ObamaCare: The Infinite Bureaucracy Act

posted at 11:36 am on August 3, 2010 by Ed Morrissey

Last week, Rep. Kevin Brady (R-TX) had the staff of the Joint Economic Committee work on a flowchart of ObamaCare that has made the rounds of the blogosphere, thanks to its impossibly complicated representation:

It turns out that Brady may be a master of understatement.  According to Politico’s Gloria Park and Fred Barbash, no one can figure out exactly how many new agencies ObamaCare will spawn once it comes into effect.  In fact, the Congressional Research Office can’t figure it out either.  The language of the bill leaves open the possibility of an infinite string of new agencies and bureaucracies:

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.

Ironically, the CRS report intended to rebut the arguments made by Brady and others in crafting diagrams such as the one above.  CRS wanted to say that there wasn’t enough certainty in the number of agencies, panels, and committees to put them into flowcharts with connecting lines.  Like Nancy Pelosi once argued, the CRS report says that we can’t know what’s in ObamaCare until the government rolls it out.

That in itself is a big, big problem.  It seems clear that Congress just authorized a self-perpetuating bureaucracy, one that can expand on its own and make determinations far outside of the boundaries Democrats promised during the ObamaCare debate.  And if that’s true, then it is equally true that the claims made on the cost of administering ObamaCare had no real basis in fact.  How can one estimate a cost for a bureaucracy that is entirely undefined in size and scope?

Brady probably didn’t create the chart above as a best-case scenario, but that may be indeed what it is, at least in terms of certainty.


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A new board game from Parker Brothers.

Electrongod on August 3, 2010 at 11:38 AM

It’ll keep the lawyers busy and, really, that’s what is important.

lorien1973 on August 3, 2010 at 11:39 AM

Obamacare only looks worse upon further review.

What are our odds of repealing this mess?

carbon_footprint on August 3, 2010 at 11:40 AM

“To Infinity and Beyond!”…famous Buzz Lightyear quote.

percysunshine on August 3, 2010 at 11:42 AM

Brady probably didn’t create the chart above as a best-case scenario, but that may be indeed what it is, at least in terms of certainty.

This chart is just one third of what the potential clusterfark will look like.

VA is leading the way to kill this beast.

Schadenfreude on August 3, 2010 at 11:42 AM

My only satisfaction is that all the idiots that wanted this will now have to live with out (ruling class exempted, of course).

Aquateen Hungerforce on August 3, 2010 at 11:43 AM

If you like your doctor you can keep your doctor, you just need to be able to find him in that rat maze before you die of starvation. Good luck, comrade.

Bishop on August 3, 2010 at 11:43 AM

out it

Aquateen Hungerforce on August 3, 2010 at 11:43 AM

I just found Waldo.

Electrongod on August 3, 2010 at 11:43 AM

If it were not for the life and death subject of health care I would look at that and bust a gut, instead I want to cause severe health care problems for the idiots who created this collosal clusterfark.

fourdeucer on August 3, 2010 at 11:43 AM

Rube Goldberg, call your office.

Drained Brain on August 3, 2010 at 11:45 AM

What are our odds of repealing this mess?

carbon_footprint on August 3, 2010 at 11:40 AM

Not good. But either we destroy the Debt Star, or it will destroy us in short order.

Dark-Star on August 3, 2010 at 11:45 AM

Ed, GOP created another chart like this last year – related to the stimulus, I believe. Might wanna remind people of that; and how well it worked out.

You had a post about it then too.

lorien1973 on August 3, 2010 at 11:47 AM

Marx Madness

faraway on August 3, 2010 at 11:47 AM

Sen Coburn MD says 1/3 of healthcare is spent on non patient care items. A cube farm won’t cure a thing.

seven on August 3, 2010 at 11:48 AM

Democrats: The IRS will soon control your healthcare, ENJOY!

Chip on August 3, 2010 at 11:48 AM

This bill, at least the parts I’ve read, repeatedly gives the HHS secretary to set “qualified plan” standards and all kinds of other things, and there’s all the ambiguous new agencies with who knows what powers.

How can a law just give virtually dictatorial powers to a bunch of vogons without specifying what they can and can’t do? How can it be judged prior to passage? How can they dole out all this authority with zero accountability?

