Bureaucratic blues: faceless but with feelings

Those faceless healthcare bureaucrats have feelings too, folks.

And the passion of one of them came shining through Monday at an otherwise dry Washington think tank event. At a discussion of the separate issue of bundling payments at the Center for American Progress, the Obama administration's former healthcare “general” launched into a defense of the controversial Independent Payment Advisory Board.

Nancy-Ann DeParle, assistant to the president and deputy chief of staff, was formerly director of the White House Office of Health Reform.

But before any of that, she was one of those unelected bureaucrats on an important Washington healthcare panel: the Medicare Payment Advisory Commission. And after last week's bipartisan bashfest of the IPAB on Capitol Hill, DeParle couldn't resist speaking up for the faceless.

“It seems that some have decided that giving nonpartisan experts, clinicians and consumers a role in protecting Medicare will set us on the path to rationed care and kill Medicare,” DeParle said. “That's an interesting argument but it isn't true.”

In actuality, the physicians, economists and consumers who constitute the IPAB's membership will help save Medicare.

Instead of suffering DeParle's fate of (six) years spent writing multivolume tomes on needed healthcare policy changes (only to have Congress ignore them), IPAB members will have the power to cut billions of dollars from Medicare—unless supermajorities of Congress intervene.

“I don't have a whole lot of confidence in the current model strengthening Medicare and eliminating waste that in the end taxpayers and beneficiaries all have to pay for,” she said. “We shouldn't have to wait for the Medicare trust fund to be facing insolvency to strengthen Medicare.”

Does that mean DeParle expects the new uberwonks on IPAB to swoop in and singlehandedly solve Medicare's solvency and quality problems? Actually, no.

For her, IPAB members are akin to muscle-bound superheroes, calmly gathered in their Hall of Solvency and encouraging the mortals in Congress to get their own affairs in order.

“We need a mechanism that gives Congress an incentive to spend more time solving problems and preventing costs from skyrocketing,” DeParle said. “And that, in the end, is all IPAB is.”

You can follow Rich Daly on Twitter @MHRdaly.