO TO THE PUBLIC OPTION…

Have I heard this correctly???

PC is Thought Control
LEE
#748013

On July 17th, 2009 at 5:08 pm, SalsaNChips said:

Watch. The entire thing is going to collapse under its own weight very quickly, probably before it even gets off the ground. Then the finger pointing over who is responsible, back-tracking, blame-shifting, etc.. The thing I’m worried about is the huge mess it will create, not if, but when it craters.
#748031

On July 17th, 2009 at 5:19 pm, purealchemy said:

There’s another article by Betsy McCaughey “Ruin Your Health with the Obama Stimulus Plan”. I remember reading it earlier this year when Ted Daschle was still in the picture for a cabinet position. She says this bill is almost identical to a plan suggested by Daschle in his book “Critical: What We Can Do About the Health Care Crisis.”
The most chilling part:

“Elderly Hardest Hit

Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.

Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.”
#748038

On July 17th, 2009 at 5:26 pm, jjmurphy said:

This whole nasty business comes down to the fact that the federal government should have NO role whatsoever in healthcare, except for military medical needs.

The horror stories mentioned above would not happen in a free society where people were raised to take responsibility for themselves and their families.

The Rube Goldberg chart shows just how idiotic the whole mess is.
#748056

On July 17th, 2009 at 6:32 pm, babiesgrandma said:

purealchemy said:

I know what you are talking about. I mentioned on another thread a couple of weeks ago about Tom Daschle’s book “Critical…..” and reading about it upset me greatly, since it talks about the masses as just that – non personal, impersonal, get too old, get rid of you — point of view. Very scary. He would have been in office if it weren’t for his typical demoncrat tax dodging.
#748058

On July 17th, 2009 at 6:55 pm, cwbois said:

Well the ONE has to fix the employment isssue as well, how else do you expect him to find jobs for everyone if not in the government?
#748062

On July 17th, 2009 at 7:08 pm, purealchemy said:

On July 17th, 2009 at 6:32 pm, babiesgrandma said:
purealchemy said:

He would have been in office if it weren’t for his typical demoncrat tax dodging.

I know. That was one of the few breaks we got.
Just occured to me, Democrats used to be the ones who couldn’t keep their pants zipped and maybe Republicans would be the tax dodgers. Now it’s reversed!
babiesgrandma, how far are you from a revamped Medicare? I’ve got a ways to go. I’m just glad my parents got the good care during their lifetimes.
#748103

On July 17th, 2009 at 8:26 pm, Freddy said:

The stress of trying to uncover all of the corrupt fraud that Obama and the democratic communist party, is giving me a major headache!
#748116

On July 17th, 2009 at 8:39 pm, tiredofit08 said:

Walter Cronkite dies at age 92…RIP
#748145

On July 17th, 2009 at 9:26 pm, sbw999 said:

The road to complete socialism. America: third world country by 2020.
#748148

On July 17th, 2009 at 9:31 pm, tiredofit08 said:

#108…don’t even give it that long with the amount of illegals flowing in..shamnesty again on our doorstep..and unchecked chain migration will bring us there far quicker than 2010….
#748204

On July 17th, 2009 at 10:47 pm, Mach1Duck said:

Pelosi declares that the Health Care Plan has the support of the American People. Just who has she been talking to?
#748207

On July 17th, 2009 at 11:29 pm, Flyoverman said:

On July 17th, 2009 at 10:47 pm, Mach1Duck said:

Pelosi declares that the Health Care Plan has the support of the American People. Just who has she been talking to?

Given her claim, most likely the little voices in her head.
#748208

On July 17th, 2009 at 11:31 pm, realitycheck said:

Patriot Act noun A Law passed by Congress limiting freedoms guaranteed by the Constitution of the United States to the American People.

verb Something done by the American People to ensure that the noun isn’t successful.
#748213

On July 18th, 2009 at 12:42 am, chotii said:

Turnout at the Bellevue, WA office of Patty Murray (which btw was reportedly empty – not so much as an aide there) was smallish…I think we had 30 people? But most of the focus locally was in Everett.

A few people honked as they went by. Mostly people probably didn’t have a chance to read signs, as the speed limit there is 35 and the road is a bit narrow for a 4-lane.

No mention in local “news” rags as usual.
#748240

On July 18th, 2009 at 8:52 am, beenthere said:

In response to the criticisms, the Obama Administration has prepared a new, streamlined diagram showing how Obamacare will run more efficiently in the future.
#748242

On July 18th, 2009 at 9:00 am, JiangxiDad said:

Good, anti gov’t healthcare commercial:

http://www.americanthinker.com/blog/2009/07/obama_care_in_60_seconds_or_le.html
#748272

On July 18th, 2009 at 10:50 am, purealchemy said:

On July 18th, 2009 at 8:52 am, beenthere said:
In response to the criticisms, the Obama Administration has prepared a new, streamlined diagram showing how Obamacare will run more efficiently in the future

That is wicked!
#748275

On July 18th, 2009 at 11:12 am, Ragspierre said:

Here’s my flow-chart for health-care reform that is proven to work:

Meprovider

Could anyone…seriously…suggest the COLLECTIVIST flow chart will yield better results? Cheaper?

Please…
#748276

On July 18th, 2009 at 11:15 am, Ragspierre said:

Well, phooooey!!!

that should have come out

ME arrow, dash, dash, dash, arrow PROVIDER

blankety, blank, blank internet stuff, anyhow…
#748302

On July 18th, 2009 at 12:16 pm, oldcollegeguy1980 said:

From oversight to complete control.

