Medicare’s Independent Payment Advisory Board

To absolutely no one’s surprise, Democrats and Republicans are still struggling to pass a 2014 budget, and have been unable to agree on where, and by how much, federal spending should be cut.

Furthermore, the deadline is approaching: Congress has until September 30th, the last day of the 2013 fiscal year, to determine which programs will receive more or less funding in 2014, and additionally, they must agree on how to implement 2014′s upcoming $91 billion in sequestration cuts.

If we are to avoid the political brinkmanship that has characterized past negotiations over the budget (the fiscal cliff debacle comes to mind) Congress must decide what programs can and should be cut–and they need to do it fast. Holding the debt ceiling hostage is not the way to reach compromise, and will certainly not increase Americans’ opinion of their central government, which is already at an all-time low.

Moreover, the approaching September showdown will mark over two years of what has amounted to a long-running game of political chicken, and it’s time for Congress to finally make a play to regain the respect of the citizens it represents, and try out a different set of tactics.

It shouldn’t be this difficult: lawmakers need to sit down and take an honest, bipartisan look at the government programs that are currently on the table, and objectively judge them based on their merits. There are number of programs that politicians on both sides of the political aisle can agree should not be continued.

Indeed, given the urgency of these impending deadlines, it is of critical importance that members of Congress sit down and differentiate between which programs are working, and which ones are not–and then cut accordingly.

For instance, one program that is up for debate is Medicare’s Independent Payment Advisory Board, or IPAB. IPAB was created in 2010 following the implementation of President Obama’s Patient Protection and Affordable Care Act, and is a fifteen-member Government agency tasked with reducing Medicare costs while retaining quality of care.

The debate over IPAB has been fierce, and both Republicans and a number of prominent Democrats have come out against the panel. However, despite this, President Obama, in making his requests for the 2014 budget, has proposed that the Independent Payment Advisory Board’s authority only be increased.

If we’re trying to pass a budget, we want to make sure that we’re funding programs that work–and IBAP unequivocally doesn’t.

IPAB takes the Medicare decision-making process away from doctors and away from Americans’ elected representatives in Congress and gives it to an unelected, unrepresentative and unaccountable advisory board. This panel is flawed and unethical–but it has total authority to make decisions regarding Medicare funding, how to implement spending cuts within the Medicare program, and how to allocate medical services.

Further, IPAB jeopardizes the quality of medical treatments and services for Medicare beneficiaries: proponents of IPAB argue that the program will improve care by reducing costs, but in reality, by advising such reduced spending per capita, IPAB can actually result in the denial of certain medical treatments, limiting services for seniors and Americans with disabilities.

Indeed, in removing doctors and elected officials from the decision-making process and replacing them with an unelected, unaccountable panel, IPAB is a threat to all Americans on Medicare.

In order to get the maximum possible benefit from the 2014 budget, lawmakers and members of Congress must eschew partisan gridlock and unite across the aisle in support of cutting funding to the programs that we can agree don’t work, and are unethical–such as IPAB–and in maintaining funding to the programs that do.

For instance, one program that works is Medicare Part D. A widely popular, bipartisan program, Medicare part D provides low-cost drugs to seniors, improves overall access to drugs, and gives both seniors and doctors flexibility. Indeed, Medicare Part D is the most effective and successful entitlement program the federal government runs.

In creating the 2014 budget, Congress has the power to prune ineffective and harmful programs, such as IBAP, and boost efficient and effective ones like Medicare Part D. Lawmakers must utilize this opportunity.

Bipartisan cooperation will be crucial in creating this latest budget, and lawmakers in Congress must unite across the aisle and find the points that everyone can agree on. One of these is that an unrepresentative board that is not subject to independent oversight must not be allowed to make decisions that could impact millions of seniors.

We must call on our Congressional representatives to make sure that the 2014 budget reflects this fact, and moreover, to abandon their current tactics and sit down and have a conversation about what really works, and what doesn’t.

Read more at Forbes.com