Arguably the most important thing we can do to limit the growth in health care costs is learning to say no; we cannot afford a system in which Medicare in particular will pay for anything, especially when that’s combined with an industry structure that gives providers a strong financial incentive to engage in excessive care.
So naturally, the Independent Payment Advisory Board, which is the first step toward making rational choices, is under attack.
Mainly the attack is coming from Republicans, who want to dismantle Medicare, not save it — their proposal is that instead of having Medicare make choices based on expert advice, we should give seniors inadequate vouchers and let insurance company executives make those choices instead.
But there are some Democrats in opposition too. Some really want Congress to make these decisions — although you really have to wonder how they can believe that’s realistic. Others, as Jonathan Cohn notes, have suspiciously close ties to industry groups that benefit from the system’s current inefficiency.
The thing is, we’re going to make choices eventually, one way or another. Should the choices be made by medical professionals, or should we rely on the kindness of corporations?
