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By Amanda Carpenter

Choices czar

The 1,990-page health care bill unveiled by House Speaker Nancy Pelosi, California Democrat, creates a new position that would give one government bureaucrat - the health care commissioner (HCC) - considerable control over how Americans get their health care.

If the bill passes, the HCC will lead a new Health Choices Administration that will function as an independent, executive-branch agency. According to the bill, the HCC will determine what "essential benefits" are in all qualified insurance plans, both private and public; administer "affordability" credits to help the low-income get insurance; and define marketing standards for all qualified plans. Most importantly, the HCC will create and operate the new Health Insurance Exchange, where individuals could shop for insurance plans, including a public-option plan. As a part of this, the HCC will obtain bids and negotiate contracts with private insurance plans available on the exchange.

The HCC, as written in the House bill, will be selected by the president and then confirmed by the Senate before assuming the position. Former Rep. Ernest Istook, Oklahoma Republican and current distinguished fellow at the Heritage Foundation, is calling the HCC envisioned in the bill a "czar."

"This new, all-powerful 'health choices commissioner' would be entrusted with more power than most superheroes," Mr. Istook wrote on the Heritage Foundation blog "The Foundry."

Studying it

Action is seldom taken in Washington before completing some kind of study, and House Speaker Nancy Pelosi's health care bill is no different.

The bill authorizes dozens of studies to be carried out by various government agencies on everything from pharmaceutical marketing techniques to how Medicare should pay to provide limited-English speakers with special language services, to the way bone mass is measured.

Many of these studies will be done in order to make recommendations to Congress for more legislation. Several studies, for example, tell various government agencies to examine how the federal poverty level could be adjusted to reflect variations in the cost of living for Americans living in different parts of the country.