iPhone app iPad app Android phone app Android tablet app More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
Doug Schoen

GET UPDATES FROM Doug Schoen
 

The Independent Payment Advisory Board Could Be Obama's Achilles' Heel

Posted: 07/26/11 11:48 AM ET

As President Obama continues to push for an ambitious deficit-reduction deal in advance of the August 2nd deadline for raising the debt limit, one thing is clear: Medicare reform will be a critical part of any budget agreement -- now and in the future.

And while essential to curbing our government's rising spending, reform must be done in a way that protects policies and programs that work while eliminating or avoiding policies and programs that prove both costly and ineffective.

For conservatives, Independents and a growing number of Democrats, the Independent Payment Advisory Board (IPAB) that was created with the passage of last year's health care law represents the worst of health care reform. IPAB would allow an unelected board to singularly enact spending cuts in the Medicare program through binding recommendations to reduce Medicare spending.

Last weekend, Reps. Tim Bishop of New York and Eddie Bernice Johnson of Texas were the latest Democrats to join the increasing bipartisan effort that opposes IPAB as they signed on as co-sponsors of Rep. Phil Roe's bill to repeal it. Quite simply, IPAB has so many opponents because it embodies centralized planning from Washington, D.C., and enables unelected bureaucrats to make decisions about people's health care. The contrast couldn't be more clear: a new government body (IPAB) charged with taking resources away from the beloved Medicare program.

Further, IPAB is a threat to critical medical treatments and services for all Medicare beneficiaries. Proponents of the board have argued that IPAB will improve the quality of care as a result of the cost-cutting measures it enacts in order to save. However, it is doubtful this will happen because the board will have to make cuts that reach annual targets. Thus, standard line item cuts will result, which will only reinforce systemic problems, not fix them, and create unsustainable savings.

Major changes in the Medicare program should be decided by elected officials who will be held accountable for their decisions. Such an arbitrary system lacks transparency and oversight, and according to the Congressional Budget Office, IPAB will save no money over the next decade because Medicare spending won't hit the threshold level to activate its powers.

Health care reform gets far greater savings from ideas that no one objects to, like developing new approaches to delivering health care services and creating policies that support medical innovation. The president can help health reform's sustainability by tossing the unnecessary baggage and leaving the primary engine intact.

When the health care bill was still working its way through Congress, more than 70 Congressional Democrats sent a letter to Nancy Pelosi asking that IPAB be excluded from the final legislation. Today, many Congressional Democrats share doubts and concerns held among conservations and Independents regarding IPAB, but they are reluctant to move against the preferences of President Obama.

It would be to President Obama's long-term political advantage to give his fellow Democrats subtle signals that they can act to repeal IPAB. In so doing, they would bolster their credentials as Medicare champions, killing a "mistake" that serves no purpose except to chop Medicare budgets.

President Obama would still maintain the heart of health care reform, full coverage of the uninsured and delivery reform innovation without IPAB in the equation. By allowing Congressional Democrats to repeal IPAB, he will also strengthen his party's chances to increase their numbers on Capitol Hill while losing nothing of any real policy consequence. As someone who has been involved in Democratic politics for more than three decades, it's as close to a win-win as one can get.

 
As President Obama continues to push for an ambitious deficit-reduction deal in advance of the August 2nd deadline for raising the debt limit, one thing is clear: Medicare reform will be a critical pa...
As President Obama continues to push for an ambitious deficit-reduction deal in advance of the August 2nd deadline for raising the debt limit, one thing is clear: Medicare reform will be a critical pa...
 
