Rep. Paul Ryan took another
pot shot at one of the administration's answers to increasing costs for Medicare, the Independent Payment Advisory Board. The board is a group of providers and health policy experts charged with reviewing payments for services covered by Medicare in order to reduce costs without lowering the quality of care. The IPAB has been a major target of Republican attacks.
But a group of health policy experts and economists like the idea a lot, and have written to Congressional leaders asking them to "back off their many attempts to repeal the health reform provision."
"We believe that an independent board is essential to promote, monitor and implement reforms that improve Medicare and the nation's health care system," they wrote.
The signers include notable centrist health economists, including Alice Rivlin of the Brookings Institution, along with many liberal health policy scholars.
"There are a lot of unreasonable fears about the IPAB. It's been associated with death panels and stuff like that," Rivlin told POLITICO in an interview. "I view it as a much more benign device to improve the efficiency of delivery systems in a lot of different ways. I don't think it's going to be some technocratic horror."
The economists and health care experts who signed the letter argued that the board will encourage providers to deliver health care more efficiently.
"The IPAB is a tool designed to help the Congress slow the rapid projected increases in health care costs in the federal budget and to improve the delivery of health care," the group wrote in its May 20 letter. "Increases in Medicare, Medicaid and the private sector could be slowed by giving providers greater incentives to adopt more cost-effective treatments and prevention interventions."
That would be Alice Rivlin, formerly of the Ryan-Rivlin healthcare plan. Providers and industry groups are predictably opposed to the whole idea, and have been pushing repeal. It takes reimbursement rates, to a degree, away from the political realm where providers can have direct lobbying influence. It allows this board to evaluate treatments and weed out the ineffective ones, a pretty common-sense and benign approach to cost control, as these independent experts who signed the letter attest.
But don't expect a politely-worded letter to cool the fervor of the repeal crowd. They'd much rather end Medicare than fix it.