Does Obamacare’s Independent Patient Advisory Board (IPAB) ration Medicare or create “death panels”? – DEBATED
General Reference (not clearly pro or con)
The Patient Protection and Affordable Care Act, Section 1899A, "Independent Medicare Advisory Board," page 371, signed into law on Mar. 23, 2010, available at www.thomas.gov, states:
"(ii) The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria.”
Paul Ryan, US Representative (R-WI) stated the following on Sep. 22, 2012, during a town hall meeting at the University of Central Florida, available at YouTube.com under the title “Paul Ryan on Death Panels”:
" The death panels, well! That's not the word I'd choose to use to describe it. It's actually called... so in Medicare, what I refer to as this board of 15 bureaucrats. It's called the Independent Payment Advisory Board. It sounds fairly innocuous...
What Obamacare does is it says, no we're going to have price controls and we're going to empower this board of 15 people that the President appoints, six year terms, they can get renewed once... these 15 bureaucrats that President Obama appoints, their job, each and every year, is to cut Medicare payments to providers... What Obamacare does is it takes control of Medicare, one of the most important and valuable programs in our country, the cornerstone of health security for all older Americans, and it takes it out of the control of your elected representatives, and it puts it in the hands of these 15 bureaucrats that are unaccountable that President Obama appoints. That is what the Independent Payment Advisory Board is, and that's I think, the issue that you are talking about..."
Does Obamacare’s Independent Patient Advisory Board (IPAB) ration Medicare or create “death panels”? – DEBATED
Sarah Palin, former Republican Governor of Alaska, wrote in her June 25, 2012 Facebook post “Death Panel Three Years Later,” available online at www.facebook.com:
"Though I was called a liar [in 2009] for calling it like it is, many of these accusers finally saw that Obamacare did in fact create a panel of faceless bureaucrats who have the power to make life and death decisions about health care funding. It's called the Independent Payment Advisory Board (IPAB), and its purpose all along has been to ‘keep costs down' by actually denying care via price controls and typically inefficient bureaucracy. This subjective rationing of care is what I was writing about in that first post:
The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's ‘death panel' so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,' whether they are worthy of health care. Such a system is downright evil.”
Stanley Kurtz, Writer for the National Review Online, wrote in his Apr. 18, 2011 article "IPAB, Obama, and Socialism," available online at www.nationalreview.com:
"...IPAB's price controls will lead to one-size-fits-all rationing. As IPAB caps Medicare payments for various services, the elderly will be unable to obtain many kinds of care, or will experience de facto rationing via long treatment delays and sharp declines in the quality of care.”
Steven Ertelt, Founder and Editor of LifeNews.com, wrote in his July 31, 2012 article "Obamacare Rationing Begins, States Cut Prescription Drug Benefits,” available online at www.LifeNews.com:
"…[Under Obamacare] the department of Health and Human Services (HHS) will be empowered to impose so-called ‘quality and efficiency' measures on health care providers, based on recommendations by the Independent Payment Advisory Board, which is directed to force private health care spending below the rate of medical inflation. In many cases treatment that a doctor and patient deem needed or advisable to save that patient's life or preserve or improve the patient's health but which runs afoul of the imposed standards will be denied, even if the patient wants to pay for it.
The law empowers HHS to prevent older Americans from making up with their own funds for the $555 billion the law cuts from Medicare by refusing to permit senior citizens the choice of private-fee-for-service plans whose premiums are sufficient to provide unrationed care but which HHS, in its unlimited discretion, disallows. The Obama health care law could thus lead to elimination of the only way that seniors will have to escape rationing — by limiting their right to spend their own money to save their own lives.”
Wesley J. Smith, Senior Fellow in Human Rights and Bioethics at the Discovery Institute, wrote in his July 6, 2012 article “IPAB: the Part of Obamacare That Can’t be Repealed,” available online at www.dailycaller.com:
"IPAB's unique ‘fast track' authority divests Congress of discretion regarding the amount of money to be cut from Medicare once IPAB has submitted its ‘advice.' Get a load of these legislative handcuffs:
By January 15, 2014, IPAB must submit a proposal to Congress and the president for reaching Medicare savings targets in the coming year.
The majority leaders in the House and Senate must introduce bills incorporating the board's proposal the day they receive it.
Congress cannot ‘consider any bill, resolution, amendment, or conference report …?that would repeal or otherwise change the recommendations of the board' if such changes fail to meet the board's budgetary target.
By April 1, all legislative committees must complete their evaluation. Any committee that fails to meet the deadline is barred from further consideration of the bill.
If Congress does not pass the proposal or a substitute plan meeting the IPAB's financial target before August 15, or if the president vetoes the proposal passed by Congress, the original Independent Payment Advisory Board recommendations automatically take effect.
Not only that, but Congress cannot consider any bill or amendment that would repeal or change this fast-track congressional consideration process without a three-fifths vote in the Senate. And to put the icing on the autocratic cake, implementation of the board's policy is exempted from administrative or judicial review.”
