HR 3200 can be found at http://energycommerce.house.gov/Press_111/20090714/aahca.pdf

Here are the pertinent sections of the health care bill, HR 3200, found by merely searching the document for the term "end of life."
The end is the agreement under Social Security Act Section 1890(a).  I strongly advise you to not not wear your literalist hat when reading this so that gems of legislative interpretive flexibility can easily be found, such as:

"‘‘(2) FORM OF AGREEMENTS.—The Secretary may carry out paragraph (1) by contract, grant, or otherwise."

Every college, university, corporation or other individual who engages with the government for any "contract, grant, or otherwise" related to health care shall find themselves being stuck with the quality standards of those entities who apply to be a "consensus-based entity" who also are "mulit-stakeholder groups."  Legally a stakeholder is the one who invests in a non-profit or not-for-profit organization, however who is the stakeholder in your health, them or you?  Are they out to protect you or their investment and notariety?  And as you read you'll learn the Secretary of Health and Human Services is entirely in control of this, they can even carry out their own reasons for rulemaking so long as it's been considered by the rest of the multi-stakeholder groups, even if not adopted by them, so long as "the Secretary shall include the rationale for continued use of such a measure in rulemaking.’’."

"End of life" is the connection between Part I (pages 424-432) and Part II (Pages 619-633).  Section 1890 is the connection between Part II and Part III.


PART I-H.R. 3200 (Pages 424-432)

SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.

    (a) MEDICARE.—
        (1) IN GENERAL.—Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended—

            (A) in subsection (s)(2)—

                (i) by striking ‘‘and’’ at the end of subparagraph (DD);
                (ii) by adding ‘‘and’’ at the end of subparagraph (EE); and
                (iii) by adding at the end the following new subparagraph:

            ‘‘(FF) advance care planning consultation (as defined in subsection (hhh)(1));’’; and
                (B) by adding at the end the following new subsection:

            ‘‘Advance Care Planning Consultation
            ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:
            ‘‘(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.
            ‘‘(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
            ‘‘(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
            ‘‘(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).
            ‘‘(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
            ‘‘(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include—
                ‘‘(I) the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes;
                ‘‘(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and
                ‘‘(III) the identification of resources that an individual may use to determine the require ments of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a health care proxy).
            ‘‘(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State—
                ‘‘(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and
                ‘‘(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
            ‘‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that—
                ‘‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;
                ‘‘(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;
                ‘‘(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and
                ‘‘(IV) is guided by a coalition of stake-holders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.

        ‘‘(2) A practitioner described in this paragraph is—
            ‘‘(A) a physician (as defined in subsection (r)(1)); and
            ‘‘(B) a nurse practitioner or physician’s assistant who has the authority under State law to sign orders for life sustaining treatments.

        ‘‘(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1).
       
            ‘‘(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.

        ‘‘(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.

        ‘‘(5)(A) For purposes of this section, the term ‘order regarding life sustaining treatment’ means, with respect to an individual, an actionable medical order relating to the treatment of that individual that—
            ‘‘(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional’s authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;
            ‘‘(ii) effectively communicates the individual’s preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;
            ‘‘(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and
            ‘‘(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.
    ‘‘(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items—
        ‘‘(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;
        ‘‘(ii) the individual’s desire regarding transfer to a hospital or remaining at the current care setting;
        ‘‘(iii) the use of antibiotics; and
        ‘‘(iv) the use of artificially administered nutrition and hydration.’’.

(2) PAYMENT.—Section 1848(j)(3) of such Act (42 U.S.C. 1395w–4(j)(3)) is amended by inserting ‘‘(2)(FF),’’ after ‘‘(2)(EE),’’.

(3) FREQUENCY LIMITATION.—Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended—
    (A) in paragraph (1)—   
        (i) in subparagraph (N), by striking ‘‘and’’ at the end;
        (ii) in subparagraph (O) by striking the semicolon at the end and inserting ‘‘, and’’; and
        (iii) by adding at the end the following new subparagraph:
            ‘‘(P) in the case of advance care planning consultations (as defined in section 1861(hhh)(1)), which are performed more frequently than is covered under such section;’’; and
            (B) in paragraph (7), by striking ‘‘or (K)’’ and inserting ‘‘(K), or (P)’’.

(4) EFFECTIVE DATE.—The amendments made by this subsection shall apply to consultations furnished on or after January 1, 2011.

(b) EXPANSION OF PHYSICIAN QUALITY REPORTING

INITIATIVE FOR END OF LIFE CARE.—
(1) PHYSICIAN’S QUALITY REPORTING INITIATIVE.—Section 1848(k)(2) of the Social Security Act(42 U.S.C. 1395w–4(k)(2)) is amended by adding at the end the following new paragraphs:

‘‘(3) PHYSICIAN’S QUALITY REPORTING INITIATIVE.—

    ‘‘(A) IN GENERAL.—For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.

    ‘‘(B) PROPOSED SET OF MEASURES.—The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary.  The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.’’.

(c) INCLUSION OF INFORMATION IN MEDICARE & YOU HANDBOOK.—
    (1) MEDICARE & YOU HANDBOOK.—
    (A) IN GENERAL.—Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall update the online version of the Medicare & You Handbook to include the following:
        (i) An explanation of advance care planning and advance directives, including—
            (I) living wills;
            (II) durable power of attorney;
            (III) orders of life-sustaining treatment; and
            (IV) health care proxies.

        (ii) A description of Federal and State resources available to assist individuals and their families with advance care planning and advance directives, including—
            (I) available State legal service organizations to assist individuals with advance care planning, including those organizations that receive funding pursuant to the Older Americans Act of 1965 (42 U.S.C. 93001 et seq.);
            (II) website links or addresses for State-specific advance directive forms; and
            (III) any additional information, as determined by the Secretary.
    (B) UPDATE OF PAPER AND SUBSEQUENT VERSIONS.—The Secretary shall include the in formation described in subparagraph (A) in all paper and electronic versions of the Medicare & You Handbook that are published on or after the date that is 1 year after the date of the enactment of this Act.


PART II-H.R. 3200 (Pages 619-633)

Subtitle C—Quality Measurements
SEC. 1441. ESTABLISHMENT OF NATIONAL PRIORITIES FOR QUALITY IMPROVEMENT.

