The ObamaCare insurance exchanges currently being set up are designed to put enormous power into the hands of state and federal bureaucracies, according to a recent article in the New England Journal of Medicine by Brookings Institution economist Henry Aaron and Georgetown University’s Kevin Lucia. The exchanges, whether they be set up by Washington, as 33 states have chosen, or by the states themselves, will expand the reach and scope of government management in health care on an unprecedented level.

According to Aaron and Lucia, “Exchanges can set additional standards for the quality of care paid for by plans, bar plans that do not meet quality or price standards, and selectively contract with those that do.” Those standards, of course, will be determined by an arbitrary panel of “experts” – unelected, unaccountable death panels. States will also be able to bar the sale of insurance to individuals and small businesses outside the exchanges, creating a virtual monopoly over the choices that people may seek. Given that Democrats’ goal is single-payer government health care, this is hardly surprising.

These are just a couple of examples of what ObamaCare has in store for the American health care system. Until now, we have been focused on the pratfalls and screw-ups of the federal government trying to get this Byzantine system up and running. Sooner or later that comedy will be superseded by the tragedy of real-life enactment.