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Obama Pushes for New Health Oversight Group

Janice Simmons, for HealthLeaders Media, July 20, 2009

President Obama has returned to his idea—expressed in a letter last month to Senate leaders—of creating an independent board of physicians and medical experts at the federal level with oversight of healthcare delivery system reform.

"Every year, there's a new report that details how much waste and inefficiency there is in Medicare, how best practices are not always used, and how many billions of dollars could be saved," Obama said in a speech at the White House on Friday afternoon. "We need an independent group that is empowered to make these changes."

To push the idea ahead, the White House asked the House of Representatives on Friday to consider including this idea in its healthcare reform legislation. (The Energy and Commerce Committee will continue its hearings on the House reform bill this week.)

White House Office of Management and Budget Director Peter Orszag wrote a letter to House Speaker Nancy Pelosi (D-CA) suggesting that the House of Representatives and its health committees consider either expanding the power of the Medicare Payment Advisory Committee (MedPAC) or creating an entirely new group called the Independent Medicare Advisory Council (IMAC).

In one approach, introduced in May by Sen. Jay Rockefeller (D-WV), MedPAC--renamed the Medicare Payment and Access Commission—would be given new powers such as determining payment rates for physicians and hospitals. The organization would be empowered to "improve efficiency and performance throughout the Medicare system."

Orszag also suggested creation of IMAC, which would have the authority to make recommendations to the president on annual Medicare payment rates, as well as other reforms. This proposed legislation would require the president to approve or disapprove each set of the IMAC’s recommendations as a package; if the President accepts the IMAC’s recommendations, Congress would have 30 days to intervene with a joint resolution before the Health and Human Services secretary is authorized to implement them.

At a briefing, Pelosi, when asked about Orszag’s request, said she "would be receptive" to the idea under certain instances of giving MedPAC more power.

In his blog, Orszag said the IMAC approach "would free Congress from the burdens of dealing with highly technical issues such as Medicare reimbursement rates" while giving political "representatives, a say in the matter."

However, one group, the Alliance of Specialty Medicine, said in a July 6 letter to Rockefeller that creating such an independent executive agency would set a dangerous example of placing too much control over healthcare decisions into the hands of small groups of unelected officials.


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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