Does the Constitution empower Congress to do this?

forest on August 3, 2010 at 11:49 AM

Physicians in the lower left corner and Patients in the lower right corner with the Matrix connecting the two.
If I pay cash, can I avoid this mess?

Electrongod on August 3, 2010 at 11:49 AM

Why do they remind me of a map of Greek islands? For some reason, Greece comes to mind…..

RBMN on August 3, 2010 at 11:49 AM

They should make a TRON movie based on that chart…

mjbrooks3 on August 3, 2010 at 11:49 AM

The NHS in the UK will be a mere barnacle compared to this gargantuan Kraken that will sink the Good Ship USA.

Missy on August 3, 2010 at 11:49 AM

Old Pelosi: We have to pass the bill to find out what’s in it.

New Pelosi: Even after we pass the bill, we won’t really know what’s in it until it gets implemented.

jwolf on August 3, 2010 at 11:50 AM

Have any of the NeoProgressives explained how the “right to Healthcare” can be reconciled against the prohibitions against involuntary servitude?

Chip on August 3, 2010 at 11:51 AM

I can’ find the red pill or the blue pill flow diagram in that chart.

NotCoach on August 3, 2010 at 11:52 AM

This and Finace Reform. Dems: “Let’s pass a bad bill, and fix it later!” This is why they a bad for the country!

EliTheBean on August 3, 2010 at 11:53 AM

Weird OT: This page and comments is already in Google search results

faraway on August 3, 2010 at 11:53 AM

Ed, you forget. ObamaCare was DESIGNED to fail.

GarandFan on August 3, 2010 at 11:54 AM

How can a bureaucratic mess like that actually save money?

How can a bureaucratic mess like that actually provide decent service?

How can a bureaucratic mess like that not bankrupt the country?

How can a bureaucratic mess like that not be a nightmare?

Chip on August 3, 2010 at 11:55 AM

Reminder: Obama administration response to oil spill.

Total incompetence.

BuckeyeSam on August 3, 2010 at 11:55 AM

A new board game from Parker Brothers.

Electrongod on August 3, 2010 at 11:38 AM

for ages 8+

cmsinaz on August 3, 2010 at 11:56 AM

Need to add one more line, a line that connects this entire mess to a circle labeled Lexington Green.

Bishop on August 3, 2010 at 11:56 AM

It is the Congressional Research Service, not Congressional Research Office.

taney71 on August 3, 2010 at 11:57 AM

Out: Dot-com and housing bubbles
In: Healthcare bubbles

faraway on August 3, 2010 at 11:59 AM

Slavery by fill in the blanks legislation … Not what our country was founded to be. And not what it will become.

tarpon on August 3, 2010 at 11:59 AM

The next step is the “Unification Board” and Directive 10-289

rattrap47 on August 3, 2010 at 12:00 PM

out it

Aquateen Hungerforce on August 3, 2010 at 11:43 AM

Oh, I think you were right the first time.

Kafir on August 3, 2010 at 12:01 PM

Exit question: Do we pop these bubbles one by one, or all at once?

faraway on August 3, 2010 at 12:01 PM

Used to be the doctors office would have you come in 15 minutes early for registration. Under Obama care we will have to sign up for a 2 week course, prior to registration, for Understanding Your Health Care- Whats New and Whats Changed.

fourdeucer on August 3, 2010 at 12:02 PM

Behold, the mechanism by which hyperinflation will be realized.

Just a thought: They had to create something so huge, so gargantuan, that it will be able to absorb the many trillions of dollars that they need to pump into the system in order to collapse the debt. Hire millions of bureaucrats, pay them lavishly to send paperwork to each other, and watch the dollar plummet to worthlessness.

ZenDraken on August 3, 2010 at 12:02 PM

That in itself is a big, big problem. It seems clear that Congress just authorized a self-perpetuating bureaucracy, one that can expand on its own and make determinations far outside of the boundaries Democrats promised during the ObamaCare debate. And if that’s true, then it is equally true that the claims made on the cost of administering ObamaCare had no real basis in fact. How can one estimate a cost for a bureaucracy that is entirely undefined in size and scope?

So they created a virus! So their answer to “affordable healthcare” is to make an infectious disease to consume the country!

