iPF on Forbes: Who Should Wield the Ax over Medicare?

Who knows best where to make Medicare cuts?

At least as far as Senate Minority Leader Mitch McConnell and House Speaker John Boehner are concerned, that responsibility does not belong with the Independent Payment Advisory Board (IPAB), an independent panel created by the Patient Protection and Affordable Care Act. The technocrats who will serve on the panel do not deserve to decide the medical fate of Americans, they declared.

In today’s Inside Patient Finance post on Forbes.com, “Who Do You Want to Cut Medicare, Politicians or Technocrats,” I make the case that the decision has already been made for us. Healthcare already is run by both politicians and technocrats. The Republicans, therefore, are fighting against principles they acquiesced to almost 20 years ago.

That said, their politicizing of IPAB had been an effective tactic. As the Washington Post reported earlier this year, recruiting qualified medical professionals and economists for the panel has been difficult. According to the Post:

“It is supposed to be 15 members, with limited salaries who can’t do any outside work,” says Peter Orszag, the former director of the Office of Budget and Management under Obama who was a key proponent of IPAB. “It will be challenging to find top 15 health-care experts are who would want that job.”

“You’re joining an organization that has uncertain authority with the certainty of being deeply political and widely criticized,” says Bob Kocher, a former Obama health policy adviser. “It doesn’t make sense for current thought leaders in American health care to want this.”