The Baffling Bureaucracy in the Dems’ Health Care Plan

July 15th, 2009 at 3:32 pm | 21 Comments |

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Today, the Senate’s Health, Education, Labor and Pensions Committee approved, on party lines, a healthcare reform bill.  The bill includes a provision to create a government run health insurance plan which will compete with private insurers.  The plan is expected to cost $1 trillion dollars over 10 years.

I examined the plan and released a detailed flow chart highlighting the 31 (at current count) departments, agencies, and programs that will administer the proposed Democratic government-run healthcare bureaucracy.


Recent Posts by Hon. Kevin Brady

21 Comments so far ↓

  • midcon

    Great job Mr. Brady You need to make sure this is widely distributed! Send it to WAPO and the NYT. See if they dare to print it!

  • joemarier

    Does Glenn Beck know about the “public health workforce camps?”

  • sinz54

    Could we see a flow chart of the health care system as it currently exists?

    With my own health problems, I have to deal with the bureaucracy of the State of Massachusetts, the bureaucracy of Medicare, the bureaucracy of Social Security, and the bureaucracy of Blue Cross–all of whom are constantly interacting with each other.

    The new health care reform is complex, because it has to build on top of all this machinery, not sweep any of it away. So it takes existing complexity, and layers more complexity on top of it.

    I am opposed to a single-payer system. But I’m the first one to admit that it would not only be cleaner and simpler than the Dems’ proposed health care reform, but also be cleaner and simpler than what we have now.

    Complexity. It’s what we pay for freedom.

  • ottovbvs

    sinz54 // Jul 15, 2009 at 6:18 pm

    “Could we see a flow chart of the health care system as it currently exists?”

    ………….Don’t hold your breath……..This chart belongs with those in the Republican house senate “budget” proposals

    “I am opposed to a single-payer system. But I’m the first one to admit that it would not only be cleaner and simpler than the Dems’ proposed health care reform, but also be cleaner and simpler than what we have now.”

    ………..So why exactly are you opposed to it?

    “Complexity. It’s what we pay for freedom.”

    …………..Duh…………Sinz……you do say the darnedest things at times……this is another one…….Complexity in fact is what enables anyone with ulterior motives to get away with them……..Corporations are in business to make money……..transparent pricing for example is an enemy of profitability……which is why many corporations as I can attest from experience pour enormous effort into making their price lists as complex and opaque as possible……To take an example we’re all familiar with……Have you looked at your telephone bill lately……you can explain all those little add ons can you?

  • joemarier

    Sinz, you can find it right here…

    Note the lack of “public health workforce camps.”

  • midcon

    joe. I think that is “public health workforce corps.” Not sure if Congressman Brady meant this to be the PHSCC – the existing Public Health Service Commissioned Corps (which is actually a uniformed corps under the Department of Health and Human Services. Probably not. Still I looked at the diagram pretty closely and I can’t find any camps (summer or otherwise).

  • ottovbvs

    ……That Republicans like Brady are reduced to this sort of inanity( why did he waste his time you have to wonder) is a measure of both their self chosen total irrelevance to the healthcare debate and their inability to prevent the passage of a major healthcare reform bill which is going to give the president 98% of what he wants……..Beck style jokes seem entirely appropriate

  • joemarier

    Shucks, my eyes must be playing tricks on me. Yes, it’s “corps” not “camps”.

  • The Blog of Record » Blog Archive » The Coming Health Care Bureaucracy

    [...] Does history offer any proof of government’s ability to efficiently manage such a scheme? [...]

  • ottovbvs

    [...] Does history offer any proof of government’s ability to efficiently manage such a scheme? [...]

    ……….Actually yes…….they are being run very effectively by govt’s around the world at roughly half the cost

  • sinz54

    ottovbvs: The complexity of your phone bill stems from the balance that the Government had to strike between deregulation and maintaining uniform common carrier service, even to the poorest and most remote communities, across multiple phone companies servicing different areas. That’s something that liberals like you should care about.

