Dear Democrats, please stop helping Paul Ryan kill Medicare

What the hell are these Democrats doing?
Republicans are poised to advance repeal Wednesday of a critical provision in the health care reform law designed to preserve traditional Medicare — and they’ve enlisted a number of key House Democrats for the cause. [...]
At issue is the Independent Payment Advisory Board, set up by the Affordable Care Act. The IPAB would comprise of 15 experts who are presidential appointees (subject to Senate confirmation). The mandate on the IPAB is that they must contain cost without cutting benefits. So naturally, Republicans want to repeal it. The surprise is the Democrats serving up willing assistance in this right wing effort.
The House GOP’s IPAB repeal bill, set to clear the Energy & Commerce health committee today, has 17 Democratic signatories as of this writing, including some key players.

The Democratic cosponsors are Reps. Allyson Schwartz (D-PA), Barney Frank (MA), Joe Baca (CA), John Barrow (GA), Shelley Berkley (NV), Timothy Bishop (NY), Michael Capuano (MA), Kathy Castor (FL), Joe Courtney (CT), Chaka Fattah (PA), Eddie Johnson (TX), Larry Kissell (NC), Jim Matheson (UT), Bill Pascrell (NJ), Loretta Sanchez (CA), Linda Sanchez (CA) and Del. Donna Christensen (VI).

Pascrell, a member of the influential Ways & Means Committee, signed on Monday. Rep. Frank Pallone (NJ), the top Dem on the E&C health subcommittee, has not cosponsored the bill but says he’ll vote for it, according to CQ HealthBeat. Schwartz, who runs recruitment at the DCCC, is an outspoken IPAB opponent.
This is sheer madness. The Democrats who are willingly helping GOP's effort to kill Medicare by first eliminating the IPAB say that they are actually for preserving and strengthening traditional Medicare (and I believe them), but that they disagree with the IPAB because it contains costs through changes in provider reimbursements in the event that providers continue to raise costs despite multidimentional cost containment efforts - both inside and outside the ACA (see our Beyond Insurance series on cost measures in the ACA). They - and the hospital lobby - say that it's unfair to focus cuts on the provider side only.

Except that the whole argument is a farce. The IPAB is not a impediment to provider-generated smart cost control; it is a catalyst for such measures. The IPAB's authority to make changes in the reimbursement schedule will only come into play if providers fail to use the technological, medical and reform-related tools available to them to hold down costs. I want to emphasize this - health reform gives providers and facilities plenty of incentives and tools to reduce costs on their own. And in fact, it's already working. According to the latest data, health reform has already begun to hold down the growth in national health expenditures.

Hospitals and other providers have plenty of incentives and avenues to hold down costs on their own. If they do, the IPAB will have nothing to say about reimbursements. But if they don't - and only if they don't - this is basic math: if cost of care continues to rise beyond a normal growth curve, there are only two ways to contain costs: cut benefits or restructure provider payments. And if your argument is that the cost control board of experts need to be taken off the watch in such event, you're effectively supporting one of two things: Medicare going bankrupt or drastic cuts in benefits.

The argument following the complaints about provider cuts is one that laments about how Congress needs to solve the problem of cost in Medicare and not a panel of experts. Give me a break, alright? First, if Congress could solve Medicare's long term cost issues, it already would have. Second, what's stopping them? There is nothing keeping Congress from coming up with a long term solution to Medicare costs now making the IPAB obsolete. Repealing the IPAB does nothing whatsoever to contain costs, and the Congress has no solutions. Before complaining about "unelected bureaucrats," maybe Congress needs to look in the mirror and confront the elected gridlock looking back at it.

Whatever motivation dragged these Democrats into this, this needs to stop. They need to realize that the GOP's repeal IPAB effort is nothing but a new step towards ending Medicare altogether. Without cost containment, it's easier to scream about how Medicare needs to be ended because it's costing too much. These Democrats supporting the IPAB repeal are wrong need to stop helping the Republican efforts to end Medicare. Tell them so!

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