http://www.newsweek.com/2010/08/13/a_prescription_forruin.htmlOn July 27, Sen. Jon Cornyn (R-Texas) introduced the Health Care Bureaucrats Elimination Act, cosponsored by Sens. Orrin Hatch (R-Utah), Jon Kyl (R-Ariz.), Pat Roberts (R-Kans.) and Tom Coburn (R-Okla.). The legislation doesn’t seek to repeal health-care reform (though many Republicans would also like to do that). Instead, it takes aim at perhaps its most promising cost control: the Independent Payment Advisory Board.
It’s a boring name, but the board—IPAB to its friends—is a radical idea. Over the past decade, Congress has not exactly been a profile in courage when it comes to reforming Medicare. The program might be bankrupting our country over the long run, but congressfolk face reelection every few years. So they’ve punted. Some Republicans say IPAB is just one more punt: it hands the hard decisions off to someone else. But that’s exactly why it might work.
Behind the acronym will be 15 presidential appointees, each confirmed by the Senate. They’ll be drawn from the health-care industry, academia, think tanks, and consumer groups. Their reform proposals will have to pass through Congress, but they will have some advantages: if Congress doesn’t act, their recommendations go into effect. If Congress says no but the president vetoes Congress and the veto isn’t overturned, their recommendations go into effect. If Congress wants to change their recommendations in a way that’ll save less money, it will need a three-fifths majority. Oh, and no filibusters allowed.
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We talk a lot about the deficit these days. And when we talk about it, what we’re really talking about is how to convince the bond markets that we’ll do what’s necessary to get our health-care spending under control and get our long-term budget into balance. If we don’t convince them, one day the bond markets might conclude that our political system is too weak and divided to cut the deficit, and then they’ll stop lending to us at low rates, sparking a fiscal catastrophe.
Which do you think would make them more confident? Seeing the two parties in a virtuous competition to make the cost controls in the health-care bill even stronger? Or watching as one party tries to systematically strip every cost control out of the first serious effort in memory to attack health-care spending?
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