Jonathan Chait

The Schwartz is Not With Us

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One of the many pathologies of the American health care system is that is creates enormous waste, in part by encouraging the most expensive rather than the most effective medical interventions. Every dollar of waste is somebody's profit, and the beneficiaries of that profit cultivate political influence to protect it. In order to circumvent this problem, the Affordable Care Act created in Independent Payment Advisory Board, a pane,l insulated from political pressure, that can recommend cuts in waste. Naturally, many members of Congress don't like this and want to repeal the board. But their justification is comical:

Senator John Cornyn, a Texas Republican who introduced a bill last month to repeal the Medicare board, said the president’s proposal “punts difficult decisions on health spending to an unelected, unaccountable board of bureaucrats.”

Representative Allyson Y. Schwartz, a Pennsylvania Democrat prominent on health care issues, said: “It’s our constitutional duty, as members of Congress, to take responsibility for Medicare and not turn decisions over to a board. Abdicating this responsibility, whether to insurance companies or to an unelected commission, undermines our ability to represent our constituents, including seniors and the disabled.”

Ms. Schwartz signed up on Friday as co-sponsor of a bill to repeal the board.

They don't object to difficult decisions being "punted." They object to difficult decisions being made at all. It's not as if we haven't tried letting Congress exert direct control over Medicare spending. We've had that system in place for 45 years. The answer is always spend whatever you want.

As Jonathan Cohn points out, Schwartz rakes in huge sums of cash from the health care industry. She's a "moderate" Democrat if you define the moderate position to mean that the federal government should shovel money out the door for any and all medical interventions regardless of value. It's "pro-business."

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