Tom Daschle, President Obama’s original choice of secretary of Health and Human Services, confirmed yesterday that the motivation behind creating Obamacare’s Independent Payment Advisory Board (IBAP) was to vest power in an unelected body that is sufficiently insulated from the American people.
Politico reports: “Former Majority Leader Tom Daschle debated former Sen. Judd Gregg over health care reform at the AHIP conference yesterday, and said the IPAB was a key piece of reform because congress would not be able to make the tough decisions when it comes to Medicare. ‘I can’t think of anything in the ACA [Obamacare] that is more important than ultimately giving some real authority to someone to make these tough decisions,’ he said.”
Congress, of course, already has the authority to make “tough decisions” that fall within the federal legislative power, whether or not it chooses to exercise it. So this is really about “giving some real authority” to an unelected body that is not directly accountable to the American people, and whose decrees cannot even be overturned by a majority vote of each house of Congress and the president’s signature.
As Politico reports, Gregg echoed Daschle’s sentiments: “Gregg agreed, insomuch as there were certain things Congress couldn’t do, specifically any policy around end-of-life care. ‘There is no way, in a populist system that you can discuss the last six months of life. It’s impossible. You do need some insulation from the political system to turn and address some of these complicated issues.’”
Federal power needs to have some “insulation” from our “political system” — from our “populist system” — so that it can make binding determinations about Americans’ end-of-life medical care? On multiple levels, this isn’t quite how the Founders viewed it.
Remember when, during Super Bowl interview II, Obama admitted that he “would have loved nothing better than to simply come up with some very elegant, you know, academically approved approach to health care….But that’s not how it works in our democracy. Unfortunately what we end up having to do is to do a lot of negotiations with a lot of different people.”
Obama’s solution to our “unfortunately” democratic system? IPAB.