Title XI of the Social Security Act, as amended by section 1401(a), is further amended by adding at the end

Subsection (a) as referenced by subsection (c) below the following new part:
    ‘‘PART E—QUALITY IMPROVEMENT
    ‘‘ESTABLISHMENT OF NATIONAL PRIORITIES FOR
    PERFORMANCE IMPROVEMENT
   
    ‘‘SEC. 1191. (a) ESTABLISHMENT OF NATIONAL PRIORITIES BY THE SECRETARY.—The Secretary shall establish and periodically update, not less frequently than triennially, national priorities for performance improvement.
    ‘‘(b) RECOMMENDATIONS FOR NATIONAL PRIORITIES.—In establishing and updating national priorities under subsection (a), the Secretary shall solicit and consider recommendations from multiple outside stakeholders.
    ‘‘(c) CONSIDERATIONS IN SETTING NATIONAL PRIORITIES.—With respect to such priorities, the Secretary shall ensure that priority is given to areas in the delivery of health care services in the United States that—
        ‘‘(1) contribute to a large burden of disease, including those that address the health care provided to patients with prevalent, high-cost chronic diseases;
        ‘‘(2) have the greatest potential to decrease morbidity and mortality in this country, including those that are designed to eliminate harm to patients;
        ‘‘(3) have the greatest potential for improving the performance, affordability, and patient-centeredness of health care, including those due to variations in care;
        ‘‘(4) address health disparities across groups
14 and areas; and
        ‘‘(5) have the potential for rapid improvement due to existing evidence, standards of care or other reasons.

‘‘(d) DEFINITIONS.—In this part:
        ‘‘(1) CONSENSUS-BASED ENTITY.—The term ‘consensus-based entity’ means an entity with a contract with the Secretary under section 1890.
        ‘‘(2) QUALITY MEASURE.—The term ‘quality measure’ means a national consensus standard for measuring the performance and improvement of population health, or of institutional providers of services, physicians, and other health care practitioners in the delivery of health care services.
‘‘(e) FUNDING.—
        ‘‘(1) IN GENERAL.—The Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 and the Federal Supplementary Medical Insurance Trust Fund under section 1841 (in such proportion as the Secretary determines appropriate), of $2,000,000, for the activities under this section for each of the fiscal years 2010 through 2014.
        ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.—For purposes of carrying out the provisions of this section, in addition to funds otherwise available, out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary of Health and Human Services $2,000,000 for each of the fiscal years 2010 through 2014.’’.

SEC. 1442. DEVELOPMENT OF NEW QUALITY MEASURES;
    GAO EVALUATION OF DATA COLLECTION
    PROCESS FOR QUALITY MEASUREMENT.

    Part E of title XI of the Social Security Act, as added by section 1441, is amended by adding at the end the following new sections:

‘‘SEC. 1192. DEVELOPMENT OF NEW QUALITY MEASURES.

‘‘(a) AGREEMENTS WITH QUALIFIED ENTITIES.—
    ‘‘(1) IN GENERAL.—The Secretary shall enter into agreements with qualified entities to develop quality measures for the delivery of health care services in the United States.
    ‘‘(2) FORM OF AGREEMENTS.—The Secretary may carry out paragraph (1) by contract, grant, or otherwise.
    ‘‘(3) RECOMMENDATIONS OF CONSENSUS-BASED ENTITY.—In carrying out this section, the Secretary shall—
        ‘‘(A) seek public input; and
        ‘‘(B) take into consideration recommendations of the consensus-based entity with a contract with the Secretary under section 1890(a).

‘‘(b) DETERMINATION OF AREAS WHERE QUALITY MEASURES ARE REQUIRED.—Consistent with the national priorities established under this part and with the programs administered by the Centers for Medicare & Medicaid Services and in consultation with other relevant Federal agencies, the Secretary shall determine areas in which quality measures for assessing health care in the United States are needed.

‘‘(c) DEVELOPMENT OF QUALITY MEASURES.—

    ‘‘(1) PATIENT-CENTERED AND POPULATION-BASED MEASURES.—Quality measures developed under agreements under subsection (a) shall be designed—

        ‘‘(A) to assess outcomes and functional status of patients;
        ‘‘(B) to assess the continuity and coordination of care and care transitions for patients across providers and health care settings, including end of life care;
        ‘‘(C) to assess patient experience and patient engagement;
        ‘‘(D) to assess the safety, effectiveness, and timeliness of care;
        ‘‘(E) to assess health disparities including those associated with individual race, ethnicity, age, gender, place of residence or language;
        ‘‘(F) to assess the efficiency and resource use in the provision of care;
        ‘‘(G) to the extent feasible, to be collected as part of health information technologies supporting better delivery of health care services;
        ‘‘(H) to be available free of charge to users for the use of such measures; and
        ‘‘(I) to assess delivery of health care services to individuals regardless of age.
       
    ‘‘(2) AVAILABILITY OF MEASURES.—The Secretary shall make quality measures developed under this section available to the public.
    ‘‘(3) TESTING OF PROPOSED MEASURES.—The Secretary may use amounts made available under subsection (f) to fund the testing of proposed quality measures by qualified entities. Testing funded under this paragraph shall include testing of the feasibility and usability of proposed measures.
        ‘‘(4) UPDATING OF ENDORSED MEASURES.—The Secretary may use amounts made available under subsection (f) to fund the updating (and testing, if applicable) by consensus-based entities of quality measures that have been previously endorsed by such an entity as new evidence is developed, in a manner consistent with section 1890(b)(3).
    ‘‘(d) QUALIFIED ENTITIES.—Before entering into agreements with a qualified entity, the Secretary shall ensure that the entity is a public, nonprofit or academic institution with technical expertise in the area of health quality measurement.
    ‘‘(e) APPLICATION FOR GRANT.—A grant may be made under this section only if an application for the grant is submitted to the Secretary and the application is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section.
    ‘‘(f) FUNDING.—
        ‘‘(1) IN GENERAL.—The Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 and the Federal Supplementary Medical Insurance Trust Fund under section 1841 (in such proportion as the Secretary determines appropriate), of $25,000,000, to the Secretary for purposes of carrying out this section for each of the fiscal years 2010 through 2014.
        ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.—For purposes of carrying out the provisions of this section, in addition to funds otherwise available, out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary of Health and Human Services $25,000,000 for each of the fiscal years 2010 through 2014.

