The most instructive part of the president’s “deficit” speech last week was his insistence that he could help balance the budget through an “independent commission” with the “authority to make additional savings by further improving Medicare.”  That commission is the Independent Payment Advisory Board (IPAB) and it is nothing more than another leg in ObamaCare’s rationing stool.

Writing in the Weekly Standard, Mark Hemmingway writes:

Here’s how IPAB 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.

In short, the IPAB would give power to unelected bureaucrats the make life or death decisions about Medicare – and probably private insurance – coverage without any way for patients to challenge the decision of the board.  Rationing would be implemented without a vote of Congress.

Writing in the National Review, James Capretta, points out that the Administration will not only use the panel to ration care but it’s real purpose is to build a stepping stone toward a nationalized health care system.

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As the Senate considers a health care bill that amounts to the largest entitlement expansion in American history, we sit down today with health care and budget policy expert James Capretta to discuss the prospects in the Senate and the wide-ranging economic ramifications of the current legislation. It’s a special edition of Coffee and Markets, a daily podcast from The New Ledger on politics, policy and the marketplace, brought to you by BigGovernment.com and by The Heartland Institute’s Health Care News.

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Related Links:

James Capretta’s Blog: Diagnosis
First Things: The Health Care Bill in the Senate
AEI: Opportunities Missed on Health Care
Abortion Vote Could Decide Fate of Health Care Bill
For more on this topic, see Health Care News, a publication of The Heartland Institute.