By HOWARD DEAN
June 09, 2015

When President Barack Obama signed the Patient Protection and Affordable Care Act five years ago, he did so without knowing whether the law would eventually prove effective. Fortunately, in large part, it has, and those who doubted the ACA — myself included — were reminded of its success when the Department of Health and Human Services recently reported that 16.4 million previously uninsured Americans have gained insurance under it. This includes 14.1 million adults and 2.3 million young adults.

In short, there’s much to celebrate, and we should make a point to shine a spotlight on what’s working — and what isn’t.

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There is one feature of ACA, however, that is unlikely to be effective and could retard further progress. The Independent Payment Advisory Board was included in the ACA as a stopgap measure to control costs if Congress was unable to do so. Given the impassable gridlock we have witnessed in Washington in recent years, proponents of IPAB seem to have a point; unfortunately, facts and evidence belie the belief that IPAB will successfully control costs or bring down health spending.

Historically, rate setting and price fixing have never worked to control costs; the medical system simply finds ways around these measures. As an M.D., I can attest that the fundamental reason medical costs regularly exceed inflation is that the system incentivizes those of us working within it to spend more. The more we do, the more we make, the more you pay.


Read more: http://www.politico.com/magazine/story/2015/06/reward-physicians-for-keeping-patients-healthy-118805.html#ixzz3d6Ng9mKX