A White House Power Grab that Congress and America Doesn’t See

by SusanAnne Hiller

To achieve the goal of a universal, single-payer health system, the White House must secure the power it needs by amending the Social Security Act to transfer pivotal controls from Congress to the executive branch.  This transfer of power would ultimately give the President and the majority party, in this case the radical left Obama White House and Pelosi-Reid led progressive Democrats, the authority to frame and manipulate new policy, coverage options, and reimbursements, ultimately reshaping the future US health care system into a something unrecognizable in this country.

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The deliberate setup for the White House power grab is built into the each of the health care bills and, if they fail, little-known twin bills called “MedPAC Reform of 2009” are waiting in the wings.  The bills, S.B. 1110 and H.R. 2718, craftily amend the Social Security Act and transfer the Medicare guideline and rule setting processes, from the legislative branch to the executive branch.  These bills offer cover to one another in case one doesn’t pass the House or Senate, respectively.  Remember, Democrats need to gain executive branch authority by amending the Social Security Act over Medicare regulations and physician fee schedules to transform the health care system in a single-payer, socialized system.

More importantly, Medicare’s regulations and physician fee schedules are the keystone to developing payer systems and reimbursement models across the entire health care industry.  And where Medicare goes, insurers follow.

To underscore the far-reaching power, a bulk of the states already reference or utilize the Medicare guidelines and fee schedules in determining policy, coverage, and payment, which impacts certain state-specific plans, including, but not limited to, self-funded plans, automobile insurance payers, and state workers’ compensation funds and plans – affecting even Big Labor.   For the executive branch to have such authority over Medicare regulations with little oversight is alarming.  This raises further issues of the powerful impact these federal mandates could potentially have on the states in stripping them of their own management of their respective insurance industries.

Specifically, the language in the Reid bill intentionally places unlimited power directly in the hands of Health and Human Services (HHS) Secretary Kathleen Sebelius, including the ability to designate covered services, or rationing.  The Pelosi bill creates a Health Choices Commission and its “commissioner” is empowered to make the same decisions.  More alarming, both will have to take direction from the White House–and its unconfirmed czars–due to their executive branch affiliation.

In retrospect, Obama’s pick of Sebelius as HHS Secretary is obvious.  Aside from being a governor, Sebelius is the former Kansas insurance commissioner and has the ability to identify the strongest and weakest links–navigating her way quite expeditiously throughout the health care system.  And she’ll never disavow one of her first career choices — executive director and chief lobbyist for the Kansas Trial Lawyers Association.  That explains the blatant omission of tort reform, in addition to the fact that the trial lawyers are the biggest Democrat donors.

Another disturbing Obama appointee is health care czar Nancy Ann DeParle, who remains unconfirmed, and was the administrator of the Health Care Financing Administration (HCFA), now known as the Centers for Medicare and Medicaid Services.  In short, she “owns” Medicare.  And if you put Sebelius and DeParle together in a room for a few hours, you’ll get a formula for a single-payer government-run health care system – with Obama’s wish list met.

These designed appointees make sense of the intentions at hand to frame a universal or single-payer health care system.  Everything in this administration makes sense when you look at the overall agenda.  Even the branding makes sense.  The urgency, caring for the uninsured, taking advantage of the uninsurable, proclaiming it’s paid for,  packaging it as deficit-neutral, and amplifying that people are ‘dying’ in the streets.

The aforementioned MedPAC Reform of 2009 bills give the executive branch power it so dearly covets to devise the single-payer system.  Currently, MedPAC–the Medicare Payment and Advisory Committee (MedPAC)–is a Clinton-era independent Congressional agency established by the Balanced Budget Act of 1997 that advises the Congress on issues affecting the Medicare program, including payments to private health plans participating in Medicare and providers in Medicare’s traditional fee-for-service program.  MedPAC also analyzes access to, quality of, and cost of health care.

