• IPAB repeal effort heating up again

    Efforts to repeal the IPAB are heating up again in both the House and Senate (overview from KHN; link to a gated Politico Pro story this morning). I reproduce below a post from last Summer that provides a series of links on the recent history of the idea of boards to improve quality and/or address costs (shorter: boards have experts and they do good things if you appoint them; they are bureaucrats and do bad things if your opponents appoint them).

    update: Energy & Commerce health subcommittee voted 17-5 to repeal IPAB (two Democrats joined all Repbulicans in voting for repeal).

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    I am pulling together several related posts that I have done suggesting that the Independent Payment Advisory Board (IPAB) is similar to two boards proposed in Title VIII of the Patients’ Choice Act (PCA), the most comprehensive Republican health reform plan offered in the 111th Congress. That doesn’t mean they are exactly the same, but does mean that some of the criticism levelled against IPAB by Republican critics is either uninformed about the advocacy for such boards by leading Republicans in the past, or seems hypocritical to me. It is also possible that Republicans have simply changed their mind, but then I would expect them to say that, and to lay out why they recently supported such boards, but no longer do so.

    Both the PCA and the ACA proposed boards that were insulated in some manner from Congress to make health policy decisions. In this way, IPAB is a prime example of a policy idea that ended up in the Affordable Care Act (ACA) that had its genesis in a Republican sponsored bill, or line of policy thought. It is an example of something that appeared to be bipartisan in policy terms (the need for boards insulated from Congress) that became politically toxic once it appeared in the ACA.

    Here are the posts I have written on the topic.

    • General argument that IPAB is similar to the boards suggested in the PCA, from May, 2011.
    • Responding to unelected bureaucrats/unconstitutional charges by showing that boards proposed in PCA were similar in structure, Monday July 11.
    • Focus on what IPAB could do in policy terms as compared to what boards in PCA were proposed to be able to do, Tuesday July 12.
    • Reaction from House Budget Committee spokesman to my blogging, and my response, Tuesday July 12.
    • ThinkProgress did a nice table comparing IPAB to boards in the PCA, Wednesday July 13.

    Other relevant information.

    • Text of the Patients’ Choice Act, Title VIII p. 206-215 are the portions relevant to this discussion. Introduced on May 20, 2009 and co-sponsored by Ryan and Nunes in House; Burr and Coburn in Senate.
    • Text of the ACA, sec. 3403 p. 982-1,033 lays out the IPAB
    • Kaiser has a comprehensive overview of the IPAB
    • Column I wrote on July 24, 2009 in the Raleigh, N.C. News and Observer on the Patients’ Choice Act

    Note: as stated in several posts, there are some Democrats who oppose IPAB as well.

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    • Pallone??!!

      I’m uncertain how many liberal Dems oppose IPAB. But they are fools to do so. (For the record, I’m a liberal Dem.)

      They are fools, because the healthcare system will likely not be able to control costs sufficiently on its own. IPAB will certainly force us to make some painful choices. But Congress hasn’t done sufficiently, and we need to take it out of Congress’ hands. And liberal Dems need to realize that we cannot only squeeze providers to slow healthcare cost growth.

      The moderate/conservative Dems who would vote against IPAB I can understand a bit better, but they’re equally as foolish, imo.

      • The fools are those in Congress who refuse to change anything about the malpractice system, or should I say dysfunction.

      • My fairly liberal Democratic representative, Allyson Schwartz, opposes IPAB. When you look at how much of her campaign $ comes from medical & pharmaceutical companies, you can guess why.