Washington Post Editorial Board Makes the Case for IPAB

With the House of Repressive getting ready to vote on a full repeal of the Independent Payment Advisory Board (IPAB), the Washington Post Editorial Board has come out in defense of the board and against the repeal bill. IPAB, created under the Affordable Care Act, is a mechanism to try to limit Medicare's spending growth - something that has to be done if we are to get our fiscal situation under the control.

The 15-member Board would be required to make recommendations to reduce Medicare provider payments in years when Medicare spending per beneficiary grew faster than a specified target (GDP plus one percent after 2019). Congress would have the opportunity to enact alternative changes, but absent Congressional action, the recommendations would go into effect automatically.

The editorial notes:

The attack on IPAB reflects a depressing reality of the current Medicare debate and of the broader debate over entitlement reform. Politicians of both parties are fond of proclaiming their willingness to make hard choices, but reluctant, when the time comes, to do anything that would discomfit those who voted for them or helped finance their campaigns. The history of congressional oversight of Medicare underscores the willingness to spend and the reluctance to impose cuts. So Republicans attack President Obama for cutting Medicare spending and rail against an effort that promises to save even more, even as they piously assert their commitment to fiscal discipline. For their part, Democrats denounce Republicans for pushing premium support plans that would, they assert, “end Medicare as we know it,” even though all rational observers agree that the existing program, with its ever-mounting costs, cannot go on.

Perhaps enough cost savings can be achieved through innovations such as electronic medical records and delivery system reform to avoid the need to resort to more painful measures. But that happy result cannot be assumed, which is why repealing IPAB would be a mistake. An even bigger mistake would be to pretend that the current arrangement is sustainable.

The editorial makes a number a great points and is well worth the read