Changing Medicare: Guinta, Bass go the right way
New Hampshire's Congressmen voted for HR 5, which would eliminate the Independent Payment Advisory Board (IPAB). That is a 15-member panel that, despite its name, does more than advise. Under Obamacare, if Medicare spending exceeds set targets in any given fiscal year, the IPAB would identify specific reductions to bring spending below that year's target. If Congress does not approve different reductions of at least the same size by August, the IPAB cuts take effect automatically.
What would be the effect? Kaiser Health News reports that 'Hospitals, doctors, drug companies and some patient groups are worried IPAB will recommend reductions in Medicare payments - which they say already are too low - and that they won't have the time or ability to counter the cuts during accelerated congressional action.' If the IPAB cuts provider payments significantly, it will do for Medicare what Medicaid payment cuts are doing for that program: reducing the number of physicians participating, thus increasing waits and limiting options for patients. If it recommends not funding certain treatments, that also would limit patient options.
Democrats attacked House Budget Committee Chairman Paul Ryan, R-Wisc., for his proposal to convert Medicare into a premium-support model. Starting a decade from now, Ryan would let seniors use their Medicare money to choose between a government-run Medicare plan and private alternatives. The competition would keep costs down. Democrats say Ryan would 'end Medicare as we know it.' If that is true for the Ryan plan, it is true for Obamacare too.
The difference is that Ryan tries to control costs by giving seniors choices and letting them shop around. Obama tries to control costs by appointing 15 government bureaucrats to impose cuts. Either way, Medicare changes. Bass and Guinta support change that empowers seniors to make their own choices; Obama wants 15 bureaucrats to make those choices instead.