    Do you remember how things were before deregulation? Your phone bill was “simpler,” all right. Because you had only one choice: AT&T, which had a monopoly on phone service. You had to rent your equipment from them or else pay a fee. Their equipment came in only a few styles, and that’s all you had to choose from. And you had to call a service man to install the phones. There were no cell phones; and for most, no satellite phones.

    Now you have many choices. But in a totally free market, poor and rural communities might lose phone service because it’s not profitable for any one company to go there. And if different companies do service in different parts of the nation, how do you do reliable long-distance transmission across the nation in a uniform way? Especially for emergency calls?

    Some of the fees on your bill go toward those purposes. The Universal Service Fund, for example. All phone companies charge you for it, and then they pay it into the USF fund that is used to subsidize phone service to poor and rural communities. That’s something that you probably find more attractive than I or barker13 do.

    With deregulation, the company that routes and transmits your calls may no longer be the same company as the company that owns the physical wires. So those are broken up into two separate charges.

    You may also find a “911″ fee on your bill. This is another fund, paid into by all the companies, that provides uniform 911 service. So that anywhere in the nation, regardless of which companies are providing service, you can dial 911 in an emergency and be sure the police or fire department will come. Would you rather live without that? Or have different codes in different parts of the nation, forcing you to remember 911 in one state and 711 in another state and 3256 in some other state?

    Complexity is an inevitable consequence of the many choices that come with a free market. No market is freer than online Internet purchases. You have zillions of websites to buy stuff from. But shopping online is “complex”; You have to use search engines to find products. Then you may find that the website with the product you want is hard to use. Or it may impose high shipping charges which makes the product more expensive than you had intended. So off you go to another website. This is certainly more “complex” than going down to your local corner convenience store to buy a newspaper. But the complexity is vastly outweighed by the zillions of choices now open to you.

    Complexity is the flip side of freedom.

  • sdspringy

    We should be asking what is the hurry. Another massive government program, thousands of pages long, no time to analyze the programs. PASS IT NOW. What would be wrong with explaining what the new healthcare coverage will cover. We all select healthcare now by comparing coverages. Yet we apparently will not be allowed to converse with our representative in government about this new government coverages at all. It MUST be passed before they go home in August. WHY??

    And any statement, like Ottos, about healthcare is simpleminded. Healthcare overruns are creating financial burdens in every government provided system in every country. Those countrys, such as France, are now having to reduce access to reduce cost. And they already tax EVERYONE in their country at 25% just for healthcare.

    So forget the Obama promise about SunShine in government. This program will be pushed through at 3am, like the stimulus, and result is yet another government program that nobody knows what will cost.

  • liv&win

    In the 1940′s, enterprizing capitalists threw some crap against the wall and said, look, we’ve invented group health insurance and it was very successful. In 1964, the gov’t, threw some crap against the wall and entered the market with Medicare. These two coexisted until the 70′s when a number of factors began to change. Medicare was beginning to lose its financial footing, and doctors who were hogtied in Medicare began to charge more and more to private payers to make up for their loses. The insurance insdusty threw more crap agains the wall and said here are PPOs. Doctors did what they do, and more changes were required, splat, precertification, splat pre-exisiting conditions, splat. Then HMOs, splat, EPOs splat, POS plans splat. Doctors responed with medical groups, splat. the government intermittently threw more crap against the wall, splat splat splat.

    And so now, we look at the wall that is our health care industry and idenfy our pile of crap, ‘look, that is my piece of crap health care plan’. Now any sane person would say, lets scrap all this stuff off and start over. But our brilliant politicians just want to throw more crap against the same wall. It is insane.

    For all the hard core conservatives, many aspects of health care DO NOT respond to normal competitive economics. With a broken leg or sudden heart attack, there is no reasonable expectation that someone will pull out the yellow pages and call around and shop for health care. First, it is too complicated…”so doctor, for that $1200 you will also be running the sportex test series and doing the follow-up protocol as described in the 2006 article of the American Medical Journal, right?” (I made these things up because I am not a doctor).

