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Veteran Advisor

ObamaCare: A Tangled Knot Around America's Throat

Bureaucratic Web: Those who wondered what was in the health care overhaul bill now have a chance to look inside. What they see is a snarl of lines, arrows and geometric shapes that will do nothing to improve medical care.

Republican Sen. Sam Brownback of Kansas, GOP Rep. Kevin Brady of Texas and the minority staff of the Joint Economic Committee have provided a priceless public service by creating a flow chart (below) of the federal health care system that is being created by the Patient Protection and Affordable Care Act.

The chart displays, in words we can't improve, "a bewildering array of new government agencies, regulations and mandates."

At the center of the new federal health care universe is the secretary of Health and Human Services, who has been granted supernational powers. Radiating from that hub are the lesser celestial objects, such as Congress in the upper right corner, the president in the upper left, and doctors in the lower left.

Patients can be found near the bottom right corner. Remember them? They were supposed to be what the health care overhaul was all about. But they've been nudged, as almost an afterthought, to the fringe of this expanding universe.

Between patients and the secretary of Health and Human Services sit galaxies of red tape, taxes, regulations, federal programs, state agencies, mandates — and thousands of bureaucrats.

But the HHS secretary does not treat patients. Doctors do. And the expanse between them, according to this chart, is vast. They are separated by a government that is growing deeper, wider and more labyrinthine, an administrative state that will ration, dilute and ineffectively manage health care.

Perhaps what is most disturbing about the chart is its size.

As imposing as it looks, it is a mere partial representation of the national health care maze forced by congressional Democrats and the White House on a country that didn't want it.

"This portrays only about one-third of the complexity of the final bill," Brady said. "It's actually worse than this."

No exaggeration there. The Congressional Research Service says it is "impossible" to tally the number of agencies, boards and commissions that the law will yield.

Government programs might be created to "help," but they fail because bureaucrats don't respond to people's needs. They respond to legislation, an entirely different goal and typically contrary to the interest of the people. Though they have built many a Rube Goldberg machine, Washington's bureaucracies simply follow the instructions of lawmakers who design programs that are too complex to work.