The House health care reform bill would establish a new entity called the Health Choices Administration, headed by a presidential appointee to be called the Health Choices Commissioner. Sounds wonderful, right? A government official whose only job is to make sure you have health care choices, right?

No. If you read the bill – Title I, Subtitle E, Sections 141-143, on pages 41-48 – it turns out that the Health Choices Commissioner’s job is, essentially, to make your health choices for you.

The Health Choices Commissioner will decide what services health insurance must cover, and under what conditions. These choice (“standards”) will apply to both employer-sponsored insurance and insurance purchased through the Health Insurance Exchange, which will be operated by the Health Choices Administration. There will be no other legal way to buy health insurance. There will, however, be a “Qualified Health Benefits Plan Ombudsman” to provide you with “assistance” in “choosing a qualified health benefits plan in which to enroll” – from among the plan or plans the Commissioner has already chosen, of course.

In choosing what services your health plan will cover, the Health Choices Commissioner will be required to consult with various entities, such as State attorneys general, the National Association of Insurance Commissioners, “other appropriate federal agencies,” and Indian tribes. However, Commissioner will not be required to consult with patients (except for Indian tribes), doctors, or other health care providers.

The Health Choices Commissioner will naturally have the right to audit anyone offering a health plan – even employers – and will be required to perform “random compliance audits” as well as “targeted audits in response to complaints or suspected non-compliance.” Furthermore, “The Commissioner is authorized to recoup from qualified health benefits plans reimbursement for the costs of such examinations and audit.” In other words, if your health plan gets audited, your health plan or your employer has to pay whatever the government claims is the cost of the audit – even if your health plan or employer did nothing wrong, and was not even suspected of doing anything wrong. Those costs will have to be passed along to in the form of higher premiums or lower pay for you.

In fact, your employer’s competitors could run your employer out of business – and you out of a job – by filing bogus complaints about your health plan, which will then be investigated at your employer’s expense!

The Health Choices Commissioner is authorized to impose penalties on any private health plan or employer, including civil monetary penalties and suspension of enrollment. No trial, hearing, or even evidence will be required to impose these penalties – the only requirement is that the Commissioner “determines” that a violation has occurred.

And when Commissioner imposes a penalty, there is no procedure for an appeal of the Commissioner’s decision, nor any requirement that the Commissioner present any evidence of the violation. In short, none of the normal constitutional protections will apply.

The so-called “Health Choices Commissioner” will be the closest the United States has come to having an absolute ruler since King George III.