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The Right-Wing Assault On The IPAB and on Sane Health Policy

Jonathan Cohn:

Here We Go Again, With the Death Panels: The... Independent Payment Advisory Board, or IPAB... an independent commission, staffed by experts appointed by the president and Congress... to alter Medicare payments in order to make the program less expensive. The concept has been kicking around for a long time, on the theory that Congress shouldn’t be micromanaging Medicare reimbursement schemes. And something like the IPAB already exists. But the current version, called the Medicare Payment Advisory Commission.... IPAB’s proposals to change Medicare will go into effect anytime the program's cost growth exceeds a certain threshold....

Republicans, meanwhile, have attacked the idea almost from the get-go, saying it would become an instrument of government-imposed rationing. It’s the IPAB that some conservative critics have likened to “death panels,” on the unfounded theory that it would cut off access to valuable, life-saving treatments. The House Republican budget calls explicitly for repealing the IPAB.... But now some Democrats are joining the calls for repeal.... The Democrat leading the charge against the IPAB right now, for example, is Allyson Schwartz, a self-proclaimed New Democrat....

Why does Schwartz want to get rid of IPAB? In a letter announcing her intentions, Schwartz said it was undemocratic to hand over that authority to a commission. And that's a legitimate (if, in my view, unpersuasive) argument. But a quick look at Schwartz's campaign finance history, from OpenSecrets.Org, shows that she receives a great deal of support from the health care industry. It’s her top source of political action committee contributions and her fourth largest source of contributions overall. It's the health care industry (hospitals, drug makers, insurers) that would feel the brunt of IPAB cost-cutting efforts.... [I]n the eyes of the Congressional Budget Office and many experts, the IPAB’s presence bolsters the Affordable Care Act’s ability to hold down the cost of health care. And it does so in a far more humane way than, say, giving seniors vouchers that would buy only a fraction of the coverage Medicare provides now.

Is that the sort of rationing that opponents of IPAB would prefer?