When I learned today that the federal bureaucracy had promulgated a rule compensating physicians for the time they spend counseling patients on end-of-life health-care decisions, I wasn’t surprised. A similar provision was dropped from the Obamacare bill, but anyone who understands the profoundly bureaucratic nature of contemporary government knew that that was not necessarily the end of it. The 2,700-page law is destined — if it is not rolled way back or repealed — to generate over 100,000 pages of enabling regulations. In such a milieu, that which can’t be obtained legislatively, can often be gotten through the bureaucratic back door. In fact, as I’ve noted elsewhere, one commission created by the law, the Medicare Independent Payment Advisory Board, can even enact laws over the president’s veto.
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