Yesterday, I argued that given the pressure Medicare spending places on the federal budget, Republicans would be crazy to repeal the cost controls in the health care law and would probably maintain some version of the IPAB board if they actually regain power. But the Minnesota Start Tribune reminds me that the sponsors of the kill-IPAB bill are two Republican lawmakers — Sen. John Cornyn (R-TX) and Rep. Phil Roe (R-TN) — whose constituents would probably face the highest cuts:
No surprise that Texas is where many of these higher-cost providers are clustered. A high concentration is also in Tennessee, home of Republican Rep. Phil Roe, author of the House companion bill to Cornyn’s legislation. Both politicians disingenuously pitch their bills as getting bureaucrats out of health care. In reality, the bills are all about protecting special interests back home. In doing so, these bills would obliterate one of the most promising proposals to date to get the deficit under control.
This is a good point that’s worth reiterating. The IPAB was designed to free lawmakers from having to make the kind of decisions that could reduce health care costs by cutting someone’s paycheck back home. (As the old adage goes, the difficulty in controlling health care spending rests in the fact that one man’s waste is another man’s profit.)
Reforms that change the payment structure and encourage providers to deliver care in new, more integrated ways, may be the future of health care, but they’ll likely force providers in the highest spending areas to take the biggest cuts. Under the law, the board’s reports become law unless Congress enacts its own proposals to achieve the same level of cuts. With hospitals insulated from any reductions until 2018, doctors’ payments are likely to get hit. And that’s exactly why Cornyn and Roe are speaking out.