SEC. 1443. MULTI-STAKEHOLDER PRE-RULEMAKING INPUT INTO SELECTION OF QUALITY MEASURES.

Section 1808 of the Social Security Act (42 U.S.C. 1395b–9) is amended by adding at the end the following new subsection:
        ‘‘(d) MULTI-STAKEHOLDER PRE-RULEMAKING INPUT INTO SELECTION OF QUALITY MEASURES.—
            ‘‘(1) LIST OF MEASURES.—Not later than December 1 before each year (beginning with 2011), the Secretary shall make public a list of measures being considered for selection for quality measurement by the Secretary in rulemaking with respect to payment systems under this title beginning in the payment year beginning in such year and for pay ment systems beginning in the calendar year following such year, as the case may be.
            ‘‘(2) CONSULTATION ON SELECTION OF ENDORSED QUALITY MEASURES.—A consensus-based entity that has entered into a contract under section 1890 shall, as part of such contract, convene multi-stakeholder groups to provide recommendations on the selection of individual or composite quality measures, for use in reporting performance information to the public or for use in public health care programs.
            ‘‘(3) MULTI-STAKEHOLDER INPUT.—Not later than February 1 of each year (beginning with 2011), the consensus-based entity described in paragraph (2) shall transmit to the Secretary the recommendations of multi-stakeholder groups provided under paragraph (2). Such recommendations shall be included in the transmissions the consensus-based entity makes to the Secretary under the contract provided for under section 1890.
            ‘‘(4) REQUIREMENT FOR TRANSPARENCY IN PROCESS.—
                ‘‘(A) IN GENERAL.—In convening multi-stakeholder groups under paragraph (2) with respect to the selection of quality measures, the consensus-based entity described in such paragraph shall provide for an open and transparent process for the activities conducted pursuant to such convening.
                ‘‘(B) SELECTION OF ORGANIZATIONS PARTICIPATING IN MULTI-STAKEHOLDER GROUPS.—The process under paragraph (2) shall ensure that the selection of representatives of multi-stakeholder groups includes provision for public nominations for, and the opportunity for public comment on, such selection.
            ‘‘(5) USE OF INPUT.—The respective proposed rule shall contain a summary of the recommendations made by the multi-stakeholder groups under paragraph (2), as well as other comments received regarding the proposed measures, and the extent to which such proposed rule follows such recommendations and the rationale for not following such recommendations.
            ‘‘(6) MULTI-STAKEHOLDER GROUPS.—For purposes of this subsection, the term ‘multi-stakeholder groups’ means, with respect to a quality measure, a voluntary collaborative of organizations representing persons interested in or affected by the use of such quality measure, such as the following:
                ‘‘(A) Hospitals and other institutional providers.
                ‘‘(B) Physicians.
                ‘‘(C) Health care quality alliances.
                ‘‘(D) Nurses and other health care practitioners.
                ‘‘(E) Health plans.
                ‘‘(F) Patient advocates and consumer groups.
                ‘‘(G) Employers.
                ‘‘(H) Public and private purchasers of health care items and services.
                ‘‘(I) Labor organizations.
                ‘‘(J) Relevant departments or agencies of the United States.
                ‘‘(K) Biopharmaceutical companies and manufacturers of medical devices.
                ‘‘(L) Licensing, credentialing, and accrediting bodies.


‘‘(7) FUNDING.—

    ‘‘(A) IN GENERAL.—The Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 and the Federal Supplementary Medical Insurance Trust Fund under section 1841 (in such proportion as the Secretary determines appropriate), of $1,000,000, to the Secretary for purposes of carrying out this subsection for each of the fiscal years 2010 through 2014.
    ‘‘(B) AUTHORIZATION OF APPROPRIATIONS.—For purposes of carrying out the provisions of this subsection, in addition to funds otherwise available, out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary of Health and Human Services $1,000,000 for each of the fiscal years 2010 through 2014.’’.

SEC. 1444. APPLICATION OF QUALITY MEASURES.
    (a) INPATIENT HOSPITAL SERVICES.—Section 1886(b)(3)(B) of such Act (42 U.S.C. 1395ww(b)(3)(B)) is amended by adding at the end the following new clause:
        ‘‘(x)(I) Subject to subclause (II), for purposes of reporting data on quality measures for inpatient hospital services furnished during fiscal year 2012 and each subsequent fiscal year, the quality measures specified under clause (viii) shall be measures selected by the Secretary from measures that have been endorsed by the entity with a contract with the Secretary under section 1890(a).
        ‘‘(II) In the case of a specified area or medical topic determined appropriate by the Secretary for which a feasible and practical quality measure has not been endorsed by the entity with a contract under section 1890(a), the Secretary may specify a measure that is not so endorsed as long as due consideration is given to measures that have been endorsed or adopted by a consensus organization identified by the Secretary. The Secretary shall submit such a non-endorsed measure to the entity for consideration for endorsement. If the entity considers but does not endorse such a measure and if the Secretary does not phase-out use of such measure, the Secretary shall include the rationale for continued use of such a measure in rulemaking.’’.
    (b) OUTPATIENT HOSPITAL SERVICES.—Section 1833(t)(17) of such Act (42 U.S.C. 1395l(t)(17)) is amended by adding at the end the following new subparagraph:
        ‘‘(F) USE OF ENDORSED QUALITY MEASURES.—The provisions of clause (x) of section 1886(b)(3)(C) shall apply to quality measures for covered OPD services under this paragraph in the same manner as such provisions apply to quality measures for inpatient hospital services.’’.
    (c) PHYSICIANS’ SERVICES.—Section 1848(k)(2)(C)(ii) of such Act (42 U.S.C. 1395w–4(k)(2)(C)(ii)) is amended by adding at the end the following: ‘‘The Secretary shall submit such a non-endorsed measure to the entity for consideration for endorsement. If the entity considers but does not endorse such a measure and if the Secretary does not phase-out use of such measure, the Secretary shall include the rationale for continued use of such a measure in rulemaking.’’.
    (d) RENAL DIALYSIS SERVICES.—Section 1881(h)(2)(B)(ii) of such Act (42 U.S.C. 1395rr(h)(2)(B)(ii)) is amended by adding at the end the following: ‘‘The Secretary shall submit such a non-endorsed measure to the entity for consideration for endorsement. If the entity considers but does not endorse such a measure and if the Secretary does not phase-out use of such measure, the Secretary shall include the rationale for continued use of such a measure in rulemaking.’’.
    (e) ENDORSEMENT OF STANDARDS.—Section 1890(b)(2) of the Social Security Act (42 U.S.C. 1395aaa(b)(2)) is amended by adding after and below subparagraph (B) the following:
        ‘‘ ‘If the entity does not endorse a measure, such entity shall explain the reasons and provide suggestions about changes to such measure that might make it a potentially endorsable measure.’ ’’.
    (f) EFFECTIVE DATE.—Except as otherwise provided, the amendments made by this section shall apply to quality measures applied for payment years beginning with 2012 or fiscal year 2012, as the case may be.

