"Obamacare," the new national health care law, is so flawed as to be, in many ways, the worst thing to happen to Americans worried about the cost and availability of medical care. Conservatives in Congress are pointing out a serious concern for the 47.6 million older Americans who rely on the Medicare program.
Under the law, the government will set up an Independent Payment Advisory Board to monitor Medicare spending. If costs increase beyond certain levels and Congress fails to rein them in, the IPAB would have power to restrict spending.
Defenders of the proposal note the IPAB would not be permitted to ration medical care, force patients to pay more, increase the Medicare eligibility age or limit benefits.
That would leave the board with few options other than reducing reimbursements to Medicare providers. History has shown several times that when government cuts health care program reimbursements, many providers stop accepting patients. Fewer providers accepting Medicare patients would have the effect of rationing care.
U.S. Sen. Jay Rockefeller of West Virginia has been a key defender of the IPAB concept. He does not believe Congress would act to contain Medicare costs in the future, meaning some system like the IPAB would be needed to do so.
"The system now is that people come up here that work the Congress like crazy, lobbyists making millions of dollars. The Congress often doesn't know how to say no. And the Congress has the practice of never saying no. And costs go up," Rockefeller told an Associated Press reporter.
Lobbyists also exert pressure on the executive branch of government, of course.
Leaving critical Medicare decisions up to an unelected board working under a White House subject to its own political agenda makes no sense. Congress should do its job, and a good first step would be to repeal the IPAB provision.