How the IPAB dies

Julian Pecquet of Healthwatch:

Two House Democrats have signed onto a Republican bill to repeal a health reform provision that the Obama administration has touted as a central tool to keep health costs under control [the Independent Payment Advisory Board, IPAB]. […]

[C]ongressional Democrats have been under tremendous pressure from doctors and hospitals to try to nix an unelected board that directly threatens their bottom line. Over the years, the current Medicare Payment Advisory Board has seen millions of dollars worth of recommended Medicare cuts ignored by Congress.

With Democrats reluctant to pick away at their top domestic accomplishment, Republicans have moved in with proposals to repeal unpopular provisions. Rep. Phil Roe (R-Tenn.) introduced legislation to repeal the IPAB at the start of the new Congress; he was joined by Rep. John Fleming (R-La.), a family physician, who called the IPAB a Soviet-style “central planning committee.”

File under, “why cost control is very hard.” Cross-list under, “how Congress blows it every time.” There really is no cost control solution if something like the IPAB can’t work. Pass any law you like, with any stipulations about capped rates of increase in public spending on health care. What’s to stop Congress from undoing it? Nothing. You can be for the IPAB for cost control reasons, but you can’t be against the IPAB for cost control reasons.

Can you be against the IPAB for “Soviet-style ‘central planning'” reasons? Well, what form of cost control lacks a capacity to say, “No, we’re not paying for that, but you’re free to pay for it out of your own pocket or buy supplemental insurance for it”?

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