For Medicare, this has been a summer of good and bad news. On one hand, the program’s costs continue to rise remarkably slowly. So far this fiscal year, they have gone up by only 2.7 percent in nominal terms, the Congressional Budget Office reports. On the other hand, opposition to the Independent Payment Advisory Board -- created as part of the Affordable Care Act -- continues to mount. And opponents continue to mischaracterize the whole point of the board. What they seem not to understand is that the board is needed mostly so that that Medicare can continue to encourage slower growth in costs. Redesigning the payment system is a fundamentally different approach to containing costs.