The tragedy of the 20th century was the march towards elite control of the population, with minor rebellions and re-establishment of individual rights.
It’s important to know how we got here, but also to spot expansions of this elite control. Here, a liberal admires the Federal Reserve for going against the wishes of the people, and wishes we could get something similar for healthcare:
Twice a year, an outside advisory board sends Congress a list of suggestions for Medicare payment rates, based on the available evidence. Congress generally ignores them, in deference to the various industry groups that oppose any cuts to their payments.
We already have a wonderful model for how to avoid such interference. It’s called the Federal Reserve. The Fed is charged with setting interest rates based on economic conditions, not politics. The Senate bill would create such a commission for Medicare.
Mickey Kaus then finds an organization somewhat like this in Reid’s health bill. The “IMAB” panel will be able to propose alterations in payments and then restricts the power of congress to disapprove of those alterations
–The new 15 member “IMAB” board makes cost-cutting recommendations if Medicare spending exceeds specific targets.
–Congress can disapprove these changes by passing a bill. But like other legislation, the president can veto that bill (and his veto can be overridden).
–The “fast tracking” provisions Klein discusses apply to the bill disapproving the changes. That is, they make it easier for opponents of the changes to block them without, say, being filibustered in the Senate. But they also sharply restrict what a “fast-tracked” disapproval can do–for example, it can’t block spending cuts if that causes cost-reduction targets to be missed. To this extent it’s an “up or down” vote, like a base-closing resolution