SEC. 1445. CONSENSUS-BASED ENTITY FUNDING.
    Section 1890(d) of the Social Security Act (42 U.S.C. 1395aaa(d)) is amended by striking ‘‘for each of fiscal years 2009 through 2012’’ and inserting ‘‘for fiscal year 2009, and $12,000,000 for each of the fiscal years 2010 through 2012.’’


PART III-SOCIAL SECURITY ACT SECTION 1890

Note, as referenced above, Social Security Act Section 1890 (42 U.S.C. 1395aaa) as copied from http://www.ssa.gov/OP_Home/ssact/title18/1890.htm

"Sec. 1890. [42 U.S.C. 1395aaa] (a)Contract.—

(1) In general.—For purposes of activities conducted under this Act, the Secretary shall identify and have in effect a contract with a consensus-based entity, such as the National Quality Forum, that meets the requirements described in subsection (c). Such contract shall provide that the entity will perform the duties described in subsection (b).

(2) Timing for first contract.—As soon as practicable after the date of the enactment of this subsection, the Secretary shall enter into the first contract under paragraph (1).

(3) Period of contract.—A contract under paragraph (1) shall be for a period of 4 years (except as may be renewed after a subsequent bidding process).

(4) Competitive procedures.— Competitive procedures (as defined in section 4(5) of the Office of Federal Procurement Policy Act (41 U.S.C. 403(5))) shall be used to enter into a contract under paragraph (1).

    (b) Duties.—

        (1) Priority setting process.—The entity shall synthesize evidence and convene key stakeholders to make recommendations, with respect to activities conducted under this Act, on an integrated national strategy and priorities for health care performance measurement in all applicable settings. In making such recommendations, the entity shall—

            (A) ensure that priority is given to measures—

                (i) that address the health care provided to patients with prevalent, high-cost chronic diseases;

                (ii) with the greatest potential for improving the quality, efficiency, and patient-centeredness of health care; and

                (iii) that may be implemented rapidly due to existing evidence, standards of care, or other reasons; and

            (B) take into account measures that—.

                (i) may assist consumers and patients in making informed health care decisions; ‘‘(ii) address health disparities across groups and

                (ii) address health disparities across groups and areas; and

                (iii) address the continuum of care a patient receives, including services furnished by multiple health care providers or practitioners and across multiple settings.

        (2) Endorsement of measures.—The entity shall provide for the endorsement of standardized health care performance measures. The endorsement process under the preceding sentence shall consider whether a measure— ‘‘(A) is evidence-based, reliable,

            (A) is evidence-based, reliable, valid, verifiable, relevant to enhanced health outcomes, actionable at the caregiver level, feasible to collect and report, and responsive to variations in patient characteristics, such as health status, language capabilities, race or ethnicity, and income level; and

            (B) is consistent across types of health care providers, including hospitals and physicians.

        (3) Maintenance of measures.—The entity shall establish and implement a process to ensure that measures endorsed under paragraph (2) are updated (or retired if obsolete) as new evidence is developed.

        (4) Promotion of the development of electronic health records.—The entity shall promote the development and use of electronic health records that contain the functionality for automated collection, aggregation, and transmission of performance measurement information.

        (5)Annual report to congress and the secretary; secretarial publication and comment.—

            (A)Annual report.—

                (i) the implementation of quality measurement initiatives under this Act and the coordination of such initiatives with quality initiatives implemented by other payers;

                (ii) (ii) the recommendations made under paragraph (1); and

                (iii) the performance by the entity of the duties required under the contract entered into with the Secretary under subsection (a).

            (B) Secretarial review and publication of annual report.— Not later than 6 months after receiving a report under subparagraph (A) for a year, the Secretary shall—

                (i) review such report; and

                (ii) publish such report in the Federal Register, together with any comments of the Secretary on such report.

    (c) Requirements Described.— The requirements described in this subsection are the following:

            (1) Private nonprofit.— The entity is a private nonprofit entity governed by a board.

            (2)Board membership.—

                (A) representatives of health plans and health care providers and practitioners or representatives of groups representing such health plans and health care providers and practitioners;

                (B) health care consumers or representatives of groups representing health care consumers; and

                (C) representatives of purchasers and employers or representatives of groups representing purchasers or employers.

            (3) Entity membership.—The membership of the entity includes persons who have experience with—

                (A) urban health care issues;

                (B) safety net health care issues;

                (C) rural and frontier health care issues; and

                (D) health care quality and safety issues.

            (4) Open and transparent.— With respect to matters related to the contract with the Secretary under subsection (a), the entity conducts its business in an open and transparent manner and provides the opportunity for public comment on its activities.

            (5) Voluntary consensus standards setting organization.— The entity operates as a voluntary consensus standards setting organization as defined for purposes of section 12(d) of the National Technology Transfer and Advancement Act of 1995 (Public Law 104–113) and Office of Management and Budget Revised Circular A–119 (published in the Federal Register on February 10, 1998).

            (6) Experience.—. The entity has at least 4 years of experience in establishing national consensus standards

            (7) Membership fees.— If the entity requires a membership fee for participation in the functions of the entity, such fees shall be reasonable and adjusted based on the capacity of the potential member to pay the fee. In no case shall membership fees pose a barrier to the participation of individuals or groups with low or nominal resources to participate in the functions of the entity.

(d) Funding.— For purposes of carrying out this section, the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 and the Federal Supplementary Medical Insurance Trust Fund under section 1841 (in such proportion as the Secretary determines appropriate), of $10,000,000 to the Centers for Medicare & Medicaid Services Program Management Account for each of fiscal years 2009 through 2012.