The MedPAC bill designer, progressive Senator John Rockefeller (D-WV), has strategically branded the need for the bill by calling Congress “inefficient” and “inconsistent” –and who wouldn’t agree with that?

Therefore, the MedPAC Reform bill creates a new MedPAC–the Medicare Payment and Access Commission–and gives the Obama White House and its advisors over-reaching control of several factors governing the economy of the health care system.  The new MedPAC, which is exempted from judicial review, would have the authority to rewrite physician fee schedules, redefine medical necessity, evaluate coverage of treatment options, rewrite beneficiary definitions and coverage, and redesign diagnostic definitions and coverage.

The new MedPAC’s mission would also be to inform new research in health services to adequately address deficiencies in the evidence. However, in reality, this would apparently cripple new treatments and technologies by overshadowing progressive research and treatment algorithms by apparently emphasizing the deficiencies, not the benefits, equaling a denial of care and arresting development of burgeoning technologies.

Rockefeller also confirms that the new MedPAC will evaluate and test new and innovative payment models for provider reimbursement.  The MedPAC reform is being packaged under the guise of efficiency; however, by maximizing the volume of care delivered at the lowest possible cost, it appears that the payment and utilization schedule is a mechanism to control the pressure that would build when the health care system is overloaded with millions of new patients.

Finally, Rockefeller highlights another intention of MedPAC, which is to expand the capacity to evaluate basic and health services research for reimbursement.  This is the pinnacle power grab because this gives the new MedPAC and the executive branch the power to ration or deny care and decide what treatment options are available or acceptable as a whole.

Senator Chuck Grassley (R-IA), ranking Republican on the Senate Finance Committee, commented, “As a congressional support agency, MedPAC’s mission is to advise Congress on Medicare payment issues.  If MedPAC were to become part of the executive branch as contemplated in the Rockefeller bill, then Congress would no longer have this support agency to provide technical support when making policy decisions.”  Senator Grassley also confirmed that he is not willing to abdicate congressional responsibilities for Medicare payment policymaking to a body that does not hold certificates of election.   He is correct that Congress wouldn’t have the support agency’s advice, but misses that it wouldn’t be Congress’s responsibility anymore—the policy decisions would be the responsibility of the new MedPAC—under the direction of the Obama White House.

What’s inherently disturbing is the fact that Rockefeller has been very outspoken in support of the public option and knows that this transfer of power must take place via the Social Security Act—in any form.  He even confirms that health care reform will not be successful, unless all authority is shifted to the executive branch.  He also rightly chooses his words–the “healthcare delivery system,” which is code for the public option.

Additionally, Rockefeller confirms the overall task at hand by stating, “Establishing MedPAC as an independent executive branch agency – which can only change through an act of Congress – is the cornerstone of improving our delivery system reform.  Health care reform will only be successful if we craft transformative changes.”  Transformative, as in a government-run health care system.

If there are any questions if the White House would flex its executive branch authority over an agency, just look the way of the EPA.  Congress stalled on cap and trade and Climategate has proven to be a problem, so the White House and EPA took matters into their own hands to keep moving on the agenda—to intentionally put regulations in place that further strangle American businesses, create unemployment, and further destabilize the economy.

Furthermore, with most of the Obama administration graduates of the Saul Alinsky school of thought, of course the main goal of all legislation and policies would be to support the overall intention of Alinsky, which is for the “have-nots on how to take it away.”

In any of these legislative scenarios–Pelosi, Reid or MedPAC bills–the White House gets the power it seeks–and needs–in order to accomplish the task at hand–a single payer, government-run health system.

These bills must be defeated; the power grab thwarted because after the Social Security Act is amended in any form these bills present and the rule changes take effect, it is not likely for the Act to be reopened and amended again.  The problem is Congress doesn’t even comprehend what’s at stake in either of the health care bills or MedPAC Reform–and you can’t stop something you don’t see.


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Posted Dec 8th 2009 at 6:31 pm in Big Labor, Congress, Healthcare, News, Obama, Politics | 149 Comments