Whiter the argument about cost? In remarks today, President Obama warned Congress he wouldn't sign a health care reform bill into law unless it bended health care cost curve downward. At the same time, his chief budget officer, Peter Orszag, sent Congress a draft of legislation to create an Independent Medicare Advisory Committee -- what WH folks refer to as iMAC, apparently without asking Apple.
Here's how it would work:
This proposed legislation would require the President to approve or disapprove each set of the IMAC's recommendations as a package. If the President accepts the IMAC's recommendations, Congress would then have 30 days to intervene with a joint resolution before the Secretary of Health and Human Services is authorized to implement them. If either the President disapproves the recommendations of the IMAC or Congress passes such a joint resolution, the recommendations would be null and void, and current law would remain in effect. The review process would permit intervention if the IMAC's reforms are not in keeping with the goals of Congress or the President, while retaining autonomy for implementing annual payment updates and other Medicare reforms for the IMAC.
Sen. Jay Rockefeller has proposed something similar: his committee would be given the authority to set Medicare reimbursement rates and other payment schedules, and Congress would have to intervene, actively, in order to stop the changes from taking effect. Congress, naturally, objects to the power invested in the committee, but it represents a step forward from the perspective of the White House. It's hard to see how the CBO could "score" the iMAC bill, not knowing what the IMAC commissioners would find when they examine competition and pricing.