By Ronald E. Bachman
Now that Congress is back in session and President Obama has spoken, Washington’s focus on the various health plans will intensify. But health legislation passing through Congress has nothing to do with health reform, or even health care. It is about raw political power.
Controlling $2.5 trillion with grants, awards and expanded federal bureaucracies is a winning combination for increasing government intrusion into citizens’ lives. Congress has proposed minimizing individual responsibility and maximizing central power in Washington. The power includes the ability to spend more, allocate pork-barrel funding and expand government bureaucracies.
The Senate Health, Education, Labor and Pension Committee (the HELP Committee) has produced one “health reform” proposal that may be the “Mother of All Slush Funds.” It proposes new commissions, councils, advisory groups, agencies, departments, teams and panels, with unlimited funds to spend on research, development, planning, studies, recommendations and organizing. Nearly every one has “granting authority” with federal funds to distribute.
The risk is that these funds will not only expand federal bureaucracies and control over private markets, but that many of the grants will go as political favors to acceptable ideologically oriented groups.
Among the proposed agencies with seemingly unlimited budgets:
Commissioned Corps and Ready Reserve Corps – “shall at all times be subject to call to active duty by the Surgeon General. The Commissioned Corps are authorized to be appropriated such sums as may be necessary.”
Health Care Program Integrity Coordinating Council – “There are authorized to be appropriated to carry out this subsection, such sums as may be necessary for fiscal year 2010 and each succeeding fiscal year.”
Advisory Committee on Interdisciplinary, Community-Based Linkages – “… are authorized to be appropriated $125,000,000 for each of fiscal years 2010 through 2014.”
The grants for these and other entities are embedded throughout legislation that few in Congress seem eager to read. Questionable new grants and government activity include “community transformation grants” and “workforce diversity grants.” Grant distribution essentially begins immediately – “not later than 60 days after the date of enactment of this section” – not even waiting until 2013, when the law would take effect.
Most grants seem to duplicate existing government agencies. The National Institutes of Health, the National Institute of Mental Health, the Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention already perform most of the needed health and health care research and functions the legislation proposes.
Some initiatives go frighteningly beyond traditional health care and into areas of city planning, home construction and transportation systems. The level of centralized power over individual rights seems far beyond anything most citizens would expect in their daily lives on the grounds of health insurance reform. Wide-sweeping “Health Impact Assessments” are proposed on “the potential health effects of the built environment.”
“The term ‘built environment’ means an environment consisting of building, spaces and products that are created or modified by individuals and entities, including homes, schools, workplaces, greenways, business areas, transportation systems, and parks and recreation areas, electrical transmission lines, waste disposal sites, and land-use planning and policies that impact urban, rural and suburban communities.”
For proponents, these proposals do a terrific job of centralizing power into the hands of government. They include health environmentalism, green impact assessments and added bureaucratic oversight and restrictions on American business. The ability to award grants seems unlimited and ideologically oriented to an expanded role of government in citizens’ lives, well beyond health and health care.
The system is broken and all sides agree to reform, if not transformation. But there’s no cure in prescribing a pork-barrel health plan that unnecessarily expands government. Supporters of constitutional freedoms, individual rights, personal responsibility and greater self-reliance need to send Congress and the president back to the drawing board to return to the core health issues: solving cost, quality and access problems. The country need a system with the compassion of a caring mother, it does not need the “Mother of All Slush Funds.”
Ronald E. Bachman FSA, MAAA, is a Senior Fellow at the Georgia Public Policy Foundation, an independent think tank that proposes practical, market-oriented approaches to public policy to improve the lives of Georgians. He is also a Senior Fellow at the Center for Health Transformation, an organization founded by former U.S. House Speaker Newt Gingrich. Mr. Bachman worked as an outside expert with members of Congress and the Clinton administration during the 1993-94 health reform. Nothing written here is to be construed as necessarily reflecting the views of the Foundation or the Center for Health Transformation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.
© Georgia Public Policy Foundation (Sept. 11, 2009). Permission to reprint in whole or in part is hereby granted, provided the author and his affiliations are cited.
