By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    stress disorder
    5 Ways To Manage Post-Traumatic Stress Disorder
    October 27, 2021
    Medical device classification and development strategies
    Medical device classification and development strategies
    April 5, 2023
    varicose veins
    Varicose Veins Prevention: 3 Lifestyle Changes to Make Right Now
    May 1, 2022
    Latest News
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
    The Hidden Impact Of Stress On Your Body’s Alignment And Balance
    May 22, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    health benefits of gene targeting research
    Breakthroughs in Gene Targeting in Mouse Can Help Humans
    December 4, 2022
    Weighing Up the Advantages and Disadvantages of Nursing Homes
    October 31, 2022
    get second opinion to avoid medical errors
    The Role Of Second Opinions In Medical Errors
    December 10, 2023
    Latest News
    Top HIPAA-Compliant Messaging Apps for Healthcare Teams
    June 25, 2025
    When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
    June 20, 2025
    Preventing Contamination In Healthcare Facilities Starts With Hygiene
    June 15, 2025
    Strengthening Healthcare Systems Through Clinical and Administrative Career Development
    June 13, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Misinformation About IPAB
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Health Reform > Misinformation About IPAB
BusinessHealth Reform

Misinformation About IPAB

gooznews
Last updated: June 9, 2011 4:13 pm
gooznews
Share
7 Min Read
SHARE

David Brooks’ op-ed in the New York Times earlier this week attacking health care reform’s Independent Payment Advisory Board has set off a mini-firestorm in the liberal blogosphere. Brooks claimed IPAB would impose centralized planning over health care decision-making, while the alternative Republican plan — vouchers — would let consumers decide how much insurance and how much health care they should buy.

David Brooks’ op-ed in the New York Times earlier this week attacking health care reform’s Independent Payment Advisory Board has set off a mini-firestorm in the liberal blogosphere. Brooks claimed IPAB would impose centralized planning over health care decision-making, while the alternative Republican plan — vouchers — would let consumers decide how much insurance and how much health care they should buy. Brooks went on to say the fight over IPAB will be a defining battle between the two ideologies contending for power in the U.S. — decentralized free-market choice and centralized planning.

Whew. That’s an awful lot of baggage to pile onto a board that the Congressional Budget Office says will pare all of $15.5 billion from overall Medicare spending between 2015 and 2019. For those keeping score, that compares to $400 to $500 billion in other Medicare cost reductions in the reform law.

Some very strong and insightful responses to Brooks came from the New Republic’s Jon Chait and Jonathan Cohn and the Washington Post’s Ezra Klein, who touched on most of the key points that help explain why more centralized health care systems have lower costs, allow for more rational decision-making in health, and deliver better results. Today Paul Krugman joined the fray, highlighting an unsigned blog post from the Economist, which I hadn’t seen yet. That’s why I’m writing. That British-based magazine inaccurately describes IPAB, which will be far less influential than either its opponents or proponents claim.

More Read

Occupy With Grace
A “Bundle” of New Learning Resources for Health Care Providers
Consumer Survey: The Virtual Waiting Room
Comorbidity of Mental and Physical Illness
EHR’s a Money Loser (Or is It?)

In attacking Brooks, the Economist writes:

Patients aren’t going to experience a loss of freedom or satisfaction because an expert reviewer at the Independant Payment Advisory Board makes the call as to whether a procedure is medically beneficial, rather than the corresponding bureaucrat at their insurance provider or at the for-profit clinic they’re attending.

If wishes were fishes. The law Congress actually passed, as opposed to the one that pro-IPAB pundits think passed, gives this 15-member body far less power than similar bodies in Europe. It cannot, by law, ration care. It cannot, by law, tinker with benefits or limit access to specific technologies if they are deemed not cost-effective. Even the use of comparative effectiveness research is constrained in the reform law.

The sole power IPAB is granted in the legislation is to pursue reduced costs through changes in payment policy. It can replace fee-for-service with bundled payments or pay-for-performance schemes. It can reward accountable care organizations with penalties for lousy care and incentives for higher quality care. Moreover, whatever IPAB recommends must be passed by Congress, which also has the option of substituting its own cost-cutting measures.

The fact is the IPAB will have much less power than comparable boards in Europe. In fact, it doesn’t even have as much power as comparable boards at insurance companies, which are unelected and operate without transparency. They actually get to make medical coverage decisions based on their cost-effectiveness. Of course, even an insurance company can’t avoid a government mandate like the recently enacted “you must cover mammography screening,” which is a terrible waste of money for certain age groups.

That’s why Brooks’ endorsement of Rep. Paul Ryan’s claim that IPAB is 15 unelected bureaucrats rationing care is a flat-out lie. If IPAB reduces payments to physicians and hospitals through, say, a bundled payment scheme to ACOs, those hospitals and doctors will be the ones rationing care. The big change in their lives is that they will get less money to accomplish their job — delivering high quality care. Given the estimated 30 percent waste in the health care system, I’m betting that they’ll be able to figure out how to do it once they’re put on a money diet. In other words, the reform law and by extension IPAB put “rationing” power where it belongs — in the hands of the people who are directly responsible for delivering medical care.

The Republican voucher scheme, on the other hand, will require individual seniors to make those choices. They will do that either by buying scaled back insurance  policies (the limited vouchers offered by Medicare will lead to most seniors purchasing far less comprehensive plans than the current benefit). Or those seniors will deny themselves needed care because they can’t afford the ever-rising co-pays and deductibles, which is how market-based solutions always ration care.

Medicare is destined to spend less in the future than current projections. So take your pick as to which rationing scheme you prefer. You can either have insurance companies and an individual senior’s personal wealth determine what gets rationed. Or you can have your doctors and other providers make those decisions.

I prefer the latter. At least the Economist got that right. As the European experience shows, centralized systems with capped budgets almost everywhere lead to better outcomes, lower costs and universal coverage.

TAGGED:healthcare businesshealthcare reformIPAB
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

women dental care
What Is a Smile Makeover and How Much Does It Cost?
Dental health
June 30, 2025
HIPAA-Compliant Messaging Apps
Top HIPAA-Compliant Messaging Apps for Healthcare Teams
Global Healthcare Policy & Law Technology
June 25, 2025
recovering from injury
Rebuilding After Injury: Path to Physical and Emotional Recovery
News
June 22, 2025
scientist using microscope
When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
Global Healthcare
June 18, 2025

You Might also Like

California Hospital Association Sues HHS

November 5, 2011
Leah Binder
BusinessFinanceHospital AdministrationPublic Health

New Era of Healthcare: Transparency, Candor and Pointed Questions

May 14, 2014

True Value Telehealth

December 13, 2013

Doctors on Google: Manhattan Research Survey 2012

July 23, 2012
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?