ObamaCare's Key to the Kingdom

The enacting legislation of ObamaCare creates a Disney World for micro-managers and other assorted scolds. But in Title V of the bill, we find the key to the Magic Kingdom, or at least the kingdom's treasury. Under the heading of "Health Care Workforce," this section lays out the infrastructure for a single-payer system, while plowing fertile ground for a perpetual left-wing voting majority.

Across the country, public employee unions (think teacher, fire, and police) have wrangled overly generous contracts for their members, and in some cases, even bankrupted the municipalities they serve. Sadly, it appears that the new paradigm of the American dream involves gaining hire with some agency of government, with mandatory membership in a government employees union. The union supports a sufficiently invertebrate politician for election and in return receives ever more generous benefits. It is this cycle that is stretched to mammoth proportions by the provisions of Title V.

It is well-known that people rarely vote against their direct personal interests, and Democrats are relying on that to maintain power in the November midterm elections. The means to accomplish this is laid out in Title V of the health care bill. Title V establishes the "National Health Care Workforce Commission" (NHCWC), responsible for acting as the primary national resource to federal, state, and local governments for what works and what doesn't regarding all things health care.

Even health care activities conducted by other departments of the government, such as Defense or Commerce, will now be coordinated through this commission. Inexplicably, the NHCWC is granted legal exemption from the statutory rules that govern federal advisory committees. Section 5101 (b) of the ObamaCare bill states:

(1) The Commission shall be composed of 15 members to be appointed by the Comptroller General, without regard to section 5 of the Federal Advisory Committee Act. (5 U.S.C. App.) [Emphasis added.]

Why is this important?  Section 5 requires that all federally constituted commissions:

(1) contain a clearly defined purpose for the advisory committee;

(2) require the membership of the advisory committee to be fairly balanced in terms of the points of view represented and the functions to be performed by the advisory committee;

(3) contain appropriate provisions to assure that the advice and recommendations of the advisory committee will not be inappropriately influenced by the appointing authority or by any special interest, but will instead be the result of the advisory committee's independent judgment [emphases added] ...

Such a broad exemption from oversight is tantamount to the establishment of a health care Politburo, and the essential nature of this exemption becomes evident once you examine the statutorily required membership of this commission. It is designed to be a star-chamber of unaccountable community organizer types, with a vast budget and a penchant for social justice.

Title V requires that the Commission comprise a "non-majority of [health care] providers," although Uncle Sam grudgingly allows the health professionals a few seats around the table, right alongside the mandatory representatives of labor unions, consumer advocate groups, and educational institutions -- although the latter do not have to be medical school educators, or even university educators, or have anything whatsoever to do with health care. They can, in fact, be drawn from elementary schools, or even local apprenticeship programs. 

One can only assume that a steamfitters' union apprentice with a 5th-grade education and an interest in the occasional consumer boycott would be the ultimate trifecta nominee.

It is of no consequence that the most offensive provisions of this bill do not go into effect until many years into the future. The soothing idea being peddled, that all this anti-constitutional chicanery can be repealed in the months following the next election, is no real security at all. This Commission will be in full operation no later than the 30th of September of this year. The true aim of this bill (which is to co-opt the existing infrastructure of the health care industry, then swell it with an orgy of hiring and spending) begins immediately.  

The left now has nearly half a year to lodge people and funding into every nook and cranny of this misbegotten legislation, all of whom will prove most unwilling to vote themselves out of work. This tactic, begun last year under the rubric of stimulus spending, becomes a juggernaut under Title V.

Progressives have long sought electoral success by granting access to the government trough. The welfare treats and other brightly-colored trinkets of government generosity have been fine tools for local or regional electioneering, but there have never been enough citizens willing to accept a dependent lifestyle for the left to achieve an unassailable national majority. 

Clearly, the holy grail of leftist electoral politics lies in swelling the ranks of a dependent class, which Title V does with alarming rapidity.

This article examines only a few provisions out of hundreds that are given the jolt of life with this legislation. If a flow chart of ObamaCare were drawn, it would graphically illustrate nearly all elements of health care funneling into and through Title V.  

This Section establishes an exclusive framework of grants, loan forgiveness programs, and various other recruitment carrots that will be dangled before new entrants to the medical field, as well as those wishing to continue their education to update their skills. The Commission also brings all existing programs of this sort under its authority, drawing to itself the millions of individuals who make up our system of medicine. The Commission will become the functional equivalent of a feudal lord, creating tens of millions of serfs reliant upon its munificence for their very livelihood.

Having become the gatekeeper to the medical field via the mechanisms in Title V, the left will have finally created a dependent constituency large enough to extort permanent electoral dominance. They have co-opted the career prospects of Americans constituting one-sixth of the economy, turning the entire medical field into rent-seekers, beholden to the government in general and to the Democrats in particular. 

Just as the members of your local municipal employee union are highly unlikely to vote for a mayoral candidate who promises to trim or eliminate their sweetheart contracts, the newly co-opted workers and businesses of our medical system will be loath to vote for a conservative repeal of Title V that would put them out of work, or take back the hundreds of billions that Title V has already begun disbursing to them.

The price of admission to high elective office will forever involve kissing the ring of Title V payments, much like Medicare, Medicaid, and Social Security. The general population will detest the system, and even those who are employed by it and derive their livelihood from it will likely feel a vague sense of molestation, but when it comes time to pull the lever for a candidate, human nature will prevail. With the passage of this legislation, the Democrats know that elections will become a formality. If I were a Democrat, I wouldn't be worried about November, either.

