If you like the Federal Reserve Board, you’ll love President Obama’s Medicare rationing panel. It may seem far-fetched to suggest that the Fed has anything to do with the Democrats’ vision for the future of our health care system, but Obama himself once embraced such a comparison.
Back in 2008, former Democratic Senate Majority Leader Tom Daschle, Obama’s original choice to serve as secretary of health and human services, proposed a new entity he called the Federal Health Board.
As Daschle described it in his book “Critical: What We Can Do About the Health-Care Crisis,” the board would be an independent panel of experts tasked with finding ways to save money and improve quality in the health care system. Because it would be “insulated from political pressure,” it would be able to make tough decisions that eluded elected officials.
Obama praised the idea on the back cover, writing that Daschle’s “Federal Reserve for Health concept holds great promise. …”
After the book’s release, Daschle had to withdraw his nomination as secretary of HHS amid a tax scandal, and the Fed’s reputation suffered during the financial downturn.
By July 2009, a Gallup poll found that just 30 percent of Americans thought the Fed was doing an “excellent” or “good” job — making it the worst-reviewed government agency among those surveyed (even the Internal Revenue Service was more popular).
While the “Federal Health Board” branding died, the central idea of creating a panel of independent experts to help contain costs survived.
And the final health care legislation that was approved by every Democratic senator and signed into law by Obama created the Medicare Independent Payment Advisory Board.
Democrats have assailed House Budget Committee Chairman Paul Ryan’s proposal to contain Medicare costs by offering future seniors the ability to choose among subsidized private health care plans.
But if Obamacare is fully implemented, IPAB’s 15 presidentially appointed experts will submit a report to Congress each year proposing ways to make sure Medicare spending does not exceed certain annual growth targets.
By law, the proposal can only be amended if the resulting change reduces Medicare spending by at least as much as IPAB’s proposals, or is approved by both chambers of Congress and three-fifths of the Senate.
If Congress doesn’t meet a deadline to approve its own version, then IPAB’s recommendations automatically get implemented.
Obama made strengthening IPAB a central component of the deficit reduction vision he announced in April. And the influential liberal group, the Center for American Progress, has proposed eventually extending IPAB’s recommendations to all health care plans in the United States.
If you think that’s unlikely, remember that the Fed was created in 1913 for the limited purposes of preventing banking panics in which everybody tries to withdraw all their money at the same time. Today, it essentially runs the U.S. economy.
Though comprised of financial experts, the Fed has made tragic miscalculations over the decades. Its decision to contract the money supply helped trigger the Great Depression, and its insistence on maintaining historically low interest rates during the last decade helped create the housing bubble that caused our current financial crisis.
Putting a similar panel of experts in charge of health care is even more problematic, because the decisions involved are much more personal. Even if the board, after considering all relevant data, makes decisions that look good on paper for the nation as a whole, they may be completely wrong for any given patient.
The ongoing debate over the future of health care, thus, is really a deeper philosophical discussion about whether a society’s important decisions are best made by individuals, or by a body of unelected elites.
Philip Klein is senior editorial writer for The Examiner. He can be reached at [email protected].