The change they voted for.
#748321

On July 18th, 2009 at 3:08 pm, greenLibertarian said:

Thanks for exposing the nightmare health care Obacracy, Michelle. Is there a larger version of that flowchart?
#748326

On July 18th, 2009 at 4:45 pm, jsmiddleton4 said:

http://www.rossputin.com/blog/media/ObamaCareChart.jpg
#748327

On July 18th, 2009 at 4:46 pm, jsmiddleton4 said:

http://rossputin.com/blog/index.php/chart-of-obamacare
#748332

On July 18th, 2009 at 6:55 pm, LOBOMAN said:

Biden will explain to us what happened (in a year or so) —- Well, we just under estimated some of the costs and now we will need another trillion of your dollars….
Trust me, it will be better this time!
#748353

On July 18th, 2009 at 9:28 pm, Mach1Duck said:

Washington has helped enough, thank you.
The most nine feared words, “I am form the government and here to help.”
#748355

On July 18th, 2009 at 9:51 pm, purealchemy said:

Dear folks,

I feel like we are in our darkest hour here but I am taking comfort in listening to Sarah Palin’s VP acceptance speech.

We need comfort.

We need a prayer vigil.
#748357

On July 18th, 2009 at 9:55 pm, purealchemy said:

On July 18th, 2009 at 9:28 pm, Mach1Duck said:
Washington has helped enough, thank you.
The most nine feared words, “I am form the government and here to help.”

I think Reagan formed that quote.
#748361

On July 18th, 2009 at 10:23 pm, rightisright said:

“White House wants more power to set Medicare rates…” news topic stated in the Drudge Report 7/18/09…this is the kind of health plan Erkle is going to give senior citizens. Cut costs so we die slowly, Congress is a bunch of sick and power hungry no good bastards. Out with them.
#748371

On July 18th, 2009 at 10:39 pm, Flyoverman said:

In Memory of Staff Sergeant Darrell “Shifty” Powers

Company E, 2nd Bn, 506th PIR, 101st Airborne Division

Darrell “Shifty” Powers, age 86, died June 17, 2009. He had been battling numerous illnesses — basically, old age.

http://www.youtube.com/watch?v=bDOyAgG_NIs

As fine a soldier who ever served.
#748377

On July 18th, 2009 at 11:35 pm, greenLibertarian said:

Thanks for the charts, JS.
#748379

On July 18th, 2009 at 11:42 pm, Ragspierre said:

Cut costs so we die slowly

Yep. In a lot more pain and discomfort, and with a lower standard of living.

Change you can believe in…
#748391

On July 19th, 2009 at 3:44 am, Living in the PSRK said:

Their Own Medicine

Senators prefer the insurance they have.
In the health debate, liberals sing Hari Krishnas to the “public option” — a new federal insurance program like Medicare — but if it’s good enough for the middle class, then surely it’s good enough for the political class too? As it happens, more than a few Democrats disagree.

On Tuesday, the Senate health committee voted 12-11 in favor of a two-page amendment courtesy of Republican Tom Coburn that would require all Members and their staffs to enroll in any new government-run health plan. Yet all Democrats — with the exceptions of acting chairman Chris Dodd, Barbara Mikulski and Ted Kennedy via proxy — voted nay.

In other words, Sherrod Brown and Sheldon Whitehouse won’t themselves join a plan that “will offer benefits that are as good as those available through private insurance plans — or better,” as the Ohio and Rhode Island liberals put it in a recent op-ed. And even a self-described socialist like Vermont’s Bernie Sanders, who supports a government-only system, wouldn’t sign himself up.

Of course, they also qualify now for generous Congressional coverage. Most Americans won’t have the same choice. Some will be transferred to the new entitlement as it uses its taxpayer bankroll to dominate insurance markets. Others work for businesses that will find it easier to dump their policies and move employees to the federal rolls. Democrats also know that the public option will try to control health spending by squeezing payments made to doctors and hospitals, and by not paying for treatments that Washington decides are too expensive, which will result in inferior care.

No doubt Mr. Dodd acceded to the Coburn amendment to blunt such objections, and in any case he’ll strip it out later in some backroom. Judd Gregg was the only GOP Senator to oppose it, on humanitarian grounds. As he told us in an interview, the public option “will be so bad that I don’t think anyone should be forced to join.”
#748407

On July 19th, 2009 at 8:29 am, Mach1Duck said:

A big selling point for this plan is the 46 million who have no health insurance. Prior to the Great Society implementation under Lyndon Johnson in the mid sixties, very few people had health insurance. They just went to the doctor and got treated. Of course then the medical profession was a service not a business. I volunteer at a local hospital which does not hire its own doctors. The doctors are under hire to a company which is contracted by the hospital to supply the needed doctors, most of which are foriegn born. Kind of makes one wonder what Federalized health care will look like.
#748420

On July 19th, 2009 at 10:23 am, NestingHawk said:

Second paragraph, this article.
http://www.foxnews.com/politics/2009/07/18/obama-walks-line-outreach-republicans-health-care-legislation/

1) How do those numbers work?
2) Isn’t this article missing one or two important tidbits of info?

I think they’ve edited it slightly since the last time I saw it, so maybe it will improve…I doubt it, though, as it seems to be off the main page.
#748510

On July 19th, 2009 at 3:39 pm, jsmiddleton4 said:

You are welcome green…..
#748513

On July 19th, 2009 at 3:41 pm, jsmiddleton4 said:

“A big selling point for this plan is the 46 million who have no health insurance.”

That is a made up figure you know right? The number is no where near that. And many in the real number have chosen to not have insurance. People in America have the right to not have insurance. The freedom to not have something is a freedom. A freedom the government is hell bent on taking away.