Brady is my congressman–good man!

cartooner on August 3, 2010 at 12:02 PM

So where are we at in all this mess??

My 3 yr old son can draw my flow chart – has three circles…..me, my doctor and my insurance company.

tommer74 on August 3, 2010 at 12:04 PM

Someone should do a graphic video of those lines connecting. It would be awesome.

The whole thing sounds existential. “We won’t know what it does until we turn it on.” It’s like SkyNet, man — it’s become self-aware and it will preemptively attack any perceived threat to its existence.

GTR640 on August 3, 2010 at 12:04 PM

Why is that one little bubble labeled “Dr. Mengele points you either to the left or the right” and it’s connected to another bubble labeled “The Showers”? I don’t get that.

Bishop on August 3, 2010 at 12:05 PM

It is a Debt Engine.

GTR640 on August 3, 2010 at 12:06 PM

Looking for the oval that says “Soylent green is people!”

cyclown on August 3, 2010 at 12:07 PM

ok, sorry. I did find where we are at, down in the lower right corner. Our line leads to “Mandates,Taxes & Regulations”. Go figure.

tommer74 on August 3, 2010 at 12:09 PM

The chart is actually one of those “3D” pictures. You actually have to focus your eyes beyond the picture. Then you’ll see how this benefits you.

Weight of Glory on August 3, 2010 at 12:09 PM

Ed, you forget. ObamaCare was DESIGNED to fail.

GarandFan on August 3, 2010 at 11:54 AM

Exactly. This was designed to complicate health care so much it fails and the Dems can implement a single payer system (read: the Federal goverment).

Johnnyreb on August 3, 2010 at 12:09 PM

How can one estimate a cost for a bureaucracy that is entirely undefined in size and scope?

License :

freedom to behave as one wishes, especially in a way that results in excessive or unacceptable behavior:

Skandia Recluse on August 3, 2010 at 12:11 PM

Ed, you forget. ObamaCare was DESIGNED to fail.

GarandFan on August 3, 2010 at 11:54 AM

Ed always presumes good faith on the part of the administration and Dems. They aren’t malicious, they’re just mistaken.

Maybe one day he’ll get it.

Missy on August 3, 2010 at 12:11 PM

Kafir on August 3, 2010 at 12:01 PM

Heh.

Aquateen Hungerforce on August 3, 2010 at 12:11 PM

How can a bureaucratic mess like that actually save money?

Chip on August 3, 2010 at 11:55 AM

It’s simple really. The lime green lines represent cash flow. There are no lime green lines exiting the Patient bubble. There are 9 green lines going to the IRS and 2 green lines going to Physicians. There is no stipulation that Patients are taxpayers.
“I want to take my chances. And then you get hit by a bus and you and I have to pay for the emergency room care, that’s…” – Obama

Electrongod on August 3, 2010 at 12:13 PM

What’s that thing up in the corner?

GTR640 on August 3, 2010 at 12:14 PM

Old Pelosi: We have to pass the bill to find out what’s in it.

New Pelosi: Even after we pass the bill, we won’t really know what’s in it until it gets implemented.

jwolf on August 3, 2010 at 11:50 AM

Future Pelosi: Now that it’s implemented, we still don’t know what’s in it.

The Monster on August 3, 2010 at 12:14 PM

The subtitle of that chart should simply be: Death Panel

paul1149 on August 3, 2010 at 12:17 PM

I am sorry to interrupt this thread, but I just happened upon a sweet, sweet article in today’s American Thinker which describes in great detail how Paul Krugman and his entire world view is being torn to shreds by smart commenters on his NYT blog. It really is a thing of beauty. I thought you might get the same kick out of it as I did.

Paul Krugman Gives Up
By Fred Douglass
A marvelous thing happened over on Paul Krugman’s blog at the New York Times last week. Krugman effectively conceded defeat on a range of economic debates. Who defeated him? People who posted comments on his New York Times blog. Mere commenters.

Sharke on August 3, 2010 at 12:17 PM

What was that argument the jackasses used about bureaucrats getting between you and your doctor?

I’d say this just about covers it.

Dominion on August 3, 2010 at 12:19 PM

Another subtitle: The Democratic HealthCare Simplification Act

faraway on August 3, 2010 at 12:22 PM

The government will have to start conscripting young people to man all of these new agencies if Obamacare isn’t overturned.

