WSJ: Obamacare Agencies Seek to Fix Prices, Limit Costs

Thursday, 24 Apr 2014 11:28 AM

By Melissa Clyne

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Obamacare’s Independent Payment Advisory Board and Center for Medicare and Medicaid Innovation are bureaucracies that hinder medical care innovation and need to be eliminated, according to a commentary in The Wall Street Journal.

"What we don't need is more bureaucratic micromanagement cloaked under the mantle of innovation," wrote Lanhee Chen, a Hoover Institution fellow and Stanford University public policy lecturer, and James Capretta, a visiting fellow at the American Enterprise Institute. "Which is why Congress should do away not just with the Independent Payment Advisory Board, but with the Center for Medicare and Medicaid Innovation as well."
 
The IPAB and its "15 supposed experts (yet to be nominated by the Obama administration)" have an agenda of imposing stricter price controls within Medicare, something that historically has led to lower quality and inducing rationing, according to Chen and Capretta.

While even many Democrats in Congress no longer support the IPAB – considered to be "an unaccountable body with the power to effectively ration Medicare services" – the Center for Medicare and Medicaid Innovation has gone largely unchecked, Chen and Capretta write.

One explanation may be its purported mission to promote more efficient payment systems and models of care, but in reality, it’s a patronage system set up to for an automatic $10 billion appropriation every 10 years, something that has resulted in the agency ballooning from 68 employees in 2012 to a planned 440 full-time workers in 2015, according to the commentary.

Ten percent of the agency’s funding is for personnel and administrative expenses.
Instead of heeding the charge to "innovate" Medicare and Medicaid, the agency actually impedes it, and Americans will be forced to deal with price controls on medical procedures, according to Chen and Capretta.

"The agency's broad mandate reveals the mind-set of Obamacare's authors," they wrote. "The premise is that the federal government is best positioned to lead an effort in innovation in medical delivery, despite all evidence to the contrary."

"The history of Medicare's payment systems over four decades is one of politicized decision-making by regulators, protection of incumbent providers, and roadblocks to new medical technologies and new ways of doing business," according to the commentary.

Healthcare delivery innovation "is necessary and can happen with reforms promoting deregulation and more intensive competition," Chen and Capretta wrote.

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