The author writes from Omaha, NE and can be reached at readmorejoe@gmail.com.
The enacting legislation of ObamaCare creates a Disney World for micro-managers and other assorted scolds. But in Title V of the bill, we find the key to the Magic Kingdom, or at least the kingdom's treasury. Under the heading of "Health Care Workforce," this section lays out the infrastructure for a single-payer system, while plowing fertile ground for a perpetual left-wing voting majority.

Across the country, public employee unions (think teacher, fire, and police) have wrangled overly generous contracts for their members, and in some cases, even bankrupted the municipalities they serve. Sadly, it appears that the new paradigm of the American dream involves gaining hire with some agency of government, with mandatory membership in a government employees union. The union supports a sufficiently invertebrate politician for election and in return receives ever more generous benefits. It is this cycle that is stretched to mammoth proportions by the provisions of Title V.

It is well-known that people rarely vote against their direct personal interests, and Democrats are relying on that to maintain power in the November midterm elections. The means to accomplish this is laid out in Title V of the health care bill. Title V establishes the "National Health Care Workforce Commission" (NHCWC), responsible for acting as the primary national resource to federal, state, and local governments for what works and what doesn't regarding all things health care.

Even health care activities conducted by other departments of the government, such as Defense or Commerce, will now be coordinated through this commission. Inexplicably, the NHCWC is granted legal exemption from the statutory rules that govern federal advisory committees. Section 5101 (b) of the ObamaCare bill states:

(1) The Commission shall be composed of 15 members to be appointed by the Comptroller General, without regard to section 5 of the Federal Advisory Committee Act. (5 U.S.C. App.) [Emphasis added.]

Why is this important?  Section 5 requires that all federally constituted commissions:

(1) contain a clearly defined purpose for the advisory committee;

(2) require the membership of the advisory committee to be fairly balanced in terms of the points of view represented and the functions to be performed by the advisory committee;

(3) contain appropriate provisions to assure that the advice and recommendations of the advisory committee will not be inappropriately influenced by the appointing authority or by any special interest, but will instead be the result of the advisory committee's independent judgment [emphases added] ...

Such a broad exemption from oversight is tantamount to the establishment of a health care Politburo, and the essential nature of this exemption becomes evident once you examine the statutorily required membership of this commission. It is designed to be a star-chamber of unaccountable community organizer types, with a vast budget and a penchant for social justice.

Title V requires that the Commission comprise a "non-majority of [health care] providers," although Uncle Sam grudgingly allows the health professionals a few seats around the table, right alongside the mandatory representatives of labor unions, consumer advocate groups, and educational institutions -- although the latter do not have to be medical school educators, or even university educators, or have anything whatsoever to do with health care. They can, in fact, be drawn from elementary schools, or even local apprenticeship programs. 

One can only assume that a steamfitters' union apprentice with a 5th-grade education and an interest in the occasional consumer boycott would be the ultimate trifecta nominee.

It is of no consequence that the most offensive provisions of this bill do not go into effect until many years into the future. The soothing idea being peddled, that all this anti-constitutional chicanery can be repealed in the months following the next election, is no real security at all. This Commission will be in full operation no later than the 30th of September of this year. The true aim of this bill (which is to co-opt the existing infrastructure of the health care industry, then swell it with an orgy of hiring and spending) begins immediately.  

The left now has nearly half a year to lodge people and funding into every nook and cranny of this misbegotten legislation, all of whom will prove most unwilling to vote themselves out of work. This tactic, begun last year under the rubric of stimulus spending, becomes a juggernaut under Title V.

Progressives have long sought electoral success by granting access to the government trough. The welfare treats and other brightly-colored trinkets of government generosity have been fine tools for local or regional electioneering, but there have never been enough citizens willing to accept a dependent lifestyle for the left to achieve an unassailable national majority. 

Clearly, the holy grail of leftist electoral politics lies in swelling the ranks of a dependent class, which Title V does with alarming rapidity.

This article examines only a few provisions out of hundreds that are given the jolt of life with this legislation. If a flow chart of ObamaCare were drawn, it would graphically illustrate nearly all elements of health care funneling into and through Title V.  

This Section establishes an exclusive framework of grants, loan forgiveness programs, and various other recruitment carrots that will be dangled before new entrants to the medical field, as well as those wishing to continue their education to update their skills. The Commission also brings all existing programs of this sort under its authority, drawing to itself the millions of individuals who make up our system of medicine. The Commission will become the functional equivalent of a feudal lord, creating tens of millions of serfs reliant upon its munificence for their very livelihood.

Having become the gatekeeper to the medical field via the mechanisms in Title V, the left will have finally created a dependent constituency large enough to extort permanent electoral dominance. They have co-opted the career prospects of Americans constituting one-sixth of the economy, turning the entire medical field into rent-seekers, beholden to the government in general and to the Democrats in particular. 

Just as the members of your local municipal employee union are highly unlikely to vote for a mayoral candidate who promises to trim or eliminate their sweetheart contracts, the newly co-opted workers and businesses of our medical system will be loath to vote for a conservative repeal of Title V that would put them out of work, or take back the hundreds of billions that Title V has already begun disbursing to them.

The price of admission to high elective office will forever involve kissing the ring of Title V payments, much like Medicare, Medicaid, and Social Security. The general population will detest the system, and even those who are employed by it and derive their livelihood from it will likely feel a vague sense of molestation, but when it comes time to pull the lever for a candidate, human nature will prevail. With the passage of this legislation, the Democrats know that elections will become a formality. If I were a Democrat, I wouldn't be worried about November, either.

The author writes from Omaha, NE and can be reached at readmorejoe@gmail.com.