Welcome to Health Reform Watch, Sarah Kliff’s regular look at how the Affordable Care Act is changing the American health-care system — and being changed by it. You can reach Sarah with questions, comments and suggestions here. Check back every Monday, Wednesday and Friday at 2 p.m. for the latest edition.
Jonathan Gruber was one of the Obama administration’s key advisers during the health-care reform debate. As the economist who conceived the ideas at the heart of the Massachusetts health-care law, he is arguably the intellectual godfather of the Affordable Care Act.
All of which would make him a natural fit for the Independent Payment Advisory Board, the new, 15-member panel that has the authority to reduce Medicare doctors’ reimbursements and pilot new ways to deliver high quality care for less. There’s just one tiny problem: Gruber has absolutely no interest in serving on the panel. “No way,” he says without pause. “Maybe if it was a part-time gig. But full time? I can’t see it.”
It’s not just Gruber. Obama’s former health policy advisers worry that other top health economists, those in hot demand in academia and in the industry, won’t be interested in a federal job where the compensation is low, the political controversy high and the ultimate payoff unclear.
“It is supposed to be 15 members, with limited salaries who can’t do any outside work,” says Peter Orszag, the former director of the Office of Budget and Management under Obama who was a key proponent of IPAB. “It will be challenging to find top 15 health-care experts are who would want that job.”