Richard Reeb, PhD, former Professor of Political Science, Philosophy and Journalism at Barstow College, wrote in his June 29, 2010 article "Health Care Rationing Is Bound to Come," available at www.desertdispatch.com:
"Critics of Obamacare were severely attacked for using allegedly overheated rhetoric such as 'death panels.' But given the fact that an 18-member Independent Payment Advisory Board will be established to set 'quality and efficiency' standards that doctors will be forced to follow after 2015, that rhetoric does not appear to be so overheated after all."
Glenn Kessler, Washington Post Reporter, wrote in his June 27, 2012 column, “The Fact Checker, the Truth Beyond the Rhetoric,” in an article titled "Sarah Palin, ‘Death Panels’ and ‘Obamacare,'” available at www.washingtonpost.com:
"It is important to note that the IPAB is primarily charged with helping to reduce the rate of growth in Medicare spending — a goal that both parties say they want to achieve. The IPAB, made up of 15 experts subject to Senate confirmation, would also make broader recommendations about controlling health costs.
Beginning in 2018, if the targets are not met, the board will submit a plan to the White House and Congress to achieve the necessary cuts. Congress could pass a different set of cuts or reject the IPAB recommendations with a three-fifths vote in the Senate.
The health-care law, by the way, explicitly says that the recommendations cannot lead to rationing of health care...”
Ira Byock, MD, Director of Palliative Care at Dartmouth-Hitchcock Medical Center, wrote in his July 18, 2012 article "Rational Healthcare, Not Rationing," available at www.articles.latimes.com:
"Many of the people I care for are incurably ill and need expensive medical care to stay alive. They've heard politicians say ‘Obamacare' will take away their choices, rob them of hope for living longer and cast their fate to ‘death panels' of faceless bureaucrats. Fortunately, none of this is true…
The Affordable Care Act advances a new approach, called accountable care, that aligns financial incentives with high-quality treatment. This key feature of the law transforms healthcare by making local health systems — made up of doctors, hospitals, clinics, laboratories and imaging facilities — responsible for the outcomes of care and the costs for the population of people they predominantly serve.
Accountable care has real potential for moving our system toward safer, more effective, and less wasteful treatments. Person-centered services, such as individualized care planning, thorough communication and coordination of care, ongoing monitoring, meticulous medication management and early response to problems, make economic sense...
Reforming healthcare to make it rational is not the same thing as rationing. The best care gives people every chance of living longer and well…”
Ben Armbruster, National Security Editor for ThinkProgress.org, wrote in his July 1, 2012 article “Republican Senator Says ObamaCare Will ‘Sovietize’ Health Care,” available at www.thinkprogress.org:
"Last week, just before the Supreme Court ruled that Affordable Care Act is constitutional, Sen. Tom Coburn (R-OK) told the Eagle Daily Investor that what ObamaCare is trying to do ‘is Sovietize the American health care system…'
But Coburn really shouldn't fear the Independent Payment Advisory Board — a commission that would make recommendations for lowering Medicare spending to Congress. IPAB's authority only kicks in if health care spending increases beyond a specific threshold and the board is specifically prohibited from rationing. The Affordable Care Act's language specifically states that IPAB's recommendations cannot ‘include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums… increase Medicare beneficiary cost- sharing (including deductibles, coinsurance, and co- payments), or otherwise restrict benefits or modify eligibility criteria.'”
The Kaiser Family Foundation, stated in a July 7, 2010 article "Kaiser Health Tracking Poll - July 2010" available at www.kff.org:
"…[L]arge shares of seniors mistakenly believe the law includes provisions that cut some previously universal Medicare benefits and creates 'death panels.' Half of seniors (50%) say the law will cut benefits that were previously provided to all people on Medicare, and more than a third (36%) incorrectly believe the law will 'allow a government panel to make decisions about end-of-life care for people on Medicare.'"
Aaron E. Carroll, MD, MS, Associate Professor and Vice Chairman of Health Policy and Outcomes Research in the Department of Pediatrics at the Indiana University School of Medicine, wrote in his July 19, 2012 article "Take Another Look at Health Care Act," available at www.cnn.com:
"Surely you've heard about the Independent Payment Advisory Board? This one, too, has cost the administration politically. It's been demonized as an actual ‘death panel' of unelected, unaccountable people who will ration your Medicare. That's not true. The panel is made up of people who need Senate approval (not easy), and they don't serve for life. Moreover, they have a very specific, limited task."
Steve Benen, MA, Producer of The Rachel Maddow Show, stated the following in a Sep. 24, 2012 article "Ryan Doesn't Call Them 'Death Panels' But...," available at www.maddowblog.msnbc.com:
"In terms of rhetoric, when Ryan says he's not comfortable with the words 'death panel,' I'm glad, but it's worth remembering that this isn't about semantics; it's about policy. Those who talk about 'death panels' aren't just using the wrong language, they're getting the substance wrong, too...
As we discussed in June, the Obama administration seeks to solve this problem [rising medical costs] through IPAB - putting the difficult decisions in the hands of qualified medical and health care professionals, free of the political process on Capitol Hill. And why is this necessary? In large part because Congress has failed so spectacularly in its ability to make these choices on its own...
Besides, it's not like the 15 panelists serving on IPAB have some kind of dictatorial rule over Medicare coverage - the law not only gives Congress oversight authority over the panel, but it also empowers Congress to replace savings if lawmakers disapprove of what the board comes up with.”