How Health Care Would Be Run

The Washington Examiner ran an interesting story late last week on how health care reform might impact the responsibilities of the Health and Human Services Secretary. I've been interested in this subject for a while, because though Congressional passage is a major step in the process, and endlessly reported on, it's really only a step, rather than full accomplishment of reform. Putting the apparatus in place, on the federal and state level, to actually implement health care reform is going to be a much longer and harder process. Especially since legislation would create new categories of responsibility for federal agencies:

"It's a huge amount of power being shifted to HHS, and much of it is highly discretionary," said Edmund Haislmaier, an expert in health care policy and insurance markets at the Heritage Foundation, a conservative think tank.

Haislmaier said one the greatest powers HHS would gain from the bill is the authority to regulate insurance. States currently hold this power, and under the Senate bill, the federal government would usurp it from them. This could lead to the federal government putting restrictions and changes in place that destabilize the private insurance market by forcing companies to lower premiums and other charges, he said.

"Health and Human Services ... doesn't have any experience with this," Haislmaier said. "I'm looking at the potential for this whole thing to just blow up on people because they have no idea what they are doing. Who in the federal government regulates insurance today? Nobody."