posted August 02, 2011 03:40 PM            

Under last year’s health care reform, "a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy."
~ Phil Gingrey on Wednesday, June 22nd, 2011 in a news conference

U.S. Rep. Phil Gingrey, who’s also a doctor, is aiming his scalpel at a lesser-known provision of last year’s health care overhaul.

The Marietta Republican recommends swift removal of the Independent Payment Advisory Board, which was created to rein in growing Medicare costs.

Gingrey, an obstetrician-gynecologist, wants the board repealed. He said at a recent news conference it’s worse than tossing Granny off Stone Mountain.

"Democrats like to picture us as pushing Grandmother over the cliff or throwing someone under the bus. In either one of those scenarios, at least the senior has a chance to survive," Gingrey said June 22.

"But under this IPAB we described that the Democrats put in Obamacare, where a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy, I guarantee you, when you withdraw that, the patient is going to die," said Gingrey. "It’s rationing."

What a bleak prognosis. Under the IPAB, does "a bunch of bureaucrats" really "decide whether you get care"?

PolitiFact Georgia asked a Gingrey spokeswoman for proof, but she did not provide any.

We turned to four health care policy experts with differing opinions on the IPAB. They all told us that Gingrey was wrong.

But before we explain their reasoning, here’s more about the Independent Payment Advisory Board.

Lawmakers created the board in response to criticism that Congress has been unable to make the politically risky and technically complex decisions needed to slow the growth of costs for Medicare, the federal program that provides health care for seniors.

Under the health care reform bill, if Medicare spending growth is projected to exceed certain targets, the IPAB must come up with plans to slow the increase. If Congress does not act on the recommendation within a set time frame, it is automatically implemented.

Both sides of the aisle have their problems with the board. Some worry it will be too hard for Congress to overrule IPAB recommendations, or that the board will stifle innovation. In recent months, Republicans such as Gingrey and even Democrats have signed on to repeal the board.

This brings us back to Gingrey’s claim that under the IPAB, "a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy."

Gingrey is "not even close to correct," said Michael Tanner, a scholar with the libertarian Cato Institute. He opposes the IPAB.

"It [IPAB] has nothing to do with individual care at all. It’s not making decisions on individuals," Tanner said.

Experts agree that the IPAB has no say in whether a specific person receives dialysis, chemotherapy or any other such treatment. The board does not intercede in individual patient cases. It makes broad policy decisions that affect Medicare’s overall cost.

Furthermore, the IPAB is barred from making policy recommendations that would block patients from receiving needed care, experts told PolitiFact Georgia.

"The legislation explicitly forbids the board from rationing care," said Stuart Guterman, a health policy expert with the Commonwealth Fund, a nonpartisan group which works to improve health care access, quality and efficiency. Guterman said he thinks the IPAB can help with health care savings.

Our analysis of the bill only found language designed to avoid the result Gingrey foretells.

For instance, the IPAB may not submit "any recommendation to ration health care," Section 3403 states.

The same section also bars raising premiums for Medicare beneficiaries, as well as increasing deductibles, coinsurance or co-payments. The IPAB cannot change who is eligible for Medicare, restrict benefits or make recommendations that would raise revenue, either.

The IPAB can reduce how much the government pays health care providers for services, reduce payments to hospitals with very high rates of readmissions, or recommend innovations that cut wasteful spending. Some may argue that because the IPAB can reduce the money a doctor receives for giving chemotherapy to a Medicare patient, this could lead to an indirect form of rationing.

If Medicare reimbursements for chemotherapy drop too low, doctors might stop treating Medicare patients, or avoid recommending chemotherapy.

But this is not the scenario that Gingrey describes.

Gingrey makes no mention of indirect or long-term consequences. He says that with the IPAB, "a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy. I guarantee you, when you withdraw that, the patient is going to die."

In other words, Gingrey says that bureaucrats will have the power to deny you treatment. And because of the bureaucrats, you could die.

This claim is incorrect. The IPAB does not have anything close to the power that Gingrey suggests. It cannot raise costs to Medicare recipients, much less kill them off by denying lifesaving care.

The claim is also outrageous. A policy board is not deadlier than pushing Grandma off a cliff.

posted August 02, 2011 04:35 PM            

Demonizing health care reform continues to wane in popularity, except for those who would like to see a REPUB take over the reigns of the WH.

It is all political, and only those who will loose money, or a candidate, seek to frame it as bad legislation.

posted August 03, 2011 09:10 AM            

ObamaCare's IPAB Spells Medicare Rationing
Congressman Charles Boustany
07/21/2011

During my career as a heart surgeon, I often treated patients who had difficulty finding a primary care doctor because they were on Medicare. The problem persists today, and the new health law will make it worse. One out of five seniors report delays in seeing a doctor.

Medicare doctors face almost $300 billion in automatic cuts during the next decade. Under current law, Medicare’s independent actuary predicts physician payments will “fall to 27% of private health insurance levels” and “less than half of the projected Medicaid rates.”

