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There is a dirty secret about health care that President Obama hopes will escape the headlines. In his newly released plan to "reform" Medicare as part of overall deficit reduction, Obama has punted actual cost-cutting and instead proposed a panel - the Independent Payment Advisory Board  - to recommend savings for the financially doomed program. Translation: Welcome to the world of rationing.

The board, which was an original part of Obamacare (remember the death panel debate?), consists of 15 unelected bureaucrats who will have unchecked, binding power in the interest of supposedly greater efficiency and lower costs. That means that instead of you or your doctor making decisions about your care, a group of Washington micromanagers will do it for you.

They will do this by cutting reimbursements to doctors and hospitals and restricting patients from costly end-of-life care by enforcing caps on how much a patient can spend to stay alive. Most at risk will be the disabled, who require special and often expensive care. Cancer patients will be at risk, as well, since chemotherapy and other oncological treatments are some of the priciest.

In the past, Obama has hinted that we'll need a way to address these patients. "The chronically ill and those toward the end of their lives are accounting for potentially 80% of the total health care bill out here," he said shortly after taking office. "There is going to have to be a very difficult democratic conversation that takes place."

But there was no real conversation. Democrats inserted the rationing panel into the Affordable Care Act (i.e., Obamacare), and when the opposition tried to draw attention to the risks involved by invoking rationing, they were branded by the left and the mainstream media as crazies.

But this is far from fantasy. In fact, it's already reality across the pond.

In many ways, Obama and congressional Democrats copied the British, who have a similar model called the National Institute for Health and Clinical Excellence, or NICE. According to The Wall Street Journal, the acronym is quite the oxymoron when one looks at what passes for standard practice: "NICE has rejected a number of pricey drugs for cancer and other diseases in the past. . . . Sometimes NICE rejects drugs for all patients with the disease, and sometimes just for patients with a specific form of the disease, where the efficacy doesn't appear to justify the price. NICE's decisions often anger patients, their families and drug companies."

Most recently, NICE made the decision to deny the use of several new drugs to treat chronic leukemia patients. This showcases how deficit savings will be achieved under Obama's plan.

First, it's baffling to me that with countless government health officials on the federal payroll, nobody has been able to definitively figure out how to save Medicare from fiscal ruin. But somehow, these 15 Independent Payment Advisory Board pencil pushers will do the trick? Unless Superman, Wonder Woman and the Flash are entering the world of public service, there is no reason to believe that the same bureaucrats who got us into this mess will be able to solve the problem simply because they've joined a newly created panel