The 15-member Independent Payment Advisory Board (i.e. the so-called “death panel”) included in the Patient Protection and Affordable Care Act (“Obamacare”) has run into a bit of problem: Very few want to join.
Jonathan Gruber, for example, helped lay the groundwork for Massachusetts’ health-care law and played an important role in making “Obamacare” the law of the land. So you’d think he’d be an obvious choice for the panel, right?
“No way,” he said, according to the Washington Post. “Maybe if it was a part-time gig. But full time? I can’t see it.”
And he’s not alone.
“It is supposed to be 15 members, with limited salaries who can’t do any outside work,” former director of the Office of Budget and Management under Obama Peter Orszag said. “It will be challenging to find top 15 health-care experts are who would want that job.”
“You’re joining an organization that has uncertain authority with the certainty of being deeply political and widely criticized,” said former Obama health policy adviser Bob Kocher. “It doesn’t make sense for current thought leaders in American health care to want this.”
The creators of “Obamacare” claim the board’s chief purpose is to keep the cost of Medicare in check by changing the amount of Medicare’s doctor payments (in the past, these changes have been left up to legislators). And it’s because the panel has the power to amend these payments while also coming up with new ways to “deliver high quality care for less,” as the WaPo puts it, that critics of the law claim it will lead to rationed medicine.
“The Independent Payment Advisory Board brings unpredictably and uncertainty to providers,” said Rep. Allyson Y. Schwartz (D-Pa.). She favors doing away with the board altogether.
Perhaps one of the reasons the Obama administration is struggling to find people to lead the board is because the process involved in becoming a member if fairly grueling: You have to first qualify and then you have to make it through the confirmation hearings.
“It’s not only the challenge of finding people who will serve but also people who will serve and can get confirmed by the Senate,” said Harvard professor John McDonough.
Furthermore, as laid out in the healthcare law, board members will be “individuals with national recognition for their expertise in health finance and economics, actuarial science,” and related medical fields. Members will serve six-year terms and during that time they are prohibited from participating in “any other business, vocation or employment.”
So what happens if the Obama administration goes forward with implementing “Obamacare” and they still haven’t found anyone to head the board? The WaPo explains:
IPAB seats unfilled by blocked confirmations or a lack of interest, the Affordable Care Act includes a fallback measure. Health and Human Services Secretary Kathleen Sebelius has the authority to produce her own set of cost-cutting measures. Like those of the IPAB’s, they would also take effect automatically should Congress not pass an alternative.
Yes, if the administration finds it cannot staff the panel, its duties and power will be temporarily transferred to the Secretary of Health and Human Services.
“They’ll find people,” said Jonathan Gruber. “There are many who are, no doubt, very qualified. But I think they’ll miss out on a number of the very best.”
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Featured image courtesy the Associated Press.