July/August 2011 Friends Like These

Buried in Obamacare is a secret weapon to contain Medicare costs. Meet the group of House Democrats who want to destroy it.

By Sebastian Jones

True to form, when Allyson Schwartz announced she would support the Republican effort to repeal IPAB, her first action was to send around a “Dear Colleague” letter. A few weeks later, an op-ed in USA Today followed; in it, Schwartz wrote that IPAB “has the potential for stifling innovation.” Not surprisingly, the only others discussing IPAB in terms of its “innovation stifling” effects have been the drug industry and its allies.

As of early June, only a handful of Democrats have signed on as cosponsors to Phil Roe’s bill, including one other New Democrat, Nevada’s Shelley Berkley. But we already know how many in the New Democrat coalition feel about an independent board to help reduce Medicare costs: during health care reform, several signed letters opposing its formation. And if past is prologue, the question is not whether other New Democrats will join Schwartz, but how many will do so, and when.

If an IPAB repeal bill passes the House with a couple dozen or more Democratic votes, it will set in motion a cascade of events that could end very badly for Barack Obama and his administration’s efforts to rein in long-term federal spending. What would once have seemed a partisan—and hence dismissible—Republican attack on a core pillar of the president’s health care reform will instead have a bipartisan glow. The Beltway media, long fixated on bipartisanship as an automatic indicator of worthiness, will quickly deem the bill to be the moderate position and IPAB as bureaucratic overreach. Indeed, industry groups are already touting Democratic opposition and labeling the repeal effort, in the words of a recent PhRMA press release, “a bipartisan issue,” knowing the value that label confers.

From there, it’s not hard to imagine what comes next. For Democratic senators wishing to come to the aid of their friends in the health care industry, the bipartisan sheen generated by the New Democrats’ support would provide cover for them to desert the White House and join Republicans in support of a Senate version of a bill killing IPAB. If enough of them do so, Senate Majority Leader Harry Reid will be under tremendous pressure to allow a floor vote, and if the bill passes, the president will find himself in a terrible bind.

On the one hand, he could sign the bill, but that would mean killing off the single most important cost-cutting and reform-enforcing element of his signature legislative accomplishment. That seems unlikely, especially given that in his April speech at George Washington University he made strengthening IPAB central to his plan for further deficit reduction.

More likely, since the bill probably won’t garner a vetoproof majority, Obama will simply veto it, and thus preserve IPAB. But this will be politically costly in an election year, especially for a president who has spent much of his first term portraying himself as a champion of bipartisanship and who is staking his reelection bid on winning over independents. It’s hard to imagine, then, that the New Democrats will be able to repeal IPAB before the 2012 election. But, by joining with Republicans in the attempt, they may well succeed in turning Medicare from a winning issue for Democrats into a losing one.

Sebastian Jones is an editor at the Washington Monthly.


  • humanetigor on June 21, 2011 12:29 PM:

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    (attention, it is not the ad of the site - it is the ad of the Truth).

  • Florca on June 21, 2011 2:56 PM:

    This was apparent along time ago.You guys are a little late to catch on... These guys have been on the case for months:

    ...The Obama administration’s policies, in health care as in every other sphere, are tailored to the interests and demands of the financial elite. As the Times itself all but admits in its editorial, the Obama health care plan was not a progressive reform, but the first step in an assault on social benefits. It is part of an escalating campaign to eliminate every social gain of the working class made in the 20th century, in the United States and internationally..."


  • IUPAPAW on June 21, 2011 11:52 PM:

    anyone voting against social security and medicare is not looking to be re-elected

  • Nancy Irving on June 22, 2011 3:43 AM:

    This piece is excellent.

    The GOP, with the collusion of conservative Democrats, are demagoguing IPAB by calling its mission "rationing." Rationing implies depriving people of *needed* treatments, the exact opposite of what IPAB is tasked to do, namely, to dispense with useless or harmful treatments in order to improve outcomes while addressing health care cost inflation.

    I can offer personal testimony that it is not patients who are driving the anti-IPAB story.

    I was diagnosed with cancer a few years ago. I underwent chemotherapy, radiation, hormone therapy, and, really, more than I can even remember.

    I hope that all of these treatments were effective and did me good. But all were unpleasant or exhausting, caused debilitating side-effects, and some may have permanently affected my future health.

