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akuma587 said:

I heard a pretty good article on NPR today talking about something like this.  They were talking about a pretty good idea of having an independent commission (which can be defined in a lot of different ways) decide what procedures are necessary based on their effectiveness rather than having government officials or insurance companies make that decision.  I thought it was a pretty good idea, and a politically palatable one for most people.

http://www.npr.org/templates/story/story.php?storyId=103458129

The problem is... that tends to not work well. 

Decisions like that are far too "case by case" basis.  So you end up with what they have in the UK.

Different commissions for each region.

The problem being this leads to unequal and uneven treatment among areas... making healthcare even more arbitrary and a "postcard lottery" for treatment.

It would probably be state based.