Obamacare is beginning to look like the product of some Marxism-besotted nihilist’s wet dream: What kind of government bureaucracy can I build that would be the equivalent of nano-bots self-replicating, doubling every fifteen minutes, until they overrun the entire country?

Aitch748 on August 3, 2010 at 12:23 PM

I love infographics like this, depressing as it is. Does anyone know what software is used typically to make these kinds of charts? Thanks!

Sir Loin on August 3, 2010 at 12:27 PM

According to me everything is going to be just fine.
This is an American project and it will succeed because us Americans will see to it that it does so.

Observation on August 3, 2010 at 12:28 PM

Sharke on August 3, 2010 at 12:17 PM

thanks for the post :)

cmsinaz on August 3, 2010 at 12:28 PM

If you like your doctor you can keep your doctor, you just need to be able to find him in that rat maze before you die of starvation. Good luck, comrade.

Bishop on August 3, 2010 at 11:43 AM

Who moved my cheese doctor?

bbordwell on August 3, 2010 at 12:35 PM

I can see another million or two new GS jobs coming out of this mess over the next few years. the Fed is already the largest employer in the country and they are about to explode in size.

Johnnyreb on August 3, 2010 at 12:41 PM

Kill it.

Maquis on August 3, 2010 at 12:44 PM

I can’t see the forest my doctor through the trees red tape.

Electrongod on August 3, 2010 at 12:44 PM

The more I think about this, the more I think this will either by repealed or the USA will end in civil war. There is no way all of that can happen without making the people insane.

WashingtonsWake on August 3, 2010 at 12:49 PM

Engineering principle: KISS (Keep It Simple, Stupid!) Engineers must follow this principle because they’re required to make things that actually work.

Democrats are generally not engineers, and they clearly cannot make anything that works.

ZenDraken on August 3, 2010 at 12:53 PM

Look at the chart. The “beige” entities currently exist, all others are new. Any “beige” entity with a circle around it has some new regulation or burden put upon it, which is approx 99% of existing entities.

It’s obvious how much money this new scheme will save.

JustTruth101 on August 3, 2010 at 12:54 PM

Government Unlimited!

Mojave Mark on August 3, 2010 at 12:59 PM

Please, it there’s a God take this health monstrosity away.

jeanie on August 3, 2010 at 1:16 PM

Ah, the wonders of universal health care:

Peakes woman loses her baby, dignity while awaiting hospital treatment

Jonas, 32, sewed up his own leg after ER wait

Coming soon, courtesy of the Democrat party, to a care center near you!

CHANGE!

Good Lt on August 3, 2010 at 1:20 PM

I am convinced that history will remember Obamacare as the worst conceived and implemented piece of legislation in the history of this country.

Scrappy on August 3, 2010 at 1:24 PM

That chart is what Jefferson drew on his cocktail napkin as he wrote the words ‘commerce clause’

Inanemergencydial on August 3, 2010 at 1:26 PM

It’s the Circumlocution Office!

dicentra63 on August 3, 2010 at 1:33 PM

The scary thing is the big red circle that says Secretary. The fact that ONE person has the power over so much that means so much to so many people is frightening.

ButterflyDragon on August 3, 2010 at 1:34 PM

Oh but this giant govt entitlement bureaucracy will be different.. and BETTER.. than all the other failed, giant govt entitlement bureaucracies. I know because Obama, Pelosi, Reid and Co. told me so……

Yakko77 on August 3, 2010 at 1:34 PM

It looks like a motherboard

I Kan Haz Battry?

tomg51 on August 3, 2010 at 1:34 PM

Is this the same chart that Glenn Beck had on his show months ago? He is wayyyyyy ahead!

Bambi on August 3, 2010 at 1:35 PM

We need a new one.

Three circles, arranged in a triangle. The two in line labeled “patient” and “doctor,” and the third labeled “insurance*.” Arrow from patient to insurance, labeled “$*.” Arrow from Insurance to doctor labeled “$*.” Arrow from doctor to patient labeled “Health care.” One final arrow from patient to doctor labeled “$.” Notation at bottom: “*- If necessary; not related to employer.”

End of chart.

