Et Tu, Gephardt?

Reporting on Politics and Policy.
June 22 2011 8:04 AM

Et Tu, Gephardt?

The former Democratic leader of the House writes an op-ed calling -- gently, gently -- for the repeal of the Independent Payment Advisory Board.

Under the new law IPAB has been made responsible for suggesting and implementing cuts to Medicare. It is critical that Congress continue to be able to fulfill its duty to the American people and maintain direct oversight of Medicare on behalf of their constituents. Changes to Medicare's payments should be based on careful consideration of the Medicare program itself -- and not arbitrary budget targets.

Under the current law, IPAB will be an unelected and unaccountable group whose sole charge is to reduce Medicare spending based on an arbitrary target growth rate. It will propose cuts to Medicare that Congress can override only with supermajority votes, an unnecessarily high and unrealistic bar. Just as important, these cuts are likely to have devastating consequences for the seniors and disabled Americans who are Medicare's beneficiaries because, while technically forbidden from rationing care, the Board will be able to set payment rates for some treatments so low that no doctor or hospital or other healthcare professional would provide them.

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He sounds awfully concerned, but why? We look for clues in the client list provided by Gephardt Government Affairs. And we see: the radiation oncology company Accuray, the Council for Medical Innovation, the Cyberknife Coalition -- which demonstrates its wares like this:

And we go on to eHealth, ISCON ("whole body imaging solutions without radiation"), pHRMA, and United Health Group.

Anyway, I'm stumped. Can we think of a reason Gephardt wants to get rid of IPAB?

David Weigel is a Slate political reporter.