    Believe me, if a board like IPAB had produced good empirical evidence that *any* of these treatments were ineffective, I (and I think, most patients) would have been the first to say, please don't give me this treatment. If conservatives want to call this "rationing," then, please, bring it on!

    This article is absolutely correct: conservatives in the pay of drug and device manufacturers would like us to believe that IPAB will deprive patients of needed treatment. But IPAB's mission is actually the opposite: to save patients from undergoing unnecessary and even harmful treatment.

    Thanks for pointing this out so clearly.

    P.S. Florca, why not read the article before posting. It demonstrates the exact opposite of what you seem to be saying.

  • GoozNews on June 22, 2011 5:47 PM:

    Great piece. But I would worry less about Obama losing senior votes because he vetoes an IPAB repeal bill than his signing it because he buys the basic argument: that lowering costs and ridding Medicare of wasteful tests, drugs and procedures will somehow "choke off" innovation. That's always been industry's trump card.

    The reality is just the opposite. The high prices industry charges for new technologies, whose addition to medical value almost always remains unproven, has made medicine among the least efficient industries in America.

  • IUPAPAW on June 28, 2011 4:04 PM:


  • Fred Adler on June 29, 2011 6:33 PM:

    It would be very useful if someone pointed out that with current health care costs (caused by many different reasons some popular and some not so popular) are not sustainable using taxes. And that increasing taxes on "everyone else" won't work either because with the demographic freight train bearing down on us, there just will never be enough money to pay for the level of health care "given" (they certainly used more money than they put in) to seniors during the last couple decades. There just is not enough money. Look at your SS statement some time see how much money you actually put into the system and ask yourself, how much do you think you will take out. First move, take the "special program" away for all government workers and make them use only social security and their own savings and contributions for retirement and make them use only Medicare. How can they fix the system when they don't have the incentive to fix it for themselves? Now, they just buy votes...........that is there only incentive. They call it serving their constituency but really it is buying votes. Often that is buying votes and contributions from "interested parties". Stop that now. There is not enough money. There are not enough people paying enough to maintain the current system since our parents had 3 children and we had a little more than 1. Not enough people paying it forward.

  • tom h on July 07, 2011 11:56 AM:

    It's interesting that when Michael Moore in "Sicko" attacks the mean nasty health insurance companies (non-union private employees) for denying coverage, refusing to pay for certain types of treatment etc the ins companies are the devil. When the Medicare burocracy (federal unionized workers) does the same thing it's much needed reform and it's a great thing.

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  • appletree on July 17, 2011 3:42 PM:

    Excellent article. I will make sure that Congresswoman Schwartz hears from me. Loudly.

  • a on August 03, 2011 12:30 AM:

    This article is a massive smear job. It is stuffed full of assertions about others' motives while making no attempt whatsoever to substantiate those assertions and while making no attempt whatsoever to falsify the targets' own explanations for their actions.

    As such, both the article and its author are utterly ignorable.

  • Crissa on August 08, 2011 7:43 PM:

    You ever notice how an article like this comes up, and comments (with no or little reasoning) spring up without any citations?

    Why can't medicare be supported by taxes? Demographics! ...Why, though? It's not just supported by taxes, it's supported by user-fees as well. There's no reason it can't continue to work. If you think the growth of medical costs can't be sustained... That's a different issue.

    You never see these negative comments ever wondering why people in the US pay several times more for the same services.

    And you never see these negative comments ever differentiate between paying for things which the evidence says doesn't work, vs paying for things which are cheaper now than later!

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  • GreenRaccoon on August 16, 2011 3:11 AM:

    IPAB sounds like an absolutely brilliantly crafted idea to restrain the effect of the destruction of Medicare should the cost of medicine, itself, and particularly the cost of pharmaceuticals, [hopefully] leading to the improvement of our overall patent system to reign back on the length of monopolies that were once GIVEN to them and other inventors and producers long ago when such action was still needed. Today, the long, and perhaps efforts to make it longer, have caused a problem in the cost of medical delivery in this country, not present in others, as can be seen by the greatly variant costs that are present for such care in other similar nations. Thus, I can easily see why drug lobbyists have leaned on on both their Republican and Democratic friends to disallow or, better, the deletion of the IPAB authorization article from the Affordable Care--just in case it was needed after all. Let's hope that since the matter has been brought to the attention of at least some well read Americans, our Congressmen, and hopefully President Obama
    by that time, to press hard NOT to let it be removed. Thank you Mr. President.Thanks you for such foresight.

