Who Decides: Bureaucrats or Patients?
The New York Times this morning has a good article and the Wall Street Journal an editorial highlighting the bipartisan opposition to the Independent Payment Advisory Board. The board was created in the health care law to enforce an cap on overall Medicare spending; President Obama’s deficit plan proposed lowering the cap even further. The Times piece features quotes from lawmakers in both parties expressing concern to the idea of unelected bureaucrats micro-managing the Medicare program. Perhaps the definitive quote came from (of all people) Rep. Pete Stark, a self-described San Francisco liberal: “In theory at least, you could set [Medicare] vouchers at an adequate level…But, in its effort to limit the growth of Medicare spending, the board is likely to set inadequate payment rates for health care providers, which could endanger patient care.”
Apart from the fact that even liberals won’t defend the IPAB – and believe a Medicare “voucher” may be superior to a Medicare program subject to payment cuts imposed by bureaucrats – other important questions remain:
- The Times piece notes that “in general, federal courts could not review actions to carry out the board’s recommendations.” That prohibition on judicial review is one of 14 separate instances in the health care law where Democrats acted to block patient lawsuits against bureaucrat decisions. Why do Democrats OPPOSE enacting reasonable limits on private-sector lawsuits, but SUPPORT banning patients from suing government bureaucrats outright? And if the IPAB will not harm Medicare beneficiaries, why did Democrats feel the need to prohibit patients from filing lawsuits against these bureaucrats’ proposals?
- The Times also notes that the Administration “has yet to submit any nominations” for the IPAB. If the IPAB will be so positive for Medicare and for seniors, why has the President failed to put forth his choices for the board he finds so important? Last year President Obama nominated to head the Medicare program an appointee so controversial that Democrats refused to hold a confirmation hearing. Is the President now deferring his IPAB selections until after his re-election – and if so, what does that say about the board’s unpopularity?
- The Wall Street Journal editorial correctly points out that “decades of government faith in omniscient miracle workers” – aka government bureaucrats micro-managing prices for a $500 billion program – “has left Medicare in its present shambles.” President Obama says he wants to “improve” Medicare, but with the Medicare program adding to the deficit by tens of billions of dollars – and scheduled to become insolvent entirely within the coming decade – how much more “improvement” by unelected bureaucrats can the program stand?
One of the fundamental questions surrounding entitlement reform involves the extent to which patients will control their health care choices, as opposed to unelected bureaucrats. The fact that one of the House’s most prominent liberals suggested a Medicare voucher program could be preferable to the President’s approach should provide a cautionary tale to those who believe a panel of unelected officials can and should be allowed to manage the health care choices of millions of American seniors.