Former Vermont governor and Democratic National Committee Chairman Howard Dean has had plenty of good things to say about Obamacare, but he does not believe an independent board that can determine health-care cost rates and services — dubbed a “death panel” by its most vociferous detractors — will work as intended.
The Independent Payment Advisory Board (IPAB) — “essentially a health-care rationing body,” Mr. Dean writes — has “no possibility” of working to curb health care costs and “will almost certainly make the system more bureaucratic and therefore drive up administrative costs.”
“By setting doctor reimbursement rates for Medicare and determining which procedures and drugs will be covered and at what price, the IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them,” Mr. Dean writes in a piece in the Wall Street Journal.
There does have to be control of costs in our health-care system, Mr. Dean writes, but rate setting “has a 40-year track record of failure.”
“What ends up happening in these schemes (which many states including my home state of Vermont have implemented with virtually no long-term effect on costs) is that patients and physicians get aggravated because bureaucrats in either the private or public sector are making medical decisions without knowing the patients,” he writes. “Most important, once again, these kinds of schemes do not control costs. The medical system simply becomes more bureaucratic.”
He does write that President Obama’s health-care overhaul could eliminate duplicative services, and that health-care benefit exchanges will provide patients with competitive plan options.
But Mr. Dean writes that in order to have a secure future, the country has to move away from fee-for-service medicine, “which is all about incentives to spend more, and has no incentives in the system to keep patients healthy. The IPAB has no possibility of helping to solve this major problem and will almost certainly make the system more bureaucratic and therefore drive up administrative costs.”
The IPAB was labeled a “death panel” by Republicans in the run-up to the 2010 midterm elections; among its most prominent critics was former Alaska Gov. Sarah Palin.
On the campaign trail last year, Rep. Paul Ryan, the GOP’s vice presidential nominee, said that with the board, Mr. Obama “puts a board of 15 unelected, unaccountable bureaucrats in charge of Medicare, who are required to cut Medicare in ways that will lead to denied care for current seniors.”
PolitiFact rated the claim “mostly false,” but Mr. Dean has provided some high-profile bipartisan opposition to the board.
“The IPAB will cause frustration to providers and patients alike, and it will fail to control costs,” Mr. Dean wrote. “When, and if, the atmosphere on Capitol Hill improves and leadership becomes interested again in addressing real problems instead of posturing, getting rid of the IPAB is something Democrats and Republicans ought to agree on.”