One of the more pernicious legacies of Obamacare is the provision in the law for the establishment of an Independent Payment Advisory Board (IPAB). This layer of bureaucracy would empower 15 people to find ways to reduce the costs of Medicare. These decisions should be made by just over a dozen minimally accountable appointees operating under the concept that technocrats know best. Congress needs to eliminate the power of the IPAB, before the board can take action.
The IPAB is the epitome of central planning and an abdication of congressional responsibility. According to the Centers for Medicare and Medicaid Services, “Medicare spending grew 4.5% to $646.2 billion in 2015,” which represents 20% of national health expenditures. Moving forward, Medicare costs are expected to continue to nearly double over the next decade. This rate of increase in spending is simply not sustainable. But potential reforms by the legislative branch are politically fraught.
That is one of the reasons why the IPAB was enshrined as part of Obamacare. Medicare exists to “provide health insurance to individuals 65 and older, and has been expanded over the years to include permanently disabled individuals under the age of 65.” Since it impacts the permanently disabled and seniors, reforming Medicare is one of the dozens of third rails in American politics. The IPAB takes advantage of the politically difficult choices that Medicare growth poses and provides a solution based on expediency and punting policy: leave this problem to a board of experts who never have to concern themselves with being elected or reelected to fix Medicare.
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