  • Evergreen2U on August 19, 2011 5:23 PM:

    Looked up the "New Democrat Coalition" referred to in this article. Sounds like they back the neoliberalism that is subsuming democracy...money to the top crappola. Pasted from their website below:

    In March 2005, the New Democrat Coalition (NDC) in the U.S. House of Representatives was re-launched and the New Democrat Coalition PAC was established soon after. Thanks to great support in Washington and across the country, the NewDemPAC is thriving.

    NewDems have built a reputation as effective leaders on the critical issues of technology policy, economic growth, security and personal responsibility. Intent on modernizing both the Democratic party and the country, New Democrats support policies to expand economic growth and ensure that all Americans have the opportunity to benefit; a fiscally responsible and efficient government; a secure home front; and a robust foreign policy that includes trade, constructive U.S. leadership throughout the world, and a modern and strong military.

    We encourage you to help us ensure that our leaders continue to have the support they need to be a strong voice in Congress.

    Joe Crowley, NY
    Joe Crowley
    New York 7th
    NewDem Coalition Chair Ron Kind, WI
    Ron Kind
    Wisconsin 3rd
    NewDem Vice Chair Allyson Schwartz, PA
    Allyson Schwartz
    Pennsylvania 13th
    NewDem Vice Chair Jim Himes, CT
    Jim Himes
    Connecticut 4th
    NewDem Coalition Vice Chair Rick Larsen, WA
    Rick Larsen
    Washington 2nd
    NewDem Coalition Vice Chair Jason Altmire, PA
    Jason Altmire
    Pennsylvania 4th
    NewDemPAC Chair

    John Barrow, GA
    John Barrow
    Georgia 12th
    Shelly Berkley, NV
    Shelly Berkley
    Nevada 1st
    Lois Capps, CA
    Lois Capps
    California 23rd
    Russ Carnahan, MO
    Russ Carnahan
    Missouri 3rd

    John Carney, DE
    John Carney
    Delaware, At-Large
    Andre Carson, IN
    Andre Carson
    Indiana 7th
    Gerry Connolly, VA
    Gerry Connolly
    Virginia 11th
    Jim Cooper, TN
    Jim Cooper
    Tennessee 5th
    Joe Courtney, CT
    Joe Courtney
    Connecticut 2nd
    Susan Davis, CA
    Susan Davis
    California 53rd
    Eliot Engel, NY
    Eliot Engel
    New York 17th
    Gabrielle Giffords, AZ
    Gabrielle Giffords
    Arizona 8th
    Charles Gonzalez, TX
    Charles Gonzalez
    Texas 20th
    Colleen Hanabusa, HI
    Colleen Hanabusa
    Hawaii 1st
    Martin Heinrich, NM
    Martin Heinrich
    New Mexico 1st
    Brian Higgins, NY
    Brian Higgins
    New York 27th
    Rush Holt, NJ
    Rush Holt
    New Jersey 12th
    Jay Inslee, WA
    Jay Inslee
    Washington 1st
    Carolyn McCarthy, NY
    Carolyn McCarthy
    New York 4th
    Mike McIntyre, NC
    Mike McIntyre
    North Carolina 7th

    Gregory Meeks, NY
    Gregory Meeks
    New York 6th
    Jim Moran, VA
    Jim Moran
    Virginia 8th
    Chris Murphy, CT
    Chris Murphy
    Connecticut 5th
    Bill Owens, NY

    Bill Owens
    New York 23rd
    Ed Perlmutter, CO
    Ed Perlmutter
    Colorado 7th
    Gary Peters, MI
    Gary Peters
    Michigan 9th
    Pedro Pierluisi, PR
    Pedro Pierluisi
    Puerto Rico
    Jared Polis, CO
    Jared Polis
    Colorado 2nd
    Laura Richardson, CA
    Laura Richardson
    California 37th
    Cedric Richmond, LA
    Cedric Richmond
    Louisiana 2nd
    Loretta Sanchez, CA
    Loretta Sanchez
    California 47th
    Adam Schiff, CA
    Adam Schiff
    California 29th
    Kurt Schrader, OR
    Kurt Schrader
    Oregon 5th
    David Scott, GA
    David Scott
    Georgia 13th
    Terri Sewell, AL
    Terri Sewell
    Alabama 7th
    Adam Smith, WA
    Adam Smith

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