And, remember, the health care industry accounts for roughly one-sixth of the entire U.S. economy.
The Fed’s ability to set interest rates certainly gives it enormous power. But imagine if the Fed could also issue rules determining the core design of one-sixth of all the products in America, from automobiles to houses.
In health care, that’s essentially what the NHB would do.
For millions of Americans, it would mean that a distant, unelected board - not their doctor or themselves - would ultimately determine what health care they could receive. These are literally life-or-death determinations.
To be sure, those with enough money could buy additional coverage or services beyond the board-determined package.
But for those without a fat wallet, the board’s decision would be final.
The board’s very independence from the people and their representatives - touted as its key benefit - is what is actually so alarming.
Some advocates respond to that concern by pointing to the track record of Britain’s National Institute for Health and Clinical Excellence, which researches effective treatments and determines which treatments will be funded by the National Health Service.
But the Institute, known by its Orwellian acronym “NICE,” cannot override Parliament, which ultimately calls the shots in the NHS. By contrast, the health board would be beyond reach of Congress.
In reality, the extraordinary power exercised by an NHB would make it less like the Fed and more like a Supreme Court of Health. And that analogy exposes the faulty premise of board advocates.
Giving the board enormous powers and supposed independence won’t depoliticize its membership and work. On the contrary, every NHB nomination would produce a political firestorm similar to those triggered by a nomination to the Supreme Court.
Yes, critical decisions over people’s health should be free of interest-group pressure.
But to vest this decision-making in a board that is beyond the jurisdiction of Congress, and thus beyond the reach of ordinary Americans, is not the right answer.
A far better approach is to move critical health decision-making from Congress and give it to families and individuals themselves.
• Stuart Butler is vice president for domestic policy issues for the Heritage Foundation (www.heritage.org).
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