    Note that some medical services and procedures do infact respond to normal competitive pressures and economic principals. Cosmetic surgery does, but it is also voluntary and non-urgent. People can shop for that care.

    But for you crazy anti-captialist liberals, government has demonstrated time and time again, that they can implement a program, but over time, the effectiveness and efficiency of those programs declines. Medicare was a decent idea, not great, but decent. But it was designed on a set of actuarial facts which have changed dramatically affecting the program adversely. Rather than adapting, the goverment has only one major tool, it reduces funding. Its the same with every socialized program in the world.

    And to the liberals, the choice you want to make is this or that. But ‘this’ has positive and negatives as does ‘that’. Nowhere do I see an objective view coming from your side of the arguement.

    Also, I would like to point out that the auto industry, which is so crucial to our economy has 622,000 manufacturing jobs. The health care industry has 14 million. IN addition, there are 436,00 health insurance agents who will be out of a job with health care reform. the insurance industry has 2.3 million jobs. Health care reform, if not done properly will have a tremendous impact on a major industry in USA. A reasonable estimate will be that between 1.5 and 2.5 million jobs will be lost with the current reform legislation going through congress.

    I have not seen 1 liberal commentator discuss this FACT. Yet with the auto bailout, jobs was the only discussion.

    Here is the bad news…2 million more out of work, no benefits, no insurance, paying no taxes…further straining a public system which is currently broke and not working. Add in health care legislation which does ZERO, NADA, NOTHING to reduce the cost of health care to you and me, and you have a catastrophe. I actually think the jobs picture will be worse because the legislation affects pharma in a big way. That impacts high tech jobs in the public sector and will have a dramatic impact on universities which do a lot of medical research. All that work will be outsourced and those jobs will be lost for a long time. Further, the pace of innovation and research will decline dramatically.

    If this legislation passes, you will have lived through the golden age of health care. For the forseeable future, there will be little if any innovation. There will be fewer doctors. Access will be severly limited. People in the last 1-5 years of their lives will have limited access to health care. Infants, especially premature babies will not have access to the live saving technology on the scale that it is available today. Chronic diseases will be offered one treatment protocol, diet, exersize or death.

  • liv&win

    Oh, and by the way, the chart put out by the republicans is similar to the chart which described Hillary-Care. I would have thought the dems capable of learning more from that…in the end, the people want to be able to understand the health care system. This is a bad start for the dems.

  • barker13

    Re: Liv&win // Jul 17, 2009 at 1:36 pm and Liv&win // Jul 17, 2009 at 1:42 pm –

    Notice the deafening silence which greats the splashing (or shall I say “splatting”) of the cold water of fact and reason in the faces of the libs – and some self-identified conservatives.

    See… this is why we’re f–ked. Reality and reason just doesn’t trump “hope” and personal ideals and preferences for most folks. When they’re faced with unpleasant truths… (*SHRUG*)… they’ll just ignore it and hope reality goes away.


    Well… off to play racquetball! (*WINK*)


  • Spartacus


    The actuarial and demographic factors you refer to in criticizing Medicare have nothing to do with inefficiencies in the program and more to do with the success of the program itself as well as an unreasonable belief that all or most costly end-of-life care is beneficial. More people are on the program because they are living longer, in large part, because of access to healthcare.

    With respect to costly end-of-life care, I’m sure you are aware that 25% of the Medicare budget is spent on the last 3 months of a person’s life, and about 1/3 of that 25% is spent in the last month of life. This has nothing to do with program efficiencies and almost everything to do with how we choose to die in this country. There is a de facto rationing of care away from those who could benefit the most and toward those who have very little to gain at the ends of their lives.

  • barker13

    Re: Spartacus // Jul 19, 2009 at 11:35 pm –

    Any thoughts…???

    “…the success of the program itself…”

    As in “successfully heading towards bankruptcy…???”

    Sparky my regularly crucified gladiator cyberfriend… (*SMILE*)… Liv&Win’s “actuarial and demographic” data sharing is EXACTLY on point.

    (Are you SURE you’re not Otto just posting under a different handle…???)