Thank you very much for taking the time to do this little bit of what most Congresspersons and Senators will not do at all, and have myriad excuses to not accomplish:  read the bill.  Towing the party-line, making up for decades of frustration for many a politician whose been in Washington for decades solely to bask in the glory of their new found power, but democrat and republican alike.  Oddly they forget they serve at our pleasure.  When we speak, they shall be quiet.  When we yell, they shall take note of the import of what we have to say.  We are not the subjects of a sovereign government but they are the subjects of a soverieign people!  It is about time we remember they are the tail and we are the dog, that those limits placed on them, the ones further affirmed by the 10th Amendment, are there to protect us from government, while empowering government to take it's proper role and place in our lives.  Our failure to recognize and remember this is something politicians and every other broker of power, of currency manipulations of all sorts, has been wanting and waiting for since our Birth as a Nation.


Toddy Littman

That is the headline that should be on every newspaper tomorrow, for the clock is getting turned back to just after the Civil War, or at least before the 1986 Tax Reform Act.

The electorate so busy taking out vengeance on conservatives has forgotten the devil is in the details, they haven't any care or concern with the tax shelter haven that Obama has promised to create for the billionaires who assure him a means to have this much money to buy our election.

All they had to do was appeal to the anger of the last 2 elections.  No one cares about the issues, about the 500 billion dollars surrounding Obama now, his friends so long as he give them the benefit they seek:  Tax Shelters.

I guess when liberal education breeds and raises Godless liberal values into every aspect of existence it only stands to reason that the people of a nation have no reason to care about their country.  Personal narcissistic interest take precedence over anything else.  I'd site history but what's the use.  Many an American will have died in vane in a few short years, and those who believed will continue to believe even while all that's meant anything of America is evaporating from existence.

But I guess there is a pride to being angry and then the sacred right to vote of all the nation's people being bought for 600 million dollars and sacrificing the Foundation of America.

Should this trend continue throughout the night I am certain the left will enjoy this moment, but moreso, they will enjoy it into the years, for they never admit wrong doing, FannieMae and FreddieMac have proven this.

Hang on folks!  Here comes Carter's 2nd term!

John McCain has been on the side of the middle-class for a very long time, taken from a February 2000 New York Times Article:

"MR. McCAIN'S tax-cut plan is valued at $238 billion over five years and $500 billion over 10 years. Its centerpiece is an expansion of the lowest income tax bracket, 15 percent, to cover higher incomes.

"Under the plan, the ceiling for the 15 percent bracket would rise to $70,000 from $43,050 for married couples filing jointly, and to $35,000 from $25,750 for single taxpayers. The effect would be to give a $3,504 tax cut to a couple with taxable income of $70,000 or more.

"Mr. McCain's plan would also double the child tax credit to $1,000 a year, expand tax incentives for savings and investment, reduce the tax on large estates and reduce the marriage penalty for some people by increasing the standard deduction for couples. Mr. McCain would offset a portion of the tax cuts by closing corporate tax loopholes.

"His pitch is that the plan is modest enough in size that it leaves plenty of money from the surplus tax revenues to deal with other needs. By expanding the 15 percent bracket to cover millions of additional taxpayers, he says, his plan amounts to a start on creating a system of flatter tax rates. And he argues that his plan gives much less of its benefits to the wealthy than Mr. Bush's plan does.

''I want a balanced approach,'' Mr. McCain said in the South Carolina debate. ''The difference between Governor Bush's proposal and mine is that I put a whole lot of money into Social Security, Medicare and paying down the debt. He puts a whole lot of money into tax cuts.''

"An analysis by Citizens for Tax Justice found that only 1.8 percent of the benefits of the McCain plan would go to the wealthiest 1 percent of taxpayers. Most of his proposed tax cuts would go to a broadly defined middle class: more than 52 percent to taxpayers making $65,000 to $130,000, and 21 percent to taxpayers making $39,000 to $65,000.

"Mr. McCain's plan, however, would do almost nothing for taxpayers with incomes below $39,000. Mr. Bush asserts that Mr. McCain's plan would leave too much of the surplus in Washington, where, Mr. Bush says, it would inevitably be spent not on Social Security but instead on bigger government and wasteful programs. And Mr. Bush regularly criticizes Mr. McCain's plan, contending that it would not help the working poor."

What I find really good here is that this problem they found with McCain's plan in 2000 he fixed this time around, by adding to his proposal what Bill Bradley suggested in 2000:

"As a former member of the Senate Finance Committee and one of the fathers of the 1986 overhaul of the tax code, Mr. Bradley arguably has more experience with tax policy than any of the other candidates...

"....The only specific tax cuts he backs are tax breaks on health insurance payments, an expansion of the earned-income tax credit for the working poor and an expansion of the child care credit in a way that would help low-income people."

Senator McCain also incorporated an issue from Al Gore regarding Research and Development:

"Mr. Gore has proposed allocating $250 billion to $300 billion to tax cuts over the next decade for specific goals. In particular, he supports expanded tax incentives for education and retirement savings....a permanent extension of the tax credit for corporate research and development."

The entire article is located here:  http://query.nytimes.com/gst/fullpage.html?res=9404E7DC1F30F934A15751C0A9669C8B63&sec=&spon=&pagewanted=1


Additionally John McCain promises a ban on Internet taxes and Cell phone taxes, from his website:

"Ban Internet Taxes: John McCain believes we must make a farsighted, robust, and fervent commitment to innovation and new technologies to sustain our global competitiveness, meet our national security challenges, achieve less costly and more effective health care, reduce dangerous dependence on foreign sources of oil, and raise the quality of education in the United States. John McCain has been a leader in keeping the Internet free of taxes. As President, he will seek a permanent ban on taxes that threaten this engine of economic growth and prosperity.

Ban New Cell Phone Taxes: John McCain understands that the same people that would tax e-mail will tax every text message - and even 911 calls. John McCain will prohibit new cellular telephone taxes."

The main thing missing right now is the raising of the income the lowest tax bracket, and I believe that's probably a good thing since, we have quite a bit of government debt to afford right now.

