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IPAB Pushback Centers on Power, Politics

Margaret Dick Tocknell, for HealthLeaders Media, July 20, 2011

If you've never attended a Congressional hearing count yourself as lucky.

I spent about six hours last week watching two Congressional committees discuss the pros and cons of the Independent Payment Advisory Board. That's the controversial board created as part of the Affordable care Act and charged with recommending ways to control Medicare costs.

Congressional hearings are really just theater with committee members jawboning with selected "witnesses" who seem to espouse a preset notion of what should or should not be done on a particular issue.

And that's pretty much the way it went during two days of testimony before the Republican-led House Budget Committee and the Health Subcommittee of the House Energy and Commerce Committee. More than 15 witnesses, including HHS Secretary Kathleen Sebelius, testified ? meaning they read well-vetted statements – and answered well-planned and leading questions about the IPAB.

IPAB is the latest whipping boy for those who object to the implementation of healthcare reform. At the hearings the lines were clearly drawn primarily along partisan lines. In broad strokes, Republicans believe the board will ration healthcare, leave seniors out in the cold, and needs to be repealed. Democrats see the IPAB as a backstop or fail safe for controlling Medicare costs and preserving the program for generations to come.

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