Sticking with the theme of an unconstitutionally strong federal bureaucracy, National Review‘s Rich Lowry explores the power wielded by the federal Health and Human Services secretary:

The text of Obamacare is dry and legalistic, except when it summons the majesty of the King James Bible to intone imperiously, ?the secretary shall . . .?

The secretary in question is the secretary of health and human services, Kathleen Sebelius, who ?shall? and ?may? do all manner of things to complete the great unfinished canvas that is Obamacare. As George W. Bush might say, Sebelius is ?the decider.? Because of the discretion she?s granted to remake American health care, she rivals Nancy Pelosi, Hillary Clinton, and Oprah Winfrey as the most powerful woman in America.

The New York Times reported the other day that HHS has created a version of the ?death panels,? in Sarah Palin?s famous coinage, that were stripped out of the law after an uproar in 2009. Why did we bother having that fight, with all its fiery accusations, if Kathleen Sebelius and her underlings could simply act at their discretion?