The point of this is to show that John McCain learns from his past, he does pay attention to the American People, that with all this talk of corporate lobbyists, there remains this man who only had a corporate tax benefits even 8 years ago of 1.9% to corporations.  Admittedly 8 years ago our corporate tax rates were competitive, they no longer are.  Look at how aggressively McCain's 2000 tax plan pursued getting the lower tax rate into the lower and upper middle-class incomes (70,000 a year) in 2000.  I am certain that once our economy recovers John McCain will pursue raising the income level that the 15% tax covers, to "start on creating a system of flatter tax rates."

And McCain will do this without creating the corporate tax shelters that Obama does:

"One other thing I didn't mention, for small business people, I'm going to eliminate the capital gains taxes. So what it means is if your business succeeds, and let's say you take it from a $250,000 business to a $500,000 business, that capital gains you get, we're not going to tax you on it, because I want you to grow more. So you're actually gonna get some...you may end up, I'd have to look at your particular business, but you might end up paying lower taxes under my plan and my approach than under John McCain's plan. I can't guarantee that because I'd have to take a look a it. Alright? Thanks for your...thanks for the question though, I appreciate it." (http://www.youtube.com/watch?v=8Ilwk_wmsQk Obama says this at almost the end of the conversation.)

McCain is keeping the 15% capital gains tax in place, while phasing out the alternative minimum tax.

So the question boils down to:  Is 500 or 1000 dollar checks (essentially an economic stimulus) the answer to our economy, or, providing a framework of growth by generating wealth for decades into the future?  The answer to this is clear to me, John McCain.


Thank you for reading.

Obama has earned America's distrust.  It's the tail end of Obama's pitch to Joe the Plumber.  Obama walks right up to Joe to get his question.  Then Obama puts forth a number of his beliefs and expresses his logic to conclude a tax increase of 3% on "those making over $250,000" is necessary to give a tax break for those making less, asserting it's the government's role, the government's job to assure our incomes meet our personal needs -- that government's control of our personal input will improve our personal output.

The following transcript of what Obama said during the entire interview with Joe Wurzelbacher,
http://www.youtube.com/watch?v=8Ilwk_wmsQk. I wanted to keep the entire train of thought together so I omitted what Joe said, however I referenced it for context in brackets where the context would be lost, so without further delay I give you by transcript, what Senator Barack Obama said to "Joe the Plumber" when he believed there were no open mics:

"If your revenue is above 250, then from 250 down your taxes are going to stay the same. It is true that, say for 250 up, say from 250-300 or so....you'd go from 36 to 39% which is what it was under Bill Clinton.

"So the uh....and the reason we're doing that is because 95% of small businesses make less than 250, and so what I want to do is give them a tax cut I wanna give all these folks who are bus drivers, teachers, auto workers who make less, I wanna give them a tax cut and so what we are doing is, we are saying that folks who make more than 250, that that marginal amount above 250 that they are going to be taxed at a 39% instead of a 36% percent rate.

"Here's a way of thinking about it, um....How long you been a plumber?...Okay so over the last 15 years, when you weren't making 250, you would have been getting a tax cut from me. So you'd actually have more money, which means you would have saved more, which means you would have gotten to the point where you could build your small business quicker than under the current Tax Code.

"So there are two ways of looking at it. I mean, one way of looking at it is, now that you've become more successful....through hard work, you don't want to be taxed as much, which I understand. But another way of looking at it is 95% of folks, who are making less than 250, they may be working hard too, but they're bein taxed to the higher rate than they would be under mine.

"So, what I'm doin is...put, project yourself back 10 years ago, when you were only makin...whatever, 60 or 70, under my tax plan you'd be keeping more of your paycheck, you'd be having lower taxes, which means, you would have saved and gotten to the point where you are [now] faster.

"Now look, nobody likes high taxes, off course not. So...But what's happened is, we end up, we cut taxes a lot, for folks like me who make a lot more than 250. We haven't given a break to folks who make less, and as a consequence the average wage and income for just ordinary folks, the vast majority of Americans, has actually gone down over the last 8 years. So all I want to do is, I want to....I've got a net tax cut. The only thing that changes this, I'm going to cut taxes a little bit more for the folks who are most in need, and with the 5% of the folks who've been doing very well, even though they've been working hard, and I understand and I appreciate that. I just want to make sure that they're paying a little bit more in order to pay for those other tax cuts.

"Now....I respect the disagreement, I just want you to be clear it's not that I want to punish your success, I just want to make sure that everybody, who is behind you, that they've got a chance at success too.

"I'd be open to it [a flat tax] except for, here's the problem with the flat tax, the uh...is that actually if you put a flat tax together, you probably, in order for it to work and replace all the revenue that we've got, you'd probably end up having to make it like about a 40% sales tax. I mean that's the value added, making it up [making up for the lost revenue]. Now some people say 23 or 25 but in truth, when you add up all the revenue that would need to be raised, you'd have to slap on a whole bunch of sales taxes on it.

"So....I do believe that, for folks like me, who are, you know, have worked hard, but frankly also been lucky, I don't mind paying just a little bit more than the waitress who I just met over there, who's things were slow and, she can barely make the rent, you know, because.

"My attitude is if the economy's good for the folks from the bottom up, it's going to be good for everybody. If you've got a plumbing business, you're going to be better off if you've got a whole bunch of customers who can afford to hire you, and right now everybody's so that business is bad for everybody and I think, when you spread the wealth around it's good for everybody. But I, listen I respect what you do and I respect your question and even if I don't get your vote, I'm still going to be working hard on your behalf cause I want to make sure...Small businesses are what creates jobs in this country and I want to encourage it.

"One other thing I didn't mention, for small business people, I'm going to eliminate the capital gains taxes. So what it means is if your business succeeds, and let's say you take it from a $250,000 business to a $500,000 business, that capital gains you get, we're not going to tax you on it, because I want you to grow more. So you're actually gonna get some...you may end up, I'd have to look at your particular business, but you might end up paying lower taxes under my plan and my approach than under John McCain's plan. I can't guarantee that because I'd have to take a look a it. Alright? Thanks for your...thanks for the question though, I appreciate it."

