[HarryHirsch]

Access to healthcare is firmly in the bailiwick of Congress. Hell, the rest of the First World has similar authorities that determine what drug gets to market, their criteria are similar, and their healthcare metrics aren't nearly as awful as the United States.

And for the "career bureaucrats", if you want a modicum of stability you need them, you can't have elections or change the rules every other year - what you need is institutional memory and predictability.