Howard Dean is getting paid by health care providers to say the Independent Payment Advisory Board won’t work. That is what he does for a living now: leveraging his credibility with liberals to get bad information about health care further past their bullshit detectors than a regular hospital spokesperson could. Jonathan Cohn reminds us what Howard Dean has been up to since leaving the DNC:
Since his career in politics ended, Dean has found a home in the K Street establishment he once held in such disdain. He’s a strategic adviser to McKenna, Long, and Aldridge, a major Washington lobbying firm whose clients have included health care and pharmaceutical companies. Dean has never registered as a lobbyist, as far as I know, but the distinction is largely illusory. In 2009, one CEO told the publication BioCentury that Dean was “very helpful” in their efforts to loosen federal regulations on drug development.” Another said that “Dean has been a great addition to our team.” It looks like he still is.
The reason the fight over the IPAB is so silly is because we already have a health care payment advisory board. It is called the Specialty Society Relative Value Scale Update Committee. That is who sets prices and reimbursement rates for Medicare and Medicaid now. But they are not a government board. They are a board at the American Medical Association, where they are not the least bit accountable to the taxpayers. Naturally, the prices they think providers should be paid are laughably high, but so far this has gone unchallenged.
So IPAB is an effort to bring in other stakeholders (insurers, providers, health economists, patient advocates, and other experts) to do the same basic thing and break the RUC’s strangehold. But in one of the more disappointing water-downs, Congress decided that this counterweight to the RUC would only come into being if the Affordable Care Act’s cost control targets weren’t being hit. And Congress is allowed to overrule IPAB if they can find equivalent savings.
This is a relatively toothless board, but it’s easy to see why the people who pay Howard Dean have paid him to argue against it. They prefer to have more money!
What is not clear to me is why Allyson Schwartz hates the IPAB so much, and wants to let the AMA set reimbursement rates for the public insurers. Though she recently voted with the Democrats against the latest Republican attempt to kill off IPAB, she keeps giving opposition quotes to reporters every time House Republicans go after this. And she is still introducing bills to increase the prices public insurers pay to providers in the country with the highest health care costs in the world.
Until something changes, at this point I fail to see how Democrats can trust Allyson Schwartz to implement Obamacare and bring down Pennsylvania’s health care costs, when her recent work on this issue has been pushing in the opposite direction.