After CBO Director Doug Elmendorf pointed out on the Hill yesterday that the House health care legislation, admirable though it is in ensuring affordable coverage for everyone, doesn’t really do anything to “bend the curve” of health care cost growth, DC is now refocusing on putting the reform in health reform. In particular, John Cohn says the administration is going to put more emphasis on the obscure proposal to change the Medicare Payment Advisory Commission into something that works better:
As first reported by David Rogers in Politico, the administration is effectively calling to reconstitute, and strengthen, MedPAC–a commission that now advises Medicare on how it pays for medical services and wares. The recommendations of this new commission, which the administration would call IMAC (the Independent Medicare Advisory Commission), would go into effect automatically, unless either the President or Congress decided to block them. It’s similar to an idea that Senator Jay Rockefeller and Representative Jim Cooper have been promoting in their respective chambers. Orszag called it “the most important game-changer” now on the table.
This is a good idea. One of the main facts about American politics is that “Congress” and “sound management of public policy issues” aren’t really concepts that go together. This is obviously a pretty profound problem with our political institutions, but it’s often possible to work around it by getting congress to change default rules in this kind of way.