Think the Obamacare fight is over? Just wait until they try to implement it 

Elsewhere at the Examiner today, Tevi Troy makes the case that the health care reform debate is by no means finished because implenting grand legislation such as this is going to be a mighty struggle. Troy, who was Deputy Secretary of Health and Human Services under Bush, draws on his experience implementing Medicare Part D:

The shape of the new law will not become clear once the bill passes and is signed. The administration and personnel in charge of the implementation will have a great deal to do with the final structure of the new law.

Congress’ decisions only open the door to a host of complicated and controversial decisions that still need to be made. While the executive branch does not get to write the legislation, it does get to write the rules that determine how the legislation goes into effect, and a Democratic administration will likely do this differently than a Republican administration would.

Furthermore, even though the period between now and 2014 seems like a long time, there’s a good chance that it may actually be too short a time frame to get the job done. According to a recent analysis by Rutgers Public Policy Professor Stuart Shapiro, the mean time for completing a regulation from start to finish is 831 days – about two and a third years.

Complex rules – and this package certainly qualifies -- take even longer.

All of this means that the passed bill comes nowhere near to ending our long, unpleasant debate on the health care issue. Our last major health reform, the creation of the Medicare Part D program, passed in 2003. When it was finally implemented in 2006, it opened up a whole new public relations war on whether the implementation was done correctly, and whether the legislation should have passed in the first place.

Read the whole thing.

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Michael Daboll

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