Death Panels

The political right should get off the “death panel” kick and the political left should get real about the expectations that the Independent Payment Advisory Panel has any real ability to save money for Medicare.   Take a look at this point of view, Right’s latest “death panel” attack a bust.

As the name implies the Panel deals with payments so if you are a hospital, physician or other health care provider and especially if you are a Medicare Advantage Plan or Part D provider watch out, the law directs the IPAP to focus on you.  Vermont which is moving quickly to a single payer system also relies on a similar panel to control costs.  This plan talks about considering fixed health care budgets. 

The problem with all of this is that no matter what proponents or opponents say someone is going to get less and there are consequences of that happening.  While there is considerable room for efficiency in the health care system, capturing those savings if they are ever realized is not an easy task and once captured the ongoing growth in costs continues.  Saving money by adjusting payments to Medicare providers is another matter. Sooner or later you get to the point where there is no more to cut and long before you get there cost shifting has occurred to the private sector.  Having a fixed budget for health care spending, say with Medicare, means that at some point there will be less health care provided, just as is the case in all government managed health care programs. 

Death Panel scare tactics are not helpful, especially from those who do not have a better idea.  Unfortunately, that “better idea” as currently structured in the form of the IPAP and subject to additional whims of Congress in the years ahead has a minimal chance of solving the Medicare cost crisis.   As Democrats and Republicans battle over Medicare, keep in mind that the “final” solution can only mean Medicare beneficiaries, and all tax-payers will pay more, health care providers will be paid less and access to health care will be managed in a number of areas.  There simply is no other combination of actions that will manage health care costs.  

The fundamental question for Americans is how much of our resources do we wish to spend on health care.  Some will say there should be no such limit, some will say any limit will only unfairly apply to the less well off, other will say we must live within a budget.  That all sounds fine if you are talking about building roads, but who will make those decisions for health care?

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