Can the Senate pass permanant legislation?
The Independent Medicare Advisory board is making the rounds on the blogosphere. Reactions range from the hilarious to the sober, with the former category represented by the Weekly Standard (via Yglesias).
Democrats are protecting this rationing “death panel” from future change with a procedural hurdle. Could it be because bureaucratic rationing is one important way Democrats want to “bend the cost curve” and keep health care spending down?
The policy justification for the panel is to remove cost decisions from the political process, where they will be subject to strong lobbyist pressure. If costs are ever really going to go down on a per-procedure basis, such an independent voice is likely necessary. Controversially, there are provisions included that make it procedurally difficult or impossible to amend or repeal this provision.
But Megan McArdle at the Atlantic has an important process-oriented objection.
But process matters. What if your select commission runs amok? Or what if 80-90% of Americans simply hate it and don’t want it? It is neither practically nor ethically desirable to appoint a dictator. Nor is any man so wise that he should be able to enshrine his preference into unchangeable law for all time.
Luckily, a friend who has covered senate procedure in other contexts assures me that this probably will not work: as a law, it’s unconstitutional, and Senate rule changes require a 2/3rds majority that they are not going to get.
Although I doubt that Reid’s objective is a diabolical means of making his agenda permanent, I do think there are real dangers with senate rule changes like this; permanent legislation would remove all democratic accountability from the commission as well as hamstringing ability to redress unforeseen policy concerns. The risks run more towards slippery slope as opposed to present dangers of the provision at hand, but they exist all the same.
Indeed, the objections seem so obvious it’s really surprising that the language was included in the bill, critical as it may be. Maybe there is something to be said for the conspiracy theories asserting that the bill’s great length hides all sorts of diabolical provisions. (Probably not.)
-John
Image courtesy Wiki Commons
Related posts:
- How many votes should be required to pass bills in the Senate?
- Singer on health care rationing
- Death panels and democracy
- No hall pass
- Where are the liberal demagogues?
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