ConservativeLawStudent on August 3, 2010 at 1:37 PM

It seems clear that Congress just authorized a self-perpetuating bureaucracy, one that can expand on its own and make determinations far outside of the boundaries Democrats promised during the ObamaCare debate.

It’s alive!

Count to 10 on August 3, 2010 at 2:04 PM

New policy for the next Congress:

Repeal, rebuke, sow the ground with salt.

Merovign on August 3, 2010 at 2:14 PM

Physicians in the lower left corner and Patients in the lower right corner with the Matrix connecting the two.
If I pay cash, can I avoid this mess?

Electrongod on August 3, 2010 at 11:49 AM

No. They block what your physician is allowed to do.

Never underestimate the power of a totalitarian dictatorship to destroy the lives of the people that do not support it!

Freddy on August 3, 2010 at 2:21 PM

A new board game from Parker Brothers.

Electrongod on August 3, 2010 at 11:38 AM

Parker Bros. couldn’t afford to make this.

I DO think someone should make a good board game that teaches about building a business. Add in taxes, and licensing, and EPA regulations, and protesters, and unions. The laugh when people complain that the game is too hard.

hawksruleva on August 3, 2010 at 2:22 PM

This chart should be placed upon the 3,000+ pages of the bill, encased in glass, and put next to the Constitution of the United States…

… Underneath will be a sign.

“It was fun whilst it lasted!”

Seven Percent Solution on August 3, 2010 at 2:43 PM

I DO think someone should make a good board game that teaches about building a business.

hawksruleva on August 3, 2010 at 2:22 PM

I want the same, for power generation. Set up like Risk – so I can tilt your windmills with nuclear….

tomg51 on August 3, 2010 at 3:08 PM

Do you feel lucky?

Getting that massive enterprise up and running will be next to impossible. So Democrats streamlined the process by granting Health and Human Services Secretary Kathleen Sebelius the authority to make judgments that can’t be challenged either administratively or through the courts.

She’s a goddess, she is.

tree hugging sister on August 3, 2010 at 3:18 PM

A new board game from Parker Brothers.

Electrongod on August 3, 2010 at 11:38 AM

A friend saw that chart and said it reminded her of the Where’s Waldo game.

Sad thing is we’ll be asking Where’s Quality Healthcare and Where’s the Patient when this discombobulated monstrosity is fully formed.

ButterflyDragon on August 3, 2010 at 3:49 PM

This is so simple, it’s got to work! Study this chart carefully, there will be a quiz!

Seriously, does anyone actually believe this level of hyper-complexity could possibly be more efficient, and save money, over the competition of the free market (which we haven’t really had in health care in at least 40 years)? Bear in mind that this maze of government infrastructure does not eliminate the private sector complexities – it adds to it. Each government agency will add regulations, which must be adhered to in the private sector, creating new demand for attorneys, accountants, bureaucrats, managers, clerks, etc.

It looks to me as if it were designed deliberately to have zero chance of providing cost-effective healthcare, being as convoluted as possible. (Cloward-Pevin at work?) It certainly doesn’t resemble the other extreme, simplicity!

stonemeister on August 3, 2010 at 4:39 PM

I remember a similar flowchart for HillaryCare, and it wasn’t nearly this complex.

Ward Cleaver on August 3, 2010 at 4:53 PM

But just look at all the new government spending that will be forthcoming. This is the best stimulus/jobs bill EVAH!

MJBrutus on August 3, 2010 at 7:35 PM

Estimating the number is “impossible,” a recent Congressional Research Service report says, and a true count “unknowable.”
Didn’t Pelosi say that Obamacare was really a jobs bill?

Government jobs for everyone!

malclave on August 3, 2010 at 7:44 PM

Okay, that didn’t work well, let’s try this again.

Estimating the number is “impossible,” a recent Congressional Research Service report says, and a true count “unknowable.”

Didn’t Pelosi say that Obamacare was really a jobs bill?

Government jobs for everyone!

malclave on August 3, 2010 at 7:45 PM

A new board game from Parker Brothers.

Electrongod on August 3, 2010 at 11:38 AM

No matter how many times you play, you’ll always lose.
Guaranteed!

Amendment X on August 4, 2010 at 12:44 AM

Comment pages: 1 2