This article considers the pitfalls of the current Medicare governance which leaves provider reimbursements vulnerable to "micromanaging" by the U.S. Congress.  The authors suggest that the current system of governance could jeopardize the entire health care system on which lawmakers intend to base health care reform and further argue for establishing a new Medicare policy board, transforming the Medicare agency into an independent entity or a new department, and conducting analyses of congressional payment policy changes before they are voted on. 

Pham, H. H., Ginsburg, P. B., and Verdier, J. M. (2009). Medicare governance and provider payment policy.  Health Affairs. 28(5), 1382-1394. DOI: 10.1377/hlthaff.28.5.1382 http://content.healthaffairs.org/cgi/content/abstract/28/5/1382

Authors: Hoangmai H. Pham, Paul B. Ginsburg and James M. Verdier.