David Broder, the respected left-leaning “dean” of the pundit class, who writes for the Washington Post, has clearly defined the power that the president hopes to convey on unelected bioethics boards. From his column “Our New Medical Judges?”:
Americans are familiar with — if not altogether comfortable about — unelected officials exercising great authority over our lives...The economy is managed by the Federal Reserve Board, though no one ever forced Alan Greenspan or Ben Bernanke to campaign for a vote. If President Obama has his way, another such unelected authority will be created — a manager and monitor for the vast and expensive American health-care system. As part of his health-reform effort, he is seeking to launch the Independent Medicare Advisory Council, or IMAC, a bland title for a body that could become as much an arbiter of medicine as the Fed is of the economy or the Supreme Court of the law.
Broder isn’t exaggerating:
Under his plan, the president would name five physicians or other health-care-savvy members [me: read, utilitarian bioethicists, like the UK’s NICE] to serve for five-year terms on its board, picking one of them as chairman. Like the nominees to the Fed and the Supreme Court, they would have to be confirmed by the Senate. Each year, IMAC would have two responsibilities. First, it would recommend to the president updated fees that Medicare would pay doctors, hospitals, rehab centers, nursing homes, labs, home-care and ambulance services, equipment manufacturers, and all other providers...Second, IMAC would annually recommend a set of broader reforms to improve the quality or reduce the cost of medical care. On each report, the president would have 30 days to approve or reject the recommendations, but he would have to act on the whole package, not pick it apart.
If he approved, the package would go to Congress and could be overruled only by joint action of the Senate and House within 30 days. Absent that, the secretary of health and human services would order the changes into effect. Because Medicare looms so large in the overall health system, the changes required by IMAC would undoubtedly transform all private delivery systems as well.
Broder doesn’t take a position, but clearly sets out the stakes:
Congress will have to decide if it is willing to yield that degree of control to five unelected IMAC commissioners. And Americans will have to decide if they are comfortable having those commissioners determine how they will be treated when they are ill.
We already know, thanks to the CBO, that this reform wouldn’t save significant money. Thus, given that such a board would consist of the ilk of Ezekiel Emanuel, Dan Brock, and Alta Charo—all prominent left-leaning “quality of life” bioethicists—we permit the IMAC to gain control at all our peril.