  • Spartacus


    Are you pretending to be this slow in comprehending what I’ve written or are you just too fixated in an ideological opposition to what I’ve written?

    liv&win referred to “inefficiencies” in the Medicare program as a reason for its financial problems. I countered by writing that Medicare’s financial problems are due to demographic changes (a larger elderly population as a percentage of the total population) and the sucess of the program itself (people are living longer, in part, because they have access to quality healthcare and, therefore, use more medical services than they would if they died sooner).

    The purpose of the Medicare program is to provide quality care to all senior citizens. The program has been wildly successful in achieving that goal. The fact that there are fewer and fewer workers to pay for the care required by a growing senior population is not an”inefficiency” in the program, nor does it undermine my claim that Medicare has been very successful at providing quality care to senior citizens, thereby increasing their lifespans.

    The article you linked to only points out the obvious and well-known fact that Medicare is going bankrupt. It doesn’t even address why Medicare is going broke or offer any solutions, one of which could be, as I stated in my original post, re-thinking how much care we, as a nation, consume when death is imminent.

  • barker13

    Re: Spartacus // Jul 20, 2009 at 3:17 pm –

    So are you saying there are no “inefficiencies” in Medicare/Medicaid?

    Hell… in a manner of speaking not properly factoring in demographic changes is pretty damn… er… “inefficient.”

    “The purpose of the Medicare program…”

    …is what it is. (*SIGH*) But figuring out how to IMPLEMENT that purpose without bankrupting the country… well… (*SNORT*)… that’s pretty important too, Kirk. (Sorry… I meant “Spartacus.”)

    “…are you just too fixated in an ideological opposition…”

    I’m fixated on REALITY. I’m fixated on WHAT IS and WHAT WILL BE if the same folks who dug us into this mess in the first place simply keep digging.


    “The program has been wildly successful in achieving that goal.”

    So you say. (*SMILE*) Even stipulating that – for the sake of argument – if the program is fiscally/economically unsustainable then your “successes” will soon be a thing of the past.

    “The article you linked to only points out the obvious and well-known fact that Medicare is going bankrupt.”

    (*SNORT*) (*GUFFAW*) Yeah… absolutely NOTHING in that statement to give you pause… (*GRIN*)

    Sparky. “Going bankrupt” is indeed a “fairly” important piece of the puzzle.

    Oh… and btw… as you use the term “obvious” are you suggesting that the Dems KNEW that they were creating a time bomb each time they grew and expanded Medicare/Medicaid?

    Sparky… you’re funny! I enjoy reading your ramblings. (*WINK*) Keep up the good work!


  • Spartacus

    barker13 // Jul 21, 2009 at 5:35 pm wrote: “So are you saying there are no “inefficiencies” in Medicare/Medicaid?”

    While you may have enrolled in a logic class, it seems apparent you did not attend or pass. I never said there were no inefficiencies in Medicare/Medicaid. What I said is that whatever inefficiencies exist, they are not the cause for those programs going broke. Those programs are going broke because of things that have nothing to do with how they are administered – demographic changes and longer life spans. You inability to address these points leads me to believe you either agree with me or you not sufficiently informed about the subject to offer a compelling response on the merits (and that’s ok).

    As for Democratic expectations when the programs were implemented, I have no idea if they or anyone else knew in the mid-60s that (1) medical costs would outpace inflation so much, (2) life-spans would reach the levels they’ve now reached, or (3) there would be fewer workers relative to the number of retirees. In any event, none of those things would have been a reason to not go forward with a plan to provide quality healthcare for senior citizens. As evidenced by the experiences of every other Western nation, it is possible to provide quality healthcare to every single citizen without bankrupting the country.

    You may find the link below helpful:)

  • barker13

    Re: Spartacus // Jul 21, 2009 at 7:18 pm

    “You may find the link below helpful:)”


    Cute, Sparky. (*SMILE*) (*CHUCKLE*)

    Anyway… another dead horse.

    At least when you’re pinned down you answer the questions. (*WINK*) But the pinning you down… (*SIGH*)… it’s such a long drawn out process…