Obama utterly reverses himself in this last paragraph with Joe the Plumber.  Is rich $250,000?  I mean, Obama himself doesn't seem to think so.  It is Obama who uses this amount as his example in making a specific mention of this "elimination of capital gains" to Joe, numbers relative to Joe's situation, Joe's business and Joe's hard work -- remember $250,000 is the line for "rich" when Obama is imposing his 3% tax increase.  Yet Obama has said small business will get a "tax cut" under his plan.  Well with this last paragraph, that certainly is a tax cut and on those making over $250,000, "the rich."  Now using the same figures as Obama did, the tax increase Obama proposes is $7,500 on income taxes while the capital gain tax amount would be around $37,500 of capital gains taxes -- a net loss of $30,000 to the government!

Of course this means government will come up with a large shortfall, and, the solutions will range from lowering the definition of "rich" below $250,000 to increasing the tax upon them to 5% or 10% or more, they become our source of income over time, maybe even entirely.  The government would become beholden to these wealthy, to their influence and job creation, as the source literally "over and above" the American People.  The free enterprise system and Our Will, the will of the many, would lose its authority to the will of the majority of wealth -- the top 5%.

In other words, the great "change" that is about to happen, if we take Obama's word for it, is to make the people, the poor and middle class, of this nation pay the taxes while providing the upper .1% of this nation with the largest tax cut in the history of the United States of America because of the amount of wealth they already hold.  This explains very well the list of those supporting Obama: George Soros, Warren Buffett, Oprah Winfrey, the majority of Exxon Mobile executives, and a host of others including Wall Street Banks.

These elite of wealth and power are finally going to have a President who recognizes their right to control to achieve a complete enslavement of the American people.  They will be justified if we vest this right in these elite by voting for their candidate, to be subjected to their influence on him, their will.  This is, by Barack Obama's own words, the future if Obama becomes President of the United States of America, according to this capital gains tax cut to those making over $250,000 as Obama notes to Joe above.  Please understand that those making well more than $250,000 will be able to eliminate 150 million dollars of tax on every billion they make merely by creating small businesses as tax shelters.   This capital gains tax cut creates a Ponzi Scheme for the rich, growing numerous entities, to split them again and keep them small businesses.  Mass accumulations of wealth without any responsibility to pay anymore than the tax code provides, which will be less than these billionaires would pay on their consolidated wealth.

It will look good folks, very good, but this will be short lived because the government shortfall will be so great that the threshold of the increase in income taxes will need to be lowered, lowered to include everyone who doesn't have any capital gains.  The 1986 Tax Reform Act is what brought an end to income tax shelters for the wealthy.  Are we now going to bring them back and give the wealthy elite even more places to hide their money?

This is what one must believe in light of Obama saying what he did to Joe and believing there were no open mics at the time. I have no reason not to believe Obama either considering the 600+ million dollars Obama has raised for his campaign -- Obama is just another bought and sold politician, his price was just 6 times higher than anyone else, and the above paragraph reflects his promise to the wealthy.

For weeks now I've been posting this with a variety of notions it brings up, the reason is simple:  If you read the entire transcript, or listen to it, and noticed the last thing Obama said to Joe, you can't help but walk away wondering which part is the lie.  However now I realize it's all true and this is an even greater threat to America than European socialism.  This here is the creation of a communist politburo.  We the people to be reliant on those whose wealth is so great that their desire to lead cannot be denied, they just needed a candidate willing to sell out on principle, sell out on America.  Senator Obama's election to identify with his African roots, to read angry black authors and associate with people who wish to see America and/or it's systems, especially capitalism destroyed, is that candidate.

I am convinced Obama is going to do both because his esteemed backers need recognition, and We the People whose will has defeated them time and time again must be put in our place -- what better way to do that than if we elect to be slaves?

Do the math...

Is Obama going to tax the rich or is Obama going to give the rich a break, or both and enslave 95% of Americans?

What's the truth?

Quoted as a Matter of Public Concern and National Security from Social Policy Magazine, Winter 2003, Vol 34, No. 2, Spring 2004, Vol 34, No. 3, also as a matter of artistic license I will I provide italic, underline, and bold emphasis in combination or separately:


"Case Study: Chicago-The Barack Obama Campaign

By Toni Foulkes

   

ACORN's history of nonpartisan electoral work (voter registration and voter turnout) and leadership development combined during the March, 2004 primary season to make a big difference in the level of participation of our communities in that important election.


ACORN is active in experimenting with methods of increasing voter participation in our low and moderate income communities in virtually every election.  But in some elections we get to have our cake and eat it too: work on nonpartisan voter registration and GOTV, which also turns out to benefit the candidate that we hold dear.

The March primary was not particularly important for the presidential race, as Kerry was just in the process of clinching the Dem presidential nomination.  But it was critical in the U.S. Senate race.  On March 16th, State Senator Barack Obama won the right to represent the Democratic Party in the U.S. Senate campaign.  Jack Ryan won the Republican nomination that day, but went on to self-destruct over sex club revelations in his divorce papers.  Sen. Obama went on to keynote the Democratic Convention in July and was catapulted to the national stage. As Sen. Obama puts it, how did a skinny kid with a funny name become the Democratic candidate for the U.S. Senate, with 53% of the statewide Democratic vote in a seven-person field?




[Photo of Obama sitting at table in discussion with ACORN members here.]




Obama started building the base years before.  For instance, ACORN noticed him when he was organizing on the far south side of the city with the Developing Communities Project.  He was a very good organizer.  When he returned from law school, we asked him to help us with a lawsuit to challenge the state of Illinois' refusal to abide by the National Voting Rights Act, also known as motor voter.  Allied only with the state of Mississippi, Illinois had been refusing to allow mass-based voter registration according to the new law.  Obama took the case, known as ACORN vs. Edgar (the name of the Republican governor at the time) and we won.  Obama then went on to run a voter registration project with Project VOTE in 1992 that made it possible for Carol Moseley Braun to win the Senate that year.  Project VOTE delivered 50,000 newly registered voters in that campaign (ACORN delivered about 5000 of them).

Since then, we have invited Obama to our leadership training sessions to run the session on power every year, and, as a result, many of our newly developing leaders got to know him before he ever ran for office.  Thus, it was natural for many of us to be active volunteers in his first campaign for State Senate and then his failed bid for U.S. Congress in 1996. By the time he ran for U.S. Senate, we were old friends.  And along about early March, we started to see that the African-American community had made its move: when Sen. Obama's name was mentioned at our Southside Summit meeting with 700 people in attendance from three southside communities, the crowd went crazy.  With about a week to go before the election, it was very clear how the African-American community would vote.  But would they vote in high enough numbers?

