Writing an Op-ed for Politico.com Kathleen Sebelius, Secretary of HHS defends the Independent Payment Advisory Board for Medicare in a purely political piece. She notes correctly that the Board is prevented by law from recommending rationing. However, there are many ways to ration care that are not called rationing. And if one is trying to lower costs, indeed if you are charged with being the main element in that effort, you must reduce the use of health care services and or the price you pay for each of those services. Either way someone gets less directly or indirectly. Don’t get me wrong, I am all for reducing unnecessary health care and there is a great deal of that to deal with.
However, talk about misleading, Secretary Sebelius, while pointing out what the Board cannot do, loses site of the fact the Advisory Board is prevented from doing so many things and is specifically directed to focus on Medicare Parts C and D, that it has little room to affect direct cost savings. Here is what the law says:
The Board is to consist of 15 members with expertise in health care financing, delivery, and organization. All members are to be appointed by the President and confirmed by the Senate. Proposals are to primarily focus on payments to MA and PDP plans and reimbursement rates for certain providers
In addition, the PPACA already contains about 165 initiatives including Accountable Care Organizations (ACAs), partnerships to lower hospital readmissions, more comparative effectiveness studies (all good stuff) and much more. It is hard to see what else the Board can come up with that is not duplicative. How can we know what are good new recommendations until we know if all the trial programs also part of the law work? In addition, the Board’s recommendations must be effective so far into the future that any cost savings will be many years away.
Read the provisions of PPACA applicable to the Board for yourself in the link below:
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