Crazy Legislative Process

Today I came across some really crazy news that one of the senators that helped write the healthcare reform bill hadn’t ever even read the entire bill. Here’s a section of the article:

During the debate over what later became the health care bill that was recently signed into law by President Obama, a number of federal representatives and senators both admitted that they had not read it. Some, including Rep. John Conyers (D-Mich.) even boasted of this fact. House Speaker Nancy Pelosi (D-Calif.) famously stated that “we have to pass the bill so that you can find out what is in it.”

Presumably the actual people who wrote the bill might have at least some idea what was in it. Unfortunately that isn’t the case with Max Baucus (D-Mont.), lead sponsor of the Senate bill that became law. He admitted as much Monday during a constituents meeting in the small Montana town of Libby, as reported by the Flathead Beacon, a local newspaper.

According to Baucus, the idea of him reading a bill allocating nearly $1 trillion of federal funds is “a waste of time:”

There’s just something that feels really wrong about the idea that even the senator that helped write the bill hasn’t read it all. Although, it’s not really all that surprising.

I’ve thought that the same thing happened with the HITECH Act. No doubt it was thrown together by a few people and the majority of senators had no clue what it really included or meant.

Can’t you imagine it? They kind of throw together this EHR certification term tey’ve heard. Yeah, certification sounds good. Also, let’s make them accountable by making sure they’re using the EMR. Ok, the rest of the details are up to you.

I’m sure that no senators or even junior staff actually thought much about the impact of requiring a certified EHR and how they might measure a doctor’s use of an EHR.

Of course, why should they “waste their time” on a mere $20-30 billion. They can’t waste their time on a trillion dollar ill, so why would they waste it on a so much smaller amount?

About the author

John Lynn

John Lynn

John Lynn is the Founder of, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • It has been estimated that fully 80% of a typical Representative’s time is consumed with fundraising for the ever-looming next election cycle. Staffs and lobbyists do all of the legislative drafting. House members in particular usually just show up for “drive-by” votes. “…What am I voting on today?…

    See my policy blog post from last year “Public Optional” –

    It also has links to my earlier posts on the whole health care reform circus. I actually read legislation drafts as they wind their ways through the Hill.

  • Staff’s consolidate language that comes in from outside special interests. Remember the 1000+ page ARRA bill was “crafted” in a week and voted on a Friday “because the country would collapse if we waited until Monday”.

    And they call themselves legislatures.

  • … and thus the Tea Party movements were born, to bear fruit on November 2.

    The House will likely go Republican, and 2011 will likely see critical funding for Obamacare and other legislative boondoggles withheld. (Actual repeal of all this crap will have to wait ’til after the 2012 elections since, even if both houses are taken in 2010, they can’t override a presidential veto.)

  • yep – Imagine what $862B could do in the private sector, where a real economic stimulus could occur. And one-time projects including EMR incentives do not sustain long-term growth.

    A true economic stimulus would of course be the permanent reductions of certain types of taxes to encourage business establishment and investment in this country – ie: corporate income tax rate, capital gains tax rate, dividend tax rate.

    Instead, we have an “Atlas Shrugged” environment where businesses and banks are literally sitting on trillions of dollars in cash, and small businesses can’t afford to take a chance on hiring permanent employees.

    Government central planning simply does not work — for the Soviets or any other country.

  • grr… rope.

    (John you really need to talk to your provider and see if we can get an edit tool on this side of the board.

  • Thanks, David –

    “A true economic stimulus would of course be the permanent reductions of certain types of taxes to encourage business establishment and investment in this country – ie: corporate income tax rate, capital gains tax rate, dividend tax rate”

    I could agree with that were the reductions “targeted” to in fact “encourage [tangible] business investment” rather than just more of the same likely “investment” in more inscrutable “financial products” that are nothing more than fee-generating, risk-shifting paper vehicles of the sort that, unchecked, have gotten us to the sorry state we are now in. Couple those with pursue-the-path-of-least-resistance capital flight, my concern is that tax reductions end up accomplishing little good for ordinary people inside our borders (not that there won’t be “winners”). This naive Randian vision of the legions of Beneficient Industrious Producers just chomping at the bit to leave behind such magnificent societal good in the wake of their unfettered acquisitive pursuits exists nowhere outside the covers of Ayn’s Lifetime-of-Oprah-and-Dr.-Phil-issues novels.

    “Imagine what $862B could do in the private sector”

    OK, And that is to magically materialize from precisely where? The myriad disparate contending for-profit health care interests are simply gonna henceforth pony up for the common good? Their front-burner short-term competitive fiduciary shareholder obligations aside? Color me unpersuaded.

    I used to work in subprime risk management, so, while I can’t and don’t claim to have all the macroecon answers, I do have a bit of direct relevant experience amid the boiler rooms of the now-burst most recent economic bubble.

    It’s problematic, I admit. The minute you start advocating “targeted” tax cuts, you’re right back to people screaming in your face about “socialist economic engineering.” But, notwithstanding my own chronic dubiety with respect to the relative efficacy of bureaucratic “socialism,” I find the gauzy utilitarian claims of Darwinian hypercapitalism equally specious if not moreso. Beyond abstract theorizing, these are to a great extent empirical matters, and the most recent data are more than cautionary with respect to Free-Market-Uber-Alles advocacy.

    Dunno. I am also dubious, LOL, that I will have this REC job in a year.

    All I ever wanted to do was be a guitar player anyway. 🙂

  • BobbyG,

    I agree with your “Free Market” skepticism inasmuch as the current American tax code has wildly distorted Adam Smith’s “invisible hand”. The current code in many cases does not reward mutually beneficial economic behavior, and in fact often encourages the opposite behavior. I often refer to the current tax code as “the root of all evil” because of these perverse effects. (Think of how much time and effort is expended on what you and I would agree is non-productive behavior, on Wall Street and elsewhere!)

    The existing system needs to be entirely replaced with either a flat tax or the Fair Tax — think a 3×5 card tax return in either case, with a healthy dependency allowance, but with the elimination of specialized this-or-that goodies (including those sacred home mortgages). Keep it simple and it will also be equitable, and the resulting consistency will promote investor confidence and business expansion.

    As for EMRs, IMHO vendors have yet to agree to a common data format for storing patient data so that the patient, doctor, or clinic need not worry about which vendor format to use (correct me if I’m misinformed about this). I realize that vendors want to differentiate themselves with more than just a better GUI interface, but they’re discouraging widespread EMR adoption because users don’t want to commit to specialized formats. With a standard data format (think ASCII, HTML, 8-bit byte, etc.), I think EMR adoption would flourish without government “help”.

  • @David –

    “the elimination of specialized this-or-that goodies (including those sacred home mortgages).”

    LOL. Besides perhaps you, am I the only person who sees that the putative “tax benefits” of the mortgage are precisely reflected in the concomitant market value of the property?

    I have to agree with a lot of what you proffer. I could support a auto-paid-in “value-added” tax system, btw.

    Y’know, we could take this econ stuff “offline.” Email should you wish.

    As to data interop stds, I’ve alluded to that in one of my blogs. I find much of the current “HIE” effort unnecessarily complex and duplicative. A possibly viable model already exists. See my March 17th post:

  • CCD has essentially become the standard. There’s notably one EMR vendor that doesn’t want to interoperate: Epic. Will be hard to make much progress without them.

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