Socialist "Obamacare" Continues to Reveal Ugly Things "The point of [the Patient Protection and Affordable Care Act] is cost containment. This supposedly depends on the Independent Payment Advisory Board. The IPAB, which is a perfect expression of the progressive mind, is to be composed of 15 presidential appointees empowered to reduce Medicare spending -- which is 13 percent of federal spending -- to certain stipulated targets. IPAB is to do this by making 'proposals' or 'recommendations' to limit costs by limiting reimbursements to doctors. This, inevitably, will limit available treatments -- and access to care when physicians leave the Medicare system. The PPACA repeatedly refers to any IPAB proposal as a 'legislative proposal,' and speaks of 'the legislation introduced' by the IPAB. Each proposal automatically becomes law unless Congress passes -- with a three-fifths supermajority required in the Senate -- a measure cutting medical spending as much as the IPAB proposal would. This is a travesty of constitutional lawmaking: An executive branch agency makes laws unless Congress enacts legislation to achieve the executive agency's aim. And it gets worse. Any resolution to abolish the IPAB must pass both houses of Congress. And no such resolution can be introduced before 2017 or after Feb. 1, 2017, and must be enacted by Aug. 15 of that year. And if passed, it cannot take effect until 2020. ... The essence of progressivism, and of the administrative state that is progressivism's project, is this doctrine: Modern society is too complex for popular sovereignty, so government of, by and for supposedly disinterested experts must not perish from the earth." --columnist George Will