Howard Dean: Obamacare's Rate-Setting Mechanism Won't Work

Sunday, 28 Jul 2013 07:41 PM

By Greg Richter

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One of the key provisions of Obamacare -- the Independent Payment Advisory Board -- is useless in keeping costs down, and will only add to bureaucracy, says former Democratic National Committee Chairman and Vermont Gov. Howard Dean.

Dean generally likes the Patient Protection and Affordable Care Act, popularly known as Obamacare, but he has a few quibbles with it, he writes in a Sunday Wall Street Journal op-ed.

The Independent Payment Advisory Board is a "health-care rationing body," Dean explains, which has the power to set rates for certain procedures for Medicare and determine which procedures and drugs will be covered.

"The IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them," he said.

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While Dean agrees that costs need to be contained, he says the mechanism that will run the IPAB -- known as rate-setting -- has a 40-year track record of failure.

"What ends up happening in these schemes … is that patients and physicians get aggravated because bureaucrats in either the private or public sector are making medical decisions without knowing the patients," he said.

The Congressional Budget Office has admitted that the IPAB won't save a penny before 2021, he said, but "(a)s everyone in Washington knows, but less frequently admits, CBO projections of any kind — past five years or so — are really just speculation."

Based on his own state of Vermont, and others, Dean said he believes the IPAB will never control costs.

So far, 22 Democrats have joined Republicans in Congress in an effort to kill the IPAB. Dean wants to see more join the effort, but fears current bickering is stifling the effort.

A group of Senate Republicans led by Sen Mike Lee, R-Utah, have threatened to block continuing to fund government operations past Sept. 30 if Obamacare funding is included.

"The IPAB will cause frustration to providers and patients alike, and it will fail to control costs," Dean said.


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