Tuesday, September 18, 2012

14. Independent Payment Advisory Board

Obamacare establishes the Independent Payment Advisory Board, IPAB. Their job is to control
healthcare costs by limiting reimbursement to Medicare providers. Doesn’t sound so bad,
does it? But this is definitely a case of “the devil’s in the details”…

The IPAB is a panel of 15 members, not elected, but appointed by the President and approved
by the Senate. Now it gets interesting: this panel of unelected officials will have the power to
make law. Not rules and regulations with the force of law (which is bad enough), but actual
law. They will do this initially by making recommendations on changes in Medicare payments
to providers. They submit these to Congress and Congress has 4 months to vote “yes” or “no”,
BUT, if they vote “no”, they have to come up with cuts of their own that will equal or exceed
the cuts to Medicare recommended by the IPAB board. If Congress does nothing in 4 months,
the recommendations become LAW.

Because of these cuts, more providers will stop seeing Medicare and Medicaid patients, and
patients will have even longer wait times to see a physician. Many physicians will just leave
practice altogether. This only trades one problem for another: it trades lower costs for
poorer access. And it won’t really lower costs—patients will end up going to the Emergency
room for routine care since it will be easier than trying to find a physician or clinic to see you.
That will actually add to healthcare costs. It will only make a bad situation much worse, for
both patients and providers.

Now think about this from a politician’s standpoint: your congressman needs your vote,
and the support of doctors, hospitals, businesses and patients. The IPAB does not. If your
congressman doesn’t want to risk the consequences of limiting payments to doctors, or
limiting benefits to his constiuents, he’ll just let the IPAB recommendations go thru as law.
When election time rolls around, he can just tell voters that he was unable to stop the IPAB-
afterall, HE didn’t recommend those cuts….Can you see how this works? It’s brilliantly devised
to transfer the burden of controlling healthcare costs from elected Congressmen who have
to answer to voters, to an unaccountable panel of bureaucrats, who do not. In other words,
Obama and the Democrats have taken We the People out of the healthcare equation.

On November 6, 2012, it’s time to take Obama and the Democrats out of the equation.

(Note: This commentary is by Dr. Jill Vecchio.)

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