- The Washington Times - Friday, September 18, 2009


On July 31, Energy and Commerce became the third House committee to pass HR 3200, a 1,000-plus-page health-reform bill. But to this day, no one on the committee can tell you, for sure, what’s in the final version of the bill.

That’s because no hard copy of the latest version of the House bill exists.

Nor is the committee in any rush to publish the package. When editors of the Washington Examiner asked committee staffers for a copy, they were told that the amended version might not even be compiled, much less posted, until after the August recess.

How convenient — for members who want to duck those awkward questions about what’s in the bill.

And the House committee is not alone. The Senate Health, Education, Labor and Pensions Committee still hasn’t released the final text of the health-reform legislation it passed on July 15.

Despite liberal health reformers’ reluctance to let the sun shine on their handiwork, curious constituents can get a good idea of what’s in the bills by employing the Sherlock Holmes method.

In “Silver Blaze,” Holmes solved a horse kidnapping with the help of one vital clue: the dog that did not bark. So perhaps we can solve the mystery of what’s in the House bill by examining what happened in the House Ways and Means Committee and check out those amendments that did not pass.

Mystery No. 1: Will the reforms let federal officials decide what treatments patients can get? The House bill would create a new agency, the Center for Comparative Effectiveness Research, to gather data on which treatments work best in dealing with particular medical cases.

Sounds reasonable. But could federal bureaucrats issue rules or regulations that would use the center’s findings to restrict payments, treatments and coverage that patients might want? After all, as the president told one of his guests at the ABC-televised White House summit that sometimes painkillers are a better choice than surgery for patients. Sometimes they are, but that decision should be based on informed consent in consultation with the patient’s doctor.

To rule out the possibility of federal officials in any way making such judgments, Rep. Wally Herger, California Republican, proposed barring the Centers for Medicare and Medicaid Services from using comparative-effectiveness research to restrict coverage. Take note, the Herger amendment was defeated.

Mystery No. 2: Will it give taxpayer-subsidized health benefits to illegal immigrants? The Census Bureau estimates that 9.6 million uninsureds — nearly a quarter of all uninsured in this country — are not U.S. citizens. If the public plan has to cover illegal immigrants, it would ramp up the costs and undercut the president’s goal of bending the “health care cost” curve downward.

Rep. Dean Heller, Nevada Republican, offered an amendment requiring verification of citizenship for anyone seeking insurance credits or enrollment in the public plan. That, too, failed on a straight party-line vote.

Mystery No. 3: Will the House bill increase the deficit? President Obama has said he won’t support a health bill that increases the national deficit. The Congressional Budget Office, though, said that the original version of the House bill would add $239 billion to the deficit over 10 years.

In advancing the president’s stated goal of “deficit neutrality,” Rep. Patrick Tiberi, Ohio Republican, proposed that the secretary of health and human services be required to submit an annual report comparing the plan’s projected costs and revenues over a 10-year period. Should projected spending outpace revenue, the secretary would have to cut costs.

Mr. Tiberi’s amendment was shot down all the same.

Following detective Holmes’ logical deduction, the rejection of these amendments (the evidence) would indicate a congressional intent that is at least very different from that of the sponsors of these defeated amendments. In other words, Congress intends to:

c Give government more say in what drugs and treatments can be covered.

c Force taxpayers to provide health coverage for illegal immigrants.

c Increase the federal deficit.

What’s worse, by flatly rejecting these common-sense amendments, congressional liberals have established a record of congressional “intent” that will make it harder to correct problems arising from the legislation years in the future. Defenders of the federal bureaucracy can calmly point to these defeated amendments and say: “Not to worry. These concerns were raised — and dismissed when we considered the bill.”

Washington could use some barking dogs — red or blue — before Congress approves a bill that winds up biting patients and taxpayers for years to come.

Robert E. Moffit is director of the Center for Health Policy Studies at the Heritage Foundation.

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