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Monday, August 24, 2009

Expanding The Size Of Government

In the past two decades Americans have seen all levels of their government expand rapidly. City, county, state and federal government budgets and powers have not just crept higher and stronger but have leaped. As I read, listen and watch the health care debate across the country one of the factors of the current proposal that concerns, in many cases frightens, many people is the huge leap it makes in expanding government.

Presidents Clinton and Bush both contributed to the expansion of the federal government, but their contributions to such expansion combined pale in comparison to what has happened--or is proposed--since January when President Obama took office. Of even greater concern is not just the expansion of the federal government but specifically the expansion of power of the Executive Branch.

With a $787 billion spending package passed in just a few weeks that was to stimulate the economy, and we were told create or save 3 million jobs, Obama quickly showed his power over members of Congress that created the Democratic majority. With over 90% of the stimulus money still not spent the impact of the stimulus package is non-existent as our economy still struggles, but the timing of the money hitting the economy will coincide with the 2010 mid-term Congressional elections . With that money hitting local economies while candidates will be stumping for votes, President Obama will be able to use his charisma and oratory skills to help re-elect any Democrats that may find themselves in trouble following whatever results from the health care reform debates and proposals.

That is normal political power that all past Presidents have typically been able to wield, or try to wield, in their terms of office. Generating even more power for his Administration and the Executive Branch is the ownership of three companies, GM, AIG and Chrylser. Two of the companies, GM and AIG, are the biggest in their industry in the United States. With major ownership stakes in these companies policies and regulations from a multitude of federal departments from the Department of Transportation, to Treasury to the Federal Reserve are all now impacted on how it affects U.S. investment in these companies. Rather than establish independent trustees to run the companies and act as stockholders by voting and controlling the stock as to how it might best benefit the companies and their profitability, the ownership interests are controlled by various "Czars" and members of the Obama Administration. The President of the United States has control of three major U.S. corporations, unprecedented in the history of our country.

Speaking of Czars, the current count in the Obama White House is 32 (list here). The benefit of creating a "Czar" is there is no confirmation from the Senate. The position is filled by appointment from the President and the duties are rather fungible, basically whatever the Administration feels the position needs to be. Advise, policy creation, enforcement, the powers vary from Czar to Czar, but in the end who says "no" when being called by an individual appointed by the President? And should not these positions be under one of the Cabinet positions, whose leaders are confirmed by the Senate?

Now the Obama Administration is proposing to Congress an Independent Medical Advisory Committee that would have very broad powers to set rates and reimbursements for Medicare and Medicaid; basically by-passing the current Medicare Payment Advisory Commission who reports to Congress. The new IMAC would be appointed by the President and once it passes regulations and prices the Congress would have 30 days to pass a joint resolution, currently on the table is with a two-thirds majority according to the California Hospital Association, over turning any IMAC recommendations. If Congress is unable to provide a joint resolution in 30 days the decisions are binding.

One of the pillars of Obama's arguments for paying for the one trillion plus cost of the health care reform is "fixing" Medicare and Medicaid, goodness knows they need some fixing but so far from what I have read and heard his idea of fixing is to reduce reimbursements to providers. Recently doctors across the country received notices their Medicare reimbursements are dropping, over 12% across the board from what I have read and heard from doctors, and up to 40% for cardiologists. This is to "fix" the costs in Medicare. If the purpose of IMAC is to control expenses and there is a take-it-or-leave-it relationship with a divided Congress, the Executive Branch is now in the roll of fixing health care reimbursements for hospitals and doctors across the country.

A $787 billion stimulus package with 90% of the funds not spent and therefore not stimulating, take over of private corporations, cash for clunkers that has proven to bill ill conceived and ill managed, and over 30 top level administrators in office with no Congressional oversight. Now we are being shown a grab for even more power for the Executive Branch to control the payment of those who take care of our nation's health.

Checks and balances? Advise and Consent? Is anyone concerned about the disintegration of the enumeration of powers as defined in our Constitution?


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