Wednesday, June 8, 2011

RationCare Becoming More Unpopular

Politico this morning had an article describing how the Independent Payment Advisory Board (IPAB) created in the health care law is losing popularity even among Democrats (most of whom supported it by voting for the law in the first place).  As a reminder, the IPAB is a board of unelected, unaccountable bureaucrats directed to make binding rulings on reducing Medicare spending – and the Medicare actuary and others have indicated that IPAB’s arbitrary reductions in spending will likely reduce access to care for seniors (hence the term “RationCare”).

The Politico piece notes that RationCare “is facing a groundswell of opposition from unexpected corners,” and that “for more than a year…supporters of the reform law who didn’t like the IPAB were willing to put up with it for the greater good of the law.  But in recent weeks, that support has waned.”  Seven Democrats have signed on to a House bill repealing the board, and “others also have suggested privately that they would support the bill if it comes to the House floor.”  In other words, House Democrats are prepared to vote AGAINST RationCare, after having voted FOR it as part of the health care law last year.

In his column yesterday, David Brooks took on the fatal premise of RationCare – namely, that a group of bureaucrats can micro-manage the health decisions of the entire American health system:

In the age of the Internet and open-source technology, the Democrats are mad to define themselves as the party of top-down centralized planning.  Moreover, if 15 Washington-based experts really can save a system as vast as Medicare through a process of top-down control, then this will be the only realm of human endeavor where that sort of engineering actually works.

After having voted for the bill and supporting it for more than a year, it’s slightly comforting to see Democrats reconsidering their position.  (Speaker Pelosi famously said we had to pass the bill to find out what’s in it – and maybe these Democrats have finally found out what’s in the RationCare provisions of the law.)  But the bigger question is why anyone could be so presumptuous – even arrogant – ever to have believed that 15 bureaucrat “experts” can fix all of what’s wrong with Medicare and the American health care system.