I’ve been criticizing Allyson Schwartz for being on the wrong side of health care cost control, so I want to take a minute to praise her for ultimately voting with the Democrats against the House Republicans’ bill to repeal the Independent Payment Advisory Board (IPAB). Nice party line vote from the PA delegation, which really warms my heart.
Unfortunately, Congresswoman Schwartz’s statement on the vote keeps talking smack about IPAB:
“My opposition to IPAB reflects my firm belief that fundamental reforms to Medicare payment and delivery systems are the most appropriate means of containing costs while preserving access and quality. With the enactment of health care reform, we are making great strides towards an efficient, integrated health care system. We are moving away from a fragmented system and expanding innovative delivery models that will improve quality and reduce the rate of growth in health care spending.”
There’s some early evidence that delivery system and payment reforms are starting to achieve the results she’s talking about. See this excellent Sarah Kliff article in today’s Washington Post.
But the whole point of IPAB is that it’s a backstop in case these reforms don’t achieve the cost control we think they will.
If costs don’t come down enough, IPAB starts coming up with more aggressive payment reforms and delivery system reforms, like the ones Schwartz supports.
Congress is allowed to prevent those reforms from taking place if they can come up with equivalent savings, but the whole reason we need IPAB is that Congress is bad at controlling costs.
If Congresswoman Schwartz is really optimistic that the reforms will work, then there’s no reason for her to be worried that IPAB will have to step in. Why get rid of the backstop?