How Big Is the Health Reform Law?

House Republicans will vote next Wednesday, Jan. 12, to repeal the new health care law, making good on a top-tier GOP campaign promise and setting up a showdown with President Barack Obama over his signature domestic policy achievement. The repeal effort is not expected to succeed, given that Democrats maintain control of the Senate and the president can veto the legislation, but Republicans also plan to chip away at pieces of the law over the long term.

www. Politico.com, January 3, 2011

When the health reform law passed on March 23, 2010, Vice-President Joe Biden whispered in President Obama’s ear at the signing of the bill into law, “This is a big f-----g deal!”

If the Republicans manage to repeal it, it will be an equally big deal. A series of small deals to defund and discredit it is more likely.

How Big Is It?

How big is the Patient Protection and Affordable Care Act (PPACA)?

• It is so big about 97% of America’s 308.7 million people will now be covered. Down the line, It might become part and parcel of an even bigger deal. In 2010, Health care costs took about 17% of the Gross Domestic Product (GDP), and grew at about 7 times the rate of general inflation.


• It is so big Democrats proclaim it as an “historic achievement” and Republicans denounce it as a “monstrosity.”

• It is so big it takes 2704 pages to print. Critics claim it runs more pages than War and Peace, has nearly five times as many words as the Torah, and contains more than 400,000 words. That’s about $2.50 million per word. Its printout takes 4 reams of paper, weighs 19 pounds, and stands 9 inches tall.

• It is so big Google lists 45.08 million references to the Patient Protection and Affordable Care Act (PPACA) and its various manifestations, which consumes billions of gigabytes in gigaspace and the blogosphere.

• It is so big House Majority Leader Nancy Pelosi said on March 9, 2010 to her House of Representative colleagues, “We have to pass it to see what’s in it.”

• It is so big most House of Representatives members and Senators confess they have not read it all.

• It is so big that Medicare’s Chief Auditor said it would cost over $1 trillion to pay for in its first ten years of existence. What is a trillion dollars? Well, it's a million million. It's a thousand billion. It's a one followed by 12 zeros. 1 trillion dollar bills would be the equivalent of eight and a half planet earths stacked on top of each other. (1 dollar bill is .0043 inches thick). A stack of one dollar bills amounting to $1 trillion would be 67,000 miles high.

• It is so big that its principle components – Medicare and Medicaid – contribute about 19% of our $14 billion national debt.

• It is so big we will have to dig a budget hole clear through to China to pay for it.

• It is so big implementing and maintaining the law will require over 183 new federal agencies, commissions, panels, and other bodies - a vast new bureaucracy with 100,000 or more new federal employees, 13,500 IRS agents, and 50 new state level health exchanges to create and enforce federal mandates at a cost of roughly $2.5 trillion from 2014 to 2023.

• It is so big many states say their budgets will not allow them to pay for it.

• It is so big it cannot be explained in words, In the case of the Patient Protection and Affordable Care Act, this picture is worth 400,000 words.

• It is so big I have written a 67,847 page book, Good Intentions: A Health Reform Handbook, to explain its consequences.

Big Ending

It takes big government to do big things. But how big? And at what cost? In November 2012, after two more years of debate, the voters will decide.