The Affordable Care Act's Rate-Setting Won't Work (Howard Dean!)

Wall Street Journal ^ | July 28, 2013 | Howard Dean

[neverdem]

Experience tells me the Independent Payment Advisory Board will fail...

--snip--

There does have to be control of costs in our health-care system. However, rate setting—the essential mechanism of the IPAB—has a 40-year track record of failure. What ends up happening in these schemes (which many states including my home state of Vermont have implemented with virtually no long-term effect on costs) is that patients and physicians get aggravated because bureaucrats in either the private or public sector are making medical decisions without knowing the patients. Most important, once again, these kinds of schemes do not control costs. The medical system simply becomes more bureaucratic.

The nonpartisan Congressional Budget Office has indicated that the IPAB, in its current form, won't save a single dime before 2021. As everyone in Washington knows, but less frequently admits, CBO projections of any kind—past five years or so—are really just speculation. I believe the IPAB will never control costs based on the long record of previous attempts in many of the states, including my own state of Vermont.

If Medicare is to have a secure future, we have to move away from fee-for-service medicine, which is all about incentives to spend more, and has no incentives in the system to keep patients healthy. The IPAB has no possibility of helping to solve this major problem and will almost certainly make the system more bureaucratic and therefore drive up administrative costs.

To date, 22 Democrats have joined Republicans in the House and Senate in support of legislation to do away with the IPAB. Yet because of the extraordinary partisanship on Capitol Hill and Republican threats to defund the law through the appropriations process, it is unlikely that any change in the Affordable Care Act will take place soon.

The IPAB will cause frustration to providers...

[tanknetter]

In the Spring of 2011 I attended the Baltimore stop of the debate series Dean was the doing with Karl Rove.

Dean was emphatic that Obamacare would fail. Almost as if it were by design. (go figure)

He explicitly stated that such a failure would be a good thing, since it would drive the adoption of single payer.

Dean’s being consistant here.

[Pontiac]

yes howard if you practice as an MD, your payments are cut each year.

Which guarantees that soon there will only be three types of doctors in the system.

The Lazy

The Incompetent.

And the Fraudulent.

Which would probably be fine with Obama because these types are faithful Democratic contributors.

[tanknetter]

Note also that Dean cages his piece as an attack on fee for service and profit motive.

[no-to-illegals]

Good Points ... Backs up why many MDs are leaving or thinking of leaving according to the reports.