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The 4,000-page health-care bill?

Stan Collender explains how health-care reform could balloon to 4,000 pages:

[D]epending on whether the bill is drafted as an amendment to what is already being debated or as new standalone legislation, it may have to start by striking out the original and then substituting new language. In other words, it could end up being closer to 4000 pages not because its more complicated but because that's standard legislative drafting procedure.

If you're having trouble getting your mind around this concept, think of it as the difference between the formal way you were taught to speak in school when you were learningr a foreign language and how you're more likely to say the same thing now.

In other words, instead of saying:

"Good morning. I hope you slept well. What are your plans for the rest of the day?"

You probably say something like:

"What's up?"

In other words, unless you want to speak like your first Spanish or French teacher, you absolutely need to resist the urge to criticize health care reform because of the number of pages in the draft legislation.

By Ezra Klein  |  December 10, 2009; 10:03 AM ET
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Next: Want to listen to the Senate's health-care debate on your iPhone?


this might also be of interest (maybe Ezra's already written about it) on data growth and data management in hospitals

Posted by: bdballard | December 10, 2009 12:05 PM | Report abuse

But formal legal writing doesn't have to be so convoluted. It's just always been that way. Think about the difference between Hemingway and Faulkner. It's a stylistic choice not a requirement.

Posted by: PindarPushkin | December 10, 2009 2:25 PM | Report abuse

Let me throw in another attempt to explain why any meaningful health-care reform bill is going to take something like 4000 pages to do its job: It's a program . . . . as in, a computer program.

Legislation like a health-care reform bill is an attempt to modify the governmental operating system of our societal computer. To write legislation is to work with a programming language that is, in the long run, as rigid and unforgiving as “C” or Basic, Cobol or Fortran. I’ve been tempted to suggest this as a metaphor, but it isn’t. It’s a literal truth. Legislation and software programming are equally challenged to define terms, construct procedures, link to other subroutines, deal with “legacy” issues, specify inputs and outputs, apportion assets, and so on. Both are wise to include error-checking routines. Both end up with something called “code.” Both tend to be numbered line by line. Both, interestingly enough, are vulnerable to their own versions of bugs, hacking, malware, backdoors and the like. That’s why so much attention is being paid right now to what wording is being snuck in to HRC legislation, now that its passage in some form seems inevitable. Sneak in the right worm, virus, or trojan horse and the bill that is passed will make “health-care reform” do exactly the opposite of what it is supposed to do, with very carefully designed “unintended consequences,” in addition to those that really are surprises.

Intended or unintended, all this takes a lot of coding. To the noob programmer, something as simple as displaying the words “Hello World” on a computer screen seens to take way more programming than it ought to. Likewise with the simplist change in the legal code. With complex functions, that volume of words required explodes. It may seem wrong, but it’s inevitable, because this is not narrative, or conceptual language. It’s procedural language, step-by-step specifications of how to get the job done, and the deed is always more complicated than the idea.

Posted by: gbpuckett | December 10, 2009 8:36 PM | Report abuse

Not so nice try, Mr. Klein. Why do you think you have any credibility on the subject of complex legislation? You don't even mention that the rest of us peons need some time to digest this amended monstrosity.

You're obfuscating the obvious: These health bills have become so long and complicated that even a "minor" change will have many unintended consequences and costs, especially because they're being dreamed up literally in the middle of the night by exhausted staffers and then scored by equally exhausted CBO staffers. Surely pasting a new Medicare benefit on top of everything else and editing countless other provisions to conform with the new stuff will result in a mess beyond belief. Why can't you acknowledge this??

But, then again, it doesn't matter to you. You want a bill, any bill, that gives the Democrats yet more power over us.

Posted by: dturnerc | December 11, 2009 1:32 PM | Report abuse

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