House Democrats' Health Plan Contains Words of Coercion -- not Choice -- Text Analysis Shows

(Alexandria, Va.) -- House Democrats use words such as "choice" in stump speeches on behalf of their recently introduced health care legislation, but according to an analysis by the National Taxpayers Union Foundation (NTUF), the actual text of the bill tells a different story. NTUF determined that the words "choice," "options," and "freedom" appear just 85 times in the mammoth 1,018-page legislation, while three restrictive words -- "require," "limit," and "must" (and variations) -- were nine times more prevalent.

"Words don't always have a lot of meaning inside the Beltway, but if the language of the 'America's Affordable Health Choices Act of 2009' is a guide to its true intent, then the bill is really about empowering bureaucracy and limiting freedom, competition, and the marketplace," said NTUF Director of Congressional Analysis Jeff Dircksen. Among his findings:

  • The legislation envisions a very busy bureaucracy. The term "Secretary" -- as in the Secretaries of Health & Human Services, Labor, Defense, and Veterans Affairs -- appears 1,124 times in the bill. The Secretaries -- along with Commissioners (199 references), Committees (76 references), and Boards (17 references) -- would be "reporting" or making a "report" or "reports" (427 references), developing methodologies, and receiving recommendations as well as administering the plan's provisions.
  • Language suggesting a new patient-centric approach is relatively scarce. The terms "consumer-driven," and "patient-driven" as in consumer-driven and patient-driven choices in health care, do not appear in the bill. And while the words "benefit" and "benefits" appear 375 times, "choice" and "options" appear just 85 times combined. Even "marketplace" -- a term that the President has used to describe the so-called public option -- appears just 3 times, as does the term "competition." The word "freedom" is nowhere to be found.
  • Variants of the words "require," "limit," and "must" appeared a total of 708 times. Terms describing the consequences of failing to abide by the bill -- "penalty," "enforce," and "sanction" -- showed up in 225 places.

Dircksen consulted grammatical resources to construct a list of terms that most closely reflected the principles of consumer choice and that patient-centered care proponents of the health care plan stressed, along with their opposites. He also sought terms that would reflect who would have a role in the health care decision-making process. Dircksen then searched the bill's text for these words.

NTUF is the research arm of the 362,000-member National Taxpayers Union, a nonprofit, nonpartisan citizen group founded in 1969 to work for lower taxes, smaller government, and economic freedom at all levels. Note: Tables containing the word counts are below.

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Language of a Busy Bureaucracy...
Term(s)
Frequency
Require/Required/Requirement(s)494
Report(s)/Reporting/Reported427
Limit/Limits/Limitation167
Penalty/Penalties156
Regulations91
Tax(es)72
Enforce/Enforcement48
Must47
Prohibit/Prohibiting/Prohibition28
Sanction(s)21
Obligation/Obligations18
Restrict/Restrictive/Restriction12
Fines3

Limiting Freedom, Competition, & the Marketplace
Term(s)
Frequency
Benefit(s)375
Choice47
Options38
Private35
Rights21
Privacy17
Exempt/Exemption16
Marketplace3
Competition3
Consumer-driven0
Freedom0
Liberty0
Patient-driven0