Do you have to “be in it to win it” as the adage says? Republicans are guessing that you don’t. GOP leadership is refusing to make recommendations for their three allotted panelists for a board that is meant to monitor and slow Medicare spending. Some may view this as contradictory to all of their bluster about reigning in entitlement spending, but refusal to participate in the Independent Payment Advisor Board is a calculated political maneuver. Republican leadership does not believe the board should be in existence and how would it look if they communicated legitimacy of the Patient Protection and Affordable Care Act by participating on a board it mandates?