Decrying the problem, rejecting a solution

I remember seeing a political cartoon years ago featuring two people, each carrying a placard. One said “Pro-Life,” the other “Pro-Choice.” I’m paraphrasing, but the “Pro-Choice” advocate turned to his rival and said something like, “You know, by expanding access to contraception, we can reduce unwanted pregnancies.”

The guy carrying the “Pro-Life” sign replied, “We’re against that, too.”

The cartoon always stuck in my head. Conservatives can identify a perceived problem and demand a remedy. But when presented with a solution, the right decides they don’t like that, either.

I think about that cartoon a lot during discussions over Medicare. In this case, a progressive can go up to the conservative carrying the “Cut Medicare Now” sign and say, “You know, by creating an Independent Payment Advisory Board, we can reduce costs and restrain the growth of Medicare spending.”

At which point, the guy with the “Cut Medicare Now” sign replies, “We’re against that, too.”

Daily Kos’ Joan McCarter flagged this story about health policy experts and economists sticking up for the proposal that would give Republicans what they say they want.

One hundred health policy experts and economists sent a letter, obtained by POLITICO, to congressional leaders early this week urging legislators to back off their many attempts to repeal the health reform provision.

“We believe that an independent board is essential to promote, monitor and implement reforms that improve Medicare and the nation’s health care system,” they wrote.

The signers include notable centrist health economists, including Alice Rivlin of the Brookings Institution, along with many liberal health policy scholars.

“There are a lot of unreasonable fears about the IPAB. It’s been associated with death panels and stuff like that,” Rivlin told POLITICO in an interview. “I view it as a much more benign device to improve the efficiency of delivery systems in a lot of different ways. I don’t think it’s going to be some technocratic horror.”

The economists and health care experts who signed the letter argued that the board will encourage providers to deliver health care more efficiently.

“The IPAB is a tool designed to help the Congress slow the rapid projected increases in health care costs in the federal budget and to improve the delivery of health care,” the group wrote in its May 20 letter. “Increases in Medicare, Medicaid and the private sector could be slowed by giving providers greater incentives to adopt more cost-effective treatments and prevention interventions.”

Rivlin, of course, is perhaps best known for recently partnering with Paul Ryan on Medicare reform talks. Rivlin backs IPAB, because she’s confident it will help address the problem, while Ryan takes cheap shots at IPAB, because it doesn’t align with his ideological goals.

I don’t imagine the letter from the experts will help, but I’m glad to see the defense anyway.