Among the provisions President Obama supports for health care reform is the creation of IMAC--the Independent Medicaire Advisory Council.
The council would be made up of five members, all selected by the president and confirmed by the Senate. The president could fire any one of them for cause. They would have two jobs. First, each year, the council would make recommendations to the president regarding inflation updates to Medicare’s payment rates for hospitals, doctors, and other suppliers of services. Those recommendations, if approved by the president, would automatically go into effect in thirty days unless Congress passed a resolution disapproving them — which the president would also have to sign into law. Of course, if the president approved the council’s original package of recommendations, it is unlikely he would sign a Congressional disapproval resolution overturning them. So, as a practical matter, the proposal would force Congress to find a two-thirds supermajority to stop presidentially-approved IMAC recommendations from going into effect.
That very provision, however, undermines the checks and balances of our system. In effect, a council would be able to make law for health care, with the consent of the President. In what way will such a body be accountible to we the people, through the people we select to represent us in Washington? Our representatives are supposed to make law. The don’t have the right to let others do it. Government by unelected experts is not democratic, or republican, government. As Justice Cardozo noted when striking down the First New Deal, this is "delegation running riot."
On the other hand, if one believes in a living constitution, checks and balances are antiquated elements of the past, unsuited to the modern world. That has been dogma for Progressives since .Woodrow Wilson’s day.