 
  • Comments
  • 54
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Bloggers
Recency  | 
Popularity
Page: 1 2  Next ›  Last »  (2 total)
photo
HUFFPOST BLOGGER
Linda Bergthold
Health policy consultant
07:35 PM on 07/28/2011
Do you prefer that these health care decisions be made by your oh-so-accountable elected officials? Just watch Congress tonight. They can't make a decision on anything! The IPAB was set up to look at Medicare with some objectivity, unencumbered by lobbyists or big money donations. It has accountability to Congress, which can overturn its recommendations. But the panel would be made up of people who actually understand health care - patients, physicians, researchers. What's so awful about that? The worst thing about the IPAB is that it may not have enough power to really make changes in the health care system that will save money without sacrificing quality. Read about the IPAB before you start ranting about it.
http://www.huffingtonpost.com/linda-bergthold/independent-payment-advisory-board_b_851565.html
HUFFPOST SUPER USER
Cleverboots
03:49 PM on 07/28/2011
He's made some bad choices and IPAB is one of them.
scipio2009
Alan Wolfe's "The Future of Liberalism"
04:21 PM on 07/27/2011
not gonna happen
HUFFPOST SUPER USER
larry putman
pyrgist
01:21 PM on 07/27/2011
Layering government panels throughout the medical industry will cause serious bureaucratic red tape. I am curious of how many stamps of approval will be needed to get medical treatment. Think in the end, government inefficiency and union domination will create costs overruns that will be required for us to pay more money or threatened that we will lose our medical treatment. We will be in a lose, lose situation.
photo
HUFFPOST SUPER USER
Bart DePalma
Bart DePalma
01:20 PM on 07/27/2011
IPAB is the bureaucracy which is supposed to impose the half trillion in Medicare cuts required to finance Obamacare. Killing off the dictatorial board throws Obamacare into immediate deficit in 2014, unless of course you kill off Obamacare with it.
photo
Democrat in the South
Empathy, the most important word
01:02 PM on 07/27/2011
Just saw a commercial in my red state for AARP backed Medicare part B? plans. No wonder AARP backs cuts in Medicare....
12:15 PM on 07/27/2011
Getting rid of IPAB on the grounds that "it embodies centralized planning from Washington, D.C," is pointless so long as Medicare, a massive federal bureaucracy that utterly swamps IPAB in scale, continues to exist.

"Major changes in the Medicare program should be decided by elected officials who will be held accountable for their decisions."

That's why elected officials hide behind behind unelected bureaucracies. They have no interest in being held accountable for anything, especially in the demise of Medicare.

And, make no mistake, Medicare will collapse. It's a something-for-nothing scheme that cannot be sustained in the long run and the responsible thing to do is start phasing it out now, before catastrophic collapse hurts a lot of people. That won't happen, of course, because politicians are fundamentally irresponsible.
10:58 AM on 07/27/2011
I'm so glad we had to pass it to see what's in it. I wonder what other well thought out parts of this horrible monstrosity will come to light. Well done, Dems.
09:25 AM on 07/27/2011
It is also amazing how otherwise presumably sane individuals can make ill informed comments. The board is specifically prohibited from making recommendations that would ration care. It also does not dictate. Congress still has the power to reject changes they put forward. As I said earlier, I'd rather trust professionals who are not beholden to the insurance companies to make these kinds of decisions.
09:43 AM on 07/27/2011
Yes I much prefer professionals beholden to the government. LOL
09:20 AM on 07/27/2011
Put decisions about my health in the hands of those turkeys you chose to call "elected officials". You must be joking.
09:10 AM on 07/27/2011
For obamacare to be affordable care this has to stay. Other countries that have healthcare run by the country limits what care you recieve. So a few people have to die it will be cost effective. They are not death panels as they do not kill people they just do not treat them or give them exams that could keep them alive. How can the affordable healthcare plan be affordable without IPAB. Maybe this is what you get when you pass bills without reading them. How many of you have tried to read the obamacare bill?
01:47 PM on 07/27/2011
johnvilvens--you said "They are not death panels as they do not kill people they just do not treat them or give them exams that could keep them alive."

WHAT is the difference? That they may not specifically tell patients they are going to die, just that they are going to be denied treatments/procedures/tests that may save their lives.

Did you bother to read what you wrote?
photo
wonketteRAWKS
Hypocrisy is prevalent in BOTH parties!
08:30 PM on 07/27/2011
Did you bother to read all of what johnvilvens wrote?
08:25 AM on 07/27/2011
Things like THIS are why Obama's bill had to be passed so quickly without anyone actually reading it.

ObamaCare is going to destroy both the economy and health care in America.
09:59 AM on 07/27/2011
Yep. This was republican legislation which benefits insurance companies over individuals.
10:56 AM on 07/27/2011
I guess you missed this part, which shows us you lie: "For conservatives, Independents and a growing number of Democrats, the Independent Payment Advisory Board (IPAB) that was created with the passage of last year's health care law represents the worst of health care reform"
photo
intolleft
ObamaTAX...getting you shovel ready
08:20 AM on 07/27/2011
IPAB = Death Panel.
photo
HUFFPOST SUPER USER
wallyone
08:19 AM on 07/27/2011
What? IPAB is probably the best item in health care reform. And it needs an appointed board. So many, many procedures are done that are not necessary. So much money is spent on procedures that are not effective, and do not help produce a positive outcome. Our MDs have no idea of cost effective medicine, and this has to change.
photo
HUFFPOST SUPER USER
Mistinguette Grandison
No. Corporations are NOT people
08:18 AM on 07/27/2011
The Archilles' heel would be his pacifism and his desire for bipartisanship w/o recognizing that compromise means both sides get a bit of what they want equally and both sides fall short.