August 15th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
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In recent weeks, several Democrats and some health reform advocates including the AMA have joined Republicans in calling for a repeal of provisions in the new health law that create the Independent Payment Advisory Board (IPAB). For these people, IPAB represents the worst aspects of the new law–an unelected, centralized planning authority empowered by government to make decisions about the peoples’ health care. Arbitrary cuts to providers, short-sighted decisions that stifle innovation and rationing of care are sure to follow, they claim.
While it’s true that the rules governing IPAB are flawed and should be fixed, eliminating IPAB altogether would be a mistake. Read more »
*This blog post was originally published at Pizaazz*
May 28th, 2011 by Glenn Laffel, M.D., Ph.D. in News
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“The combined profits of the Fortune 500 increased by 81% this year, the third largest gain in history. Compare that to the unemployment rate, which fell by just 8% over the past 12 months.” Ezra Klein, while analyzing last week’s jobs report by the Federal Government.
“Why would I listen to ‘lub dub’ when I can see everything?” Eric Topol, a cardiologist in San Diego who carries a portable ultrasound device with him in lieu of a stethoscope. The device lets him and his patient see the heart muscle and valves, and blood flow into and out of the organ.
“There probably is not a whole lot that we can do at the pipeline level to dramatically improve the number of students choosing primary care. Where the money is, is where the money is.” Mark Schwartz, an associate professor at the NYU School of Medicine, discussing a study showing that high medical school debt and low compensation are driving people away from General Internal Medicine.
“It sounds like a new Apple product.” Bara Vada, describing IPAB, the Independent Payment Advisory Board, a controversial panel tasked by the Affordable Care Act to make binding recommendations to reduce Medicare spending. Read more »
*This blog post was originally published at Pizaazz*
May 18th, 2011 by Shadowfax in Health Policy, Opinion
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I shouldn’t do this. It’s madness to try to delve into the minds of conspiracy theorists and try to make sense of their ravings. But I can’t help myself; I’m drawn like a moth to the flame. It never ends well. I only wind up with a horde of trolls in the comments telling me that I’m a glib supercilious idiot and should stick to medicine or go die in a fire or something.
Sometimes it’s too hard to stay away. Maybe it was the personal affront I felt in the false imputation of ill motives onto progressives. Maybe it was the gross errors in fact, sitting there ripe for the plucking. I don’t know, but I just can’t resist a rebuttal to Dr Rich at Covert Rationing, who weaves a technocratic cost control body into a paranoid web of fantasy, concluding that:
Progressives are dedicated to “progressing” to a perfect society, and they know just how to achieve it. … Specifically, the Progressive program requires individuals to subsume their own individual interests to the overriding interests of the collective – and human nature just doesn’t function that way. Thus, the Progressive program inevitably relies on a cadre of elites – those who have dedicated themselves to furthering the Progressive program – to set things up the right way for the rest of us, while manipulating we in the teeming masses to let them. And the rest of us, once the correct programs and systems are in place, will at last understand that it was all for our own good.
I suppose this paragraph tells you everything you need to know … about Dr Rich. Any supposition that he was approaching the view of policy with a fair mind or that he is willing to attribute anything but the worst motivations to those on the other side of the aisle is completely shredded by this paragraph. As rhetoric goes, it’s up there with “Conservatives want old people to die in pain.” So we can scratch Dr Rich off the list of people who are willing to discuss health care policy with a neutral mindset. He’s engaged in a holy war of ideology. Read more »
*This blog post was originally published at Movin' Meat*
May 18th, 2011 by DrRich in Health Policy, Opinion
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In the speech President Obama gave responding to Congressman Ryan’s budget plan (the one in which he lured Ryan to sit in the front row in order to be publicly pilloried), the President did something DrRich did not think he would do before the next election. He openly invoked, and openly embraced, the Independent Payment Advisory Board (IPAB) as the chief mechanism by which Obamacare will control the cost of American healthcare.
“IPAB” might be a new term to many Americans, but DrRich pointed his readers to this entity, within a few weeks of the passage of Obamacare, as the lynchpin (and a very scary lynchpin at that) of the whole enterprise.
Until President Obama’s recent “outing” of IPAB, however, this new board has been almost entirely ignored by most commentators. Since the President’s speech, of course, many have written about it, either to celebrate it or to castigate it. (Of all these commentaries, DrRich most highly recommends the analysis provided by Doug Perednia at the Road to Hellth. In fact, DrRich recommends Perednia in general, as he is regularly producing some of the most insightful commentary, anywhere, on health policy.)
DrRich does not wish to simply repeat here all the observations that have lately been made by others regarding the IPAB. Rather, he will emphasize three particular features of the IPAB, features which are remarkable indeed, and which will tell us something very important about our Progressive leaders. Read more »
*This blog post was originally published at The Covert Rationing Blog*
