• A government of laws or men?

    Are we a nation, or government, of laws or men? (Yes, women too, but that’s not how John Adams put it.) I ask because people seem to be wondering about “rationing” and the IPAB. Do we believe what the law says or what someone tells us it says?

    Not once, but twice yesterday Rep. Paul Ryan described the law this way:

    It [the President’s plan] begins with trillions of dollars in higher taxes and relies on a plan to control costs in Medicare: A board of 15 unelected bureaucrats would be given more power to deeply ration Medicare spending in ways that would disrupt the lives of those in retirement, leading to waiting lists and denied care for today’s seniors. [Bold mine.]

    I know of no other board of unelected bureaucrats in the President’s plan other than the Independent Payment Advisory Board (IPAB). Here is precisely what the President’s plan, formally Pub. L. 111-148, § 3403, says about the IPAB’s proposals and rationing:

    The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary costsharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria. [Bold mine.]

    Thus, whatever rationing is — and in time the courts, not Rep. Ryan or you or I will decide — the IPAB cannot do it. That’s what the law says. Rep. Ryan thinks otherwise, based on what I am not sure.

    Critics of the law have argued that it is too long and complicated, that it was passed in great haste, and that it was shoved down our throats. But that was a year ago. Since then, there has been plenty of time for all of us, including members of Congress, to read it, to see what it actually says. On rationing and the IPAB, it could not be more clear.

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