The new health care law creates more life-threatening delays for seniors under President Obama’s Independent Payment Advisory Board (IPAB). This 15-member panel of presidential appointees will make new cuts to meet annual spending targets. IPAB will have unprecedented control over patients’ personal medical decisions, but limited medical expertise. The law limits membership of doctors with real experience caring for patients, instead selecting numbers-crunchers focused only on costs. Experts in “technology assessment” will help devise payment formulas that prevent new lifesaving medical breakthroughs.

In defending this new rationing board, Health and Human Services Secretary Kathleen Sebelius called IPAB's new automatic cuts “recommendations.” She neglected to explain that IPAB's decisions carry the force of law unless two-thirds of the House and Senate vote to stop them. In a shameless power grab, ObamaCare also prohibits judicial review of cuts harmful to seniors. ***Death Panel, judge, jury and executioner with no appeal. Hell, we don't even treat serial murderers this cruelly.

Sebelius insists IPAB may not “ration” care, but she admits the new law fails to define the word. By slashing payments below costs, IPAB will deprive patients of needed care. While IPAB can’t outlaw needed treatments, it can force frail patients to wait longer or travel farther. It can also penalize doctors who offer a new and more effective treatment.

Even the left-leaning Kaiser Family Foundation agrees IPAB must cut below annual spending targets “even if evidence of access or quality concerns surfaced.” Sebelius mentions her “responsibility to improve access ... for all our Medicare beneficiaries,” but will she define rationing in the final IPAB rule to protect seniors’ timely access to needed care?

We cannot serve patients’ best interests by allowing unelected bureaucrats to make critical medical decisions. Even Democrats who voted for ObamaCare support repealing IPAB before it begins. Rather than defending IPAB, Sebelius should side with the seniors it would harm and call for its repeal.

posted August 03, 2011 09:32 AM            

This week, the House Budget Committee and Energy and Commerce Committee held hearings to examine the Independent Payment Advisory Board (IPAB), a board of unelected bureaucrats tasked under Obamacare to reduce the growth in Medicare spending.

During the Budget Committee hearing, Grace-Marie Turner, president of the Galen Institute, described the board:

[T]he IPAB is unprecedented in the power given to unelected officials to direct hundreds of billions of dollars in federal spending. The IPAB will give unelected, unaccountable government appointees the power to make decisions about payment policy in Medicare that will ultimately determine whether millions of seniors have access to the care they need. This challenges the very principles of representative democracy and consent of the governed.
Understandably, the board’s overreach has lawmakers on both sides of the aisle concerned. In his testimony, Senator John Cornyn (R–TX) said he was “concerned that IPAB’s enormous power will grow at the expense of Congress and the people’s elected representatives.” Representative Frank Pallone, Jr. (D–NJ), described IPAB as a sign of a “growing imperialistic presidency.” Representative Allyson Schwartz (D–PA) struck at the heart of the issue, saying, “[W]e cannot conceal fundamental flaws in our health care system by simply cutting reimbursements to hospitals and physicians.”

Therein lies the problem. Since the board is restricted in the methods it can pursue to reduce costs, its main tool will be to cut provider reimbursement rates. Payment rates that do not accurately reflect the true costs of providing health services can serve as a dramatic barrier to care, as Medicare’s chief actuary explained before the Budget Committee in the highlighted video. Deep cuts are already included in current law, and if an unelected board cuts even further, the effects will be profound.

To imagine the result isn’t difficult. As Turner said:

If the spending reductions in the law today were to take place, seniors could face long waits for appointments and treatments, and many would be forced to wait in line in over-crowded emergency rooms to get care, just as Medicaid patients do throughout the country today.

Medicaid pays doctors only 58 cents for every dollar paid by private insurance, and in many parts of the country, providers actually lose money to see Medicaid patients. If cuts in current law go into effect, Medicare will pay doctors 57 percent of what private insurers pay in 2012, dropping below Medicaid. Moreover, the actuary warns that Obamacare’s cuts to hospital payments could cause 30 percent of providers of inpatient services to become unprofitable.

With reductions like these already written into law, IPAB’s effects would be disastrous. As a result, repeal efforts are already underway in the House of Representatives. But while bipartisan support builds against IPAB, some on the left would have the board go even further. Judith Feder of the Center for American Progress told the Budget Committee: “Congress should…modify IPAB’s current spending target to apply not just to Medicare but to private insurance. Indeed, to all health care spending, and extend its authorities to trigger recommendations for all payer payment reform if the target is breached.”***A recommendation by Center for American Progress...a George Soros front organization..which shows the lunacy of the Marxist Socialist Progressive left.***

Medicare’s $37 trillion in unfunded promises—and runaway spending in the health care sector at large—must be addressed, but not by a government body that can do so only by restricting access to health care. Instead, lower costs and higher quality of care can be achieved by introducing competition and consumer choice through the reforms included in Heritage’s Saving the American Dream plan.