It seemed to us that what Obama needed in the March primary was what we always work to deliver anyway:  increased turnout in our ACORN communities.  ACORN is active on the south and west sides of Chicago, in the south suburbs and on the east side of Springfield, the state capital.  Most of the turf where we organize in is African American, with a growing Latino presence in Chicago's Little Village and the suburbs.

ACORN members were involved in three activities around the primary:

1) Block captains were identified, as early as the summer before the March primary, and provided with lists of registered and unregistered voters and voter registration materials.  We attended trainings and accountability meetings to receive our materials and make plans to get the people registered.  Then we came back to report on our progress. We also hired voter registrars in the final three weeks to work the supermarkets in our communities.  By the February 17 voter registration deadline for the primary, ACORN had registered 12,984 new voters.  This was an organizational best for us.  (As of this writing, we have added over 27,000 new voters).

2) Block captains then went to work to turn out the vote.  They were all volunteers until the last few days, when we received funding to pay some of our block captains in some precincts of the 24th ward (North Lawndale) and  the 15th ward (West Englewood) to get out the vote on the last Saturday before the election and on election day.

3) In some precincts in the 15th ward, we were able to hire canvassers to work on voter turnout for a full two weeks before the election.  Each canvasser worked two to three precincts during that time.

The results of this activity were very interesting, and mirror what Professor Donald Green of Yale University has found about voter turnout work: where we were able to run a crew of paid and supervised canvassers for two weeks before the election, we did very well.  In those targeted ACORN precincts in the 15th ward, voter turnout improved by an average of 50% over the previous year's city election (the only other election since the redistricting).  Citywide turnout increased by only 14% over the same election.

The way the canvassers approached each door was important. Instead of a speech about a candidate they engaged the potential voter in a conversation about the issues, relating their issues to the importance of voting, and moving them to a commitment to vote in the primary.  In addition ACORN leaders were making the rounds talking to their neighbors about the election.  I am proud to report that the combination of a paid canvass and my volunteer work was especially successful in turning out the vote in my two precincts (34 and 51).  In those precincts we boosted turnout by 82% (precinct 34) and 90% (precinct 51) over the previous year’s turnout. ACORN leader Denise Dixon again paired with an effective canvasser, increased turnout in her precinct by 131%.  The best performing precincts were the ones with a canvasser and a leader who worked at least Election Day and the Saturday before.  There is a noticeable difference between these precincts and those that only had a paid canvasser in it, who wasn't a local community leader.

We're not ready to prove anything yet with our data, because we have not run a scientific test, but we believe Green's results showing that door-to-door field work for two weeks before an election yields significant results, and we believe that there is a correlation with strong local leaders assisting the paid canvassing in winning even more dramatic increases.

The 24th ward has traditionally had higher voter turnout than in the 15th.   The work leading up to the election in the 24th Ward was done by leaders who volunteered their time.  Some were paid for two half days of door knocking, election day and the Saturday before.  Turnout increased in ACORN precincts in the 24th ward at a rate higher than the city average, but not at the rate at which it increased in the 15th.  Overall turnout was still higher in our 24th ward precincts than our 15th ward precincts, but the rate of increase was not as dramatic.

None of this is rocket science, but it is important.  Good door-knocking by community residents for even two half days can impact turnout.  Good door-knocking by paid and supervised canvassers for two weeks can have dramatic impact.  And a combination of the two, especially with experienced community leaders working with the paid canvassers, can make a huge difference.

As it turned out, Obama won the primary handily, pulling white wards as well as African American.  But no one knew that that would be the case.  In each election we must act as if our work is critical for our communities.  That is what we did in the primary, and we learned something in the process.

Toni Foulkes is a Chicago ACORN leader and a member of ACORN's National Association Board."


My Thoughts

Note the "Since then..." at the start of one of the first few paragraphs above.  That date is 1992.  Since 1992 Obama has been "invited... to our leadership training sessions to run the session on power every year, and, as a result, many of our newly developing leaders got to know him before he ever ran for office.

This is the certainty of a conflict of interest and the rest an explanation of ACORN as a member in good standing of Daley Machine style politics.  This is the politics of "change?"  Machine politics of Mayor Richard J. Daley Senior from the 1960s?  Of course it is a change, there will be a "patronage system" such that Obama attached to College tuition credit in his statement in this 3rd debate:

"I will give every student a $4,000 tax credit, on condition they participate in a community organization." 

Yes, I paraphrased and likely poorly, yet the point of the statement is that it makes the tuition credit subject to the student acting in a manner that the government prescribes.  Sure the government has other requirements it prescribes but those details are irrelevant.  What is important here is that the community service requirement by government of a citizen is purely in order to have the privilege of using a tax credit of $4,000.  This requirement teaches people only to give in exchange for something, not to give for the sake of giving, which, is the whole point of community service organizations, from Red Cross to Rotary International.

You may not see this as any relation to ACORN however his lying about the relationship consistently, to claim working a court case for them and that's all, is reason to suspect a form of Machine Politics in the Mayor Daley tradition.  This especially holds true when considering the number of states investigating ACORN for voter fraud, as well as some of their actual volunteers explaining registering 73 times in order to get paid.

This is why I emphasized the "compensated canvasser" portions above, for the compensation seems to taint the system.

Lastly, ACORN defends itself by claiming these large numbers of voters they registered with pride, some 1.3 million.  Well if, in fact, some of their people are filing 20 registration forms, when you divide the 1.3 million into 20 you land at 65,000 actual participants.  The point being that, due to the number of their operations across the nation that appear to be committing this fraud, it would seem they are admitting to adding 1,235,000 illegal votes to support the candidate they prefer, as they mentioned above, "...we get to have our cake and eat it too: work on nonpartisan voter registration and GOTV, which also turns out to benefit the candidate that we hold dear."

Apparently there is a "bipartisan partisanship" that's okay so long as you're ACORN.

To Read the original article with photo, please see http://www.socialpolicy.org/index.php?id=838. I had to register as a member to get to this article.

Note please that Toni Foulkes, the author of the article from Social Policy Magazine is an Alderman today in Chicago.  I wonder how much ACORN and Senator Obama "got out the vote" for him.

Thank you for your time and reading this entire.