#1 Health reform's bureaucratic spawn08-04-2010, 02:21 AM
By GLORIA PARK & FRED BARBASH | 8/3/10 4:31 AM EDT
Don’t bother trying to count up the number of agencies, boards and commissions created under the new health care law. Estimating the number is “impossible,” a recent Congressional Research Service report says, and a true count “unknowable.”
The reasons for the uncertainty are many, according to CRS’s Curtis W. Copeland, the author of the report “New Entities Created Pursuant to the Patient Protection and Affordable Care Act.”
The provisions of the law that create the new entities vary dramatically in specificity.
The law says a lot about some of them and a little about many, and merely mentions a few. Some have been authorized without any instructions on who is to appoint whom, when that might happen and who will pay.
Those agencies created without specific appointment or appropriations procedures will have to wait indefinitely for staff and funding before they can function, according to Copeland’s report.
And others could be just the opposite: One entity might not be enough and could spawn others, resulting in an “indeterminate number of new organizations.”
The CRS report cites as an example a minority health provision that “requires the heads of six separate agencies within Health and Human Services to each establish their own offices of minority health.”
Another section, by contrast, says that the Patient-Centered Research Institute “‘may appoint permanent or ad hoc expert advisory panels as determined appropriate.’ How many such panels will be ‘determined appropriate’ by the institute is currently unclear.”
Implicit in the report is a message not to take too seriously the elaborate charts and seemingly precise numbers peddled by Republican critics that are designed to show the law’s many bureaucratic tentacles.
The Center for Health Transformation, founded by Newt Gingrich, recently estimated that the new law created as many as 159 new offices, agencies and programs. Republican staffers on the Joint Economic Committee determined that there were 47 bureaucratic entities.
“Although some observers have asserted that PPACA will result in a precise number of new boards and commissions,” the CRS document reads, “the exact number of new organizations and advisory bodies that will ultimately be created ... is currently unknowable.”
Even in the few cases in which the PPACA set explicit creation dates for organizations, the consequences of missing these deadlines remain unknown.
The legislation, for instance, mandated HHS to establish an Interagency Task Force to Assess and Improve Access to Health in Alaska by May 7, as well as an Advisory Committee on Breast Cancer in Young Women by May 22.
HHS has yet to appoint members to the breast cancer committee and is currently reviewing nominations, according to HHS spokeswoman Jessica Santillo. The Alaska task force didn’t hold its first meeting until July 16.
CONTINUEDStand up for what is right, even if you have to stand alone.
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