How many of you remember that Howard Dean is a doctor? Long before YEEEEAAAAAARRRRRRGGGGGHHHHHH, he was wielding a stethoscope, checking pulses and writing prescriptions.

Now first, let’s be clear about why Palin called it that. She did not claim that a line item in the law convenes a hooded panel to sit and pronounce death on people. What she said was that the IPAB, with its power to set rates, would be able to effectively price certain treatments and services out of existence, at least for most people. And the power to do this would serve as an effective death penalty for an awful lot of people.

That doesn’t mean we need embrace his politics - he is still, by and large, a fan of ObamaCare - but it means he speaks with some basis of knowledge when he warns of the problems that are sure to arise as a result of the Independent Payment Advisory Board, which is the component of ObamaCare that Sarah Palin called the death panel.

The IPAB is essentially a health-care rationing body. By setting doctor reimbursement rates for Medicare and determining which procedures and drugs will be covered and at what price, the IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them. There does have to be control of costs in our health-care system. However, rate setting—the essential mechanism of the IPAB—has a 40-year track record of failure. What ends up happening in these schemes (which many states including my home state of Vermont have implemented with virtually no long-term effect on costs) is that patients and physicians get aggravated because bureaucrats in either the private or public sector are making medical decisions without knowing the patients. Most important, once again, these kinds of schemes do not control costs. The medical system simply becomes more bureaucratic. The nonpartisan Congressional Budget Office has indicated that the IPAB, in its current form, won’t save a single dime before 2021. As everyone in Washington knows, but less frequently admits, CBO projections of any kind—past five years or so—are really just speculation. I believe the IPAB will never control costs based on the long record of previous attempts in many of the states, including my own state of Vermont.

Can someone tell me the difference between what Dean says about IPAB and what Palin says? There is none, save for the fact that she used the term “death panel” and Dean did not. The substance of what they’re saying is exactly the same.

I also appreciate Dean’s refreshing honesty in acknowledging that CBO projections - which are often held out by politicians of both parties and by the media as gospel - are in fact little more than wild guesses most of the time. Just because you’re “non-partisan” doesn’t mean you’re right. The CBO’s original wild guess that ObamaCare would reduce the deficit has already been exposed as laughable, but you can hardly blame the CBO itself when it has no choice but to “score” legislation using whatever numbers the legislation’s sponsors give it. It’s garbage-in, garbage-out.

So IPAB won’t save money, but it will almost certainly cost lives if it’s allowed to be convened as ObamaCare proscribes.

I understand Dean’s frustration that it’s hard to get Congress to eliminate IPAB because Republicans want to just repeal ObamaCare altogether, and Democrats don’t want to mess with it at all. If I were a member of Congress, I would take a death-of-a-thousand-cuts approach, weakening the law anywhere I could until there was nothing left to hang onto.

For now, though, it’s more than a little satisfying to hear from a Democrat, who is also a doctor and presumably knows of what he speaks in this area, being honest enough to admit that Palin was right. It almost makes you want to scream!