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Cost-control board under ACA probably doomed

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“Politics: A strife of interests masquerading as a contest of principles. The conduct of public affairs for private advantage.”

— Ambrose Bierce


Healthcare economic interest groups have the knives out for the Affordable Care Act’s Independent Payment Advisory Board, which is charged with finding ways to curb some costs in what is by far the world’s most expensive healthcare “system.” That system has by far the highest paid physicians and health-system executives but health indices near the bottom of the Developed World.

“IPAB is not a tool to improve the value of the Medicare program,” asserted Mary Grealy, president of the Healthcare Leadership Council, the group that is spearheading the repeal push. “Rather, it’s a blunt instrument intended to reduce what Medicare pays for treatment. IPAB was a fatally flawed concept from its inception, and now, as we’re on the verge of its activation, it’s a very real danger and needs to be prevented.”

Med Page Today noted: “The IPAB was designed to be a 15-member independent body that would make recommendations on cuts to the Medicare budget; if Congress didn’t agree with the IPAB’s recommendations, it would have to devise its own plan to cut the Medicare budget by an equivalent amount.”

But it must confront huge lobbying efforts aimed at maintaining, or even increasing, the revenue and profit flow to players  in the healthcare sector. Given the very pro-business stance of the incoming Trump administration, it’s probably safe to assume that  the IPAB will be killed, with rhetoric that the killing is being done for the benefit of the patients rather than for the wealth of those working in the healthcare sector.

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