What the Washington Post Gets Right…And Wrong
In this morning’s editorial, “This Cost-Cutting Reform Deserves a Chance,” the Washington Post paints opposition to the Independent Payment Advisory Board as largely political, or parochial, in nature. Republicans, the Post argues, want to sink one of President Obama’s initiatives before it can get off the ground, while some Democrats take issue with a non-elected board carrying out responsibilities that belong to Congress.
In making these points, the Post editorial goes off the rails early by focusing too heavily on inside-the-Beltway political banter. In fact, opposition to IPAB extends well beyond conventional White House-v-GOP partisan skirmishing. As of today, over 400 patient, healthcare, employer, veteran and disability organizations from all 50 states have signed a letter to Congress urging an immediate repeal of IPAB.
That kind of strong grassroots sentiment transcends partisan gamesmanship.
That’s not to say the Post editorial is entirely offbase. Actually, the opinion piece is right on the mark in saying that the Medicare status quo cannot stand and that Washington politicians have been negligent in not pursuing substantive change to address the program’s serious financial problems.
The newspaper is dead wrong, though, in asserting that IPAB represents a workable solution to this problem. The editorial pulls out what have become, by now familiar canards – that IPAB will be made up of healthcare experts, that the law creating it specifically forbids any kind of healthcare rationing. The simple fact is, though, that IPAB’s structure, in which changes must be made immediately in order to get program spending below an arbitrary level, will limit the board’s realistic options to cutting payments for healthcare services.
In some policy circles, chopping Medicare reimbursement levels is referred to as bringing greater efficiency to the program. In the real world, though, it means fewer physicians seeing Medicare patients and less beneficiary access to new healthcare innovations. The law may say that IPAB can’t recommend rationing, but reduced access to care is an inevitable result.