Winners and Losers in the Great IPAB Debate

Margaret Dick Tocknell, for HealthLeaders Media , March 28, 2012

Toss-up: Medicare
It's great that Medicare sustainability is being talked about and ideas are being put on the table. But does anyone really think that Congress is ready to act? IPAB is a backstop in case Medicare costs get out of hand. Our elected officials can't continue to fret about Medicare's future while they decline to implement any reimbursement reductions. As it stands now, the sustainable growth rate (SGR) formula remains in place and there doesn't seem to be any agreement in Congress about what to do next. The IPAB, if it survives, will force Congress to act—although even that decision is years away.


Winner: Republicans
Republicans in the House effectively framed the IPAB debate as their effort to defend seniors from a rationing board. This presents a strong campaign opportunity to appeal to Medicare beneficiaries, and it will be top of mind for senior voters. Did I mention that Republicans equate IPAB with a rationing board? That's their story and they're sticking to it.

Loser: Democrats
The Democrats simply cannot cook their arguments down to simple sound bites. Much of the IPAB debate has consisted of Republicans using the term "rationing board" and the Democrats providing long-winded explanations of why IPAB is not a rationing board. Of course, Democrats used the term "rationing board" multiple times in the process.

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