Healthcare: GOP Should Rethink Opposition to Health Care's Cost-Control Board

in the GOP's zeal to repeal a bill it considers a deficit-increasing nightmare, Republicans are focusing their fire on the parts they should like: The cost controls.

On July 27, Sen. Jon Cornyn (R-Tex.) introduced the Health Care Bureaucrats Elimination Act, co-sponsored by Sens. Orrin G. Hatch (R-Utah), Jon Kyl (R-Ariz.), Pat Roberts (R-Kan.) and Tom Coburn (R-Okla.). The legislation doesn't seek to repeal health-care reform (though many Republicans would also like to do that). Instead, it takes aim at perhaps its most promising cost control: the Independent Payment Advisory Board.

[It will be composed of] 15 presidential appointees, each confirmed by the Senate. They'll be drawn from the health-care industry, academia, think tanks and consumer groups. Their reform proposals will have to pass through Congress, but they will have some advantages: If Congress doesn't act, their recommendations go into effect. If Congress says no but the president vetoes Congress and the veto isn't overturned, their recommendations go into effect. If Congress wants to change their recommendations in a way that'll save less money, it will need a three-fifths majority. Oh, and no filibusters allowed.

The hope is that this will free Congress to permit cuts by making it easier for them to dodge the blame. "Putting the knife in someone else's hand will be a relief," says Robert Reischauer, director of the Urban Institute and a former director of the Congressional Budget Office. "It will allow Congress to rant against the cuts without actually stopping them."

Republicans have zeroed in on the board as a soft target in their campaign to gut the health-care reform bill. "In true fashion of Obama- Reid-Pelosi hubris," Cornyn said, "the IPAB is the definition of a government takeover." A government takeover of . . . Medicare?

Putting aside the metaphysics of the government taking over a government program, Cornyn makes two arguments, and they show the difficulty Republicans are having opposing health-care reform without opposing fiscal responsibility and much-needed deficit reduction.

One of his arguments is that IPAB would take these decisions away from Congress, which is more accountable to voters (and thus hasn't been able to make any of these decisions). "America's seniors deserve the ability to hold elected officials accountable for the decisions that affect their Medicare," he said.

Cornyn knows this, and so his other argument is that Congress buckled before lobbyists and that IPAB doesn't go far enough. "Special-interest groups cut deals with Democrats to specifically exempt hospitals, 28 percent of Medicare's budget, from the IPAB's ax," his statement points out.

For more, see GOP Should Rethink Opposition to Health Care's Cost-Control Board by Ezra Klein, August 15, 2010 at The Washington Post.