Yuval Levin highlighted this yesterday, and it's one of the most revealing things I've seen recently, not just about Obamacare, but how the left generally views the exercise of power.
First, a refresher: Buried deep within the Obamacare bill is the Democrats' plan for lowering Medicare costs -- something called the Independent Payment Advisory Board (IPAB). Here's how it works:
It's a panel comprised of 15 presidential appointees who are tasked with reducing Medicare spending. The panel is is given certain spending targets that kick in in 2014. At first those targets are on a sliding scale, but by 2018 the spending targets are set at the rate of GDP growth with an additional half of a percentage point tacked on. (Originally, it was GDP plus a full percentage point, but according to the "framework" released prior to the President's speech the spending target has been reduced.)
Any recommendations IPAB makes about Medicare spending automatically become law. Congress can only override IPAB with a three-fifths majority vote, which is a very high legislative hurdle, or they can pass their own Medicare plan that meets the same spending target. There's no administrative process for doctors or citizens to challenge the board's decisions. There's a school of thought that says IPAB is even more blatantly unconstitutional than the individual mandate, as its power sounds legislative in nature -- its declarations would have the force of law -- and therefore cannot legitimately be delegated to an executive entity.
For more on the constitutional problems with IPAB see this piece I wrote for THE WEEKLY STANDARD. But to sum things up, IPAB takes 13 percent of the federal budget and gives it to unelected bureaucrats to determine how it's spent, with almost no congressional oversight and no way for citizens to challenge the bureaucrats decisions. Sounds terrifying right?
Well, the left-wing Center for American Progress thinks that IPAB is the answer to our fiscal prayers. If IPAB works for health care -- and it won't, for a variety fo reasons enumerated at the links above -- why not apply it to whatever we need it for? Yuval Levin flags this proposal from the Center for American Progress aimed at addressing all of America's fiscal woes:
In our plan, aggressive implementation of PPACA, along with some enhancements to its existing cost-control mechanisms, will result in dramatically lower health expenditures, both for the federal government and overall. But predicting the exact effect of the myriad test programs and reforms in the new health law is fraught with uncertainty. Thus we also include a failsafe mechanism that would ensure significant savings. Our failsafe would be triggered if, starting in 2020, total economywide health care expenditures grow at a rate faster than the economy. Should that happen, we would empower the IPAB to extend successful reforms in Medicare and other public programs to insurance plans offered in the health care exchanges and then potentially to all health care plans, such that the target is met. This will ensure that costs are constrained across the health care sector, preventing cost-shifting and maintaining access for all.
That's right -- the Center for American Progress is more or less in favor handing off the whole of America's budget issues to a likely unconstitutional panel of democratically unaccountable bureaucrats with no meaningful oversight. Or to put it more bluntly, this is basically a recipe for tyranny.
Follow the discussion on Facebook.