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Howard Dean Sells Out: Monday Health Care Lobbyist Smackdown Weblogging


The government already sets rates for Medicare, through the RVS and the RUC process.

The Independent Payment Advisory Board--IPAB--is an attempt to set rates in a less-stupid and more evidence-based way.

Thus Howard Dean claiming that "the ACA's rate-setting won't work", thereby telling his readers that the creation of IPAB introduces rate-setting into some equilibrium of free-market prices for Medicare, is Howard Dean being mendacious to try to protect the profits of the clients of McKenna, Long, & Aldridge. It is not Howard Dean weighing in on public policy trying to make America a better place.

Shame on Howard Dean. Disgraceful.

Howard Dean:

Howard Dean: The Affordable Care Act's Rate-Setting Won't Work: Experience tells me the Independent Payment Advisory Board will fail…. The [ACA] law still has its flaws, and American lawmakers and citizens have both an opportunity and responsibility to fix them. One major problem is the so-called Independent Payment Advisory Board. The IPAB is essentially a health-care rationing body. By setting doctor reimbursement rates for Medicare and determining which procedures and drugs will be covered and at what price, the IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them…. Rate setting--the essential mechanism of the IPAB--has a 40-year track record of failure…. Bureaucrats… are making medical decisions without knowing the patients… these kinds of schemes do not control costs….

The nonpartisan Congressional Budget Office has indicated that the IPAB, in its current form, won't save a single dime before 2021. As everyone in Washington knows, but less frequently admits, CBO projections of any kind--past five years or so--are really just speculation…. The IPAB… will almost certainly make the system more bureaucratic and therefore drive up administrative costs. To date, 22 Democrats have joined Republicans in the House and Senate in support of legislation to do away with the IPAB. Yet because of the extraordinary partisanship on Capitol Hill and Republican threats to defund the law through the appropriations process, it is unlikely that any change in the Affordable Care Act will take place soon…. When, and if, the atmosphere on Capitol Hill improves and leadership becomes interested again in addressing real problems instead of posturing, getting rid of the IPAB is something Democrats and Republicans ought to agree on.