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Old 05-21-2012, 08:48 AM  
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A Backdoor Path to Health Rationing

I found this interesting and somewhat scary article at forbes.com
Quote:
President Obama's Medical Board: A Backdoor Path to Health Rationing

Last week, a House of Representatives subpanel overwhelmingly approved a measure to repeal a key component of President Obama?s 2010 health reform bill.

By a bipartisan 17-5 margin, the Energy and Commerce Committee?s Health Subcommittee agreed to get rid of Sections 3403 and 10320 of the Patient Protection and Affordable Care Act, which celebrates its second anniversary on March 23. Those provisions established the Independent Payment Advisory Board (IPAB) ? a new federal agency charged by Obamacare with bringing down costs in Medicare starting in 2014.

The full House and Senate must ratify the subcommittee?s vote and scrap the Board from the books. If they don?t, America?s seniors could face the prospect of government-rationed health care.

The repeal measure is expected to reach the House floor the week of March 19. Sen. John Cornyn (R-Texas) has introduced companion legislation in the upper chamber, but Majority Leader Harry Reid (D-Nev.) has not yet placed it on the schedule.

There?s support for repeal of IPAB in both houses of Congress. Republicans uniformly favor scrapping the panel. And on the Health Subcommittee, two Democrats voted with the majority. One of them, ranking member Rep. Frank Pallone (D-N.J.), has said he ?would certainly be in favor of abolishing? IPAB. Seventeen House Democrats have co-sponsored the repeal legislation.

IPAB will consist of 15 members appointed by the president and confirmed by the Senate. Each member can serve up to two consecutive six-year terms. If the Centers for Medicare and Medicaid Services determine that Medicare spending will exceed a preset growth target, then IPAB is empowered to make cost-cutting recommendations.

The Obama Administration?s newly released 2013 budget proposal actually ratchets down the target growth rate ? which means that IPAB will more than likely be called upon to start slashing.

There are some limits on what IPAB can propose. The panel is not allowed to make any changes to Medicare?s fee-for-service structure or to adjust the level of benefits that seniors receive.

The Board is empowered to try some ?innovative? approaches to modernizing the program. But these approaches have all been described by the Congressional Budget Office (CBO) as achieving only marginal cost savings.

Realistically, the Board has only one legitimate cost-cutting tool that can get Medicare under the targets ? lowering reimbursement rates for participating doctors, nurses, and hospitals. And since IPAB has to reduce overall Medicare expenditures by focusing on just this one area, these cuts will likely be very deep.

Now, according to the CBO, Medicare will cost $1 trillion and be bankrupt by 2022. There?s a roughly $280-billion gap between the premiums and taxes coming into the system and the benefits flowing out. About 10,000 new seniors sign up for the program every day. Without substantial reform, Medicare is going to go bankrupt ? and take the rest of the government with it.

But IPAB is a remedy that?s worse than the disease. Reimbursements in Medicare are already dangerously low ? less than 65 percent of the private market rate on average, according to one estimate. As a result, many doctors and other caregivers simply refuse to treat new program enrollees ? or opt out of Medicare entirely. That leaves seniors without someone to care for them. They have to suffer longer wait times, and their conditions deteriorate.


The Affordable Care Act has already installed hundreds of billions of dollars in Medicare payment cuts. According to Medicare?s own actuary, just these cuts alone will make it ?unprofitable? for many healthcare providers to treat enrollees. By further slashing rates, IPAB would make this situation worse.

What?s more, there are effectively zero checks on the Board?s powers. IPAB has to submit its recommendations to the Department of Health and Human Services, which then presents them to Congress. These recommendations would automatically go into effect unless legislators either completely vetoed them via supermajorities in both Chambers or passed alternative legislation that achieved the same level of cost savings.

Both outcomes would be near impossibilities. And to make matters worse, Congress would have to consider them on a ?fast track,? which would give lawmakers just one month to act. After that, IPAB?s dictates would take effect. In the end, a small group of unelected, unaccountable bureaucrats would have unchecked power over the health care of 45 million seniors ? and with the coming retirement of the Baby Boom generation, even more than that.

Last week?s initial vote to scrap IPAB was a good start. But several legislative hurdles remain. If this board isn?t erased from our nation?s laws, then a healthcare nightmare could soon dawn for America?s seniors.

Sally C. Pipes is President, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her latest book is The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare (Regnery 2012).
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Old 06-11-2012, 06:48 PM  
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but according to republican rhetoric regarding health insurers that is NOT rationing, just efficiency....

what do you want? we have rationing already regardless of how you cut it or what you pretend to see. the only way to be fair is to get over this silly idea that competition is ALWAYS better. Placing the rich and the poor alike in the same health plans will lead to everyone having the same goals, Instead of the rich having private plans and creating plans/schools for poor people.

take schools for example, if white rich kids had to go to the same schools as poor black kids you think the schools would receive more tax money and be more of a priority? you bet they would. But instead we send them to private schools and say **** the public schools and then wonder why we have such high crime rates in those areas.
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Old 06-12-2012, 11:46 AM  
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Quote:
Originally Posted by RedJeepXJ View Post
but according to republican rhetoric regarding health insurers that is NOT rationing, just efficiency....

what do you want? we have rationing already regardless of how you cut it or what you pretend to see. the only way to be fair is to get over this silly idea that competition is ALWAYS better. Placing the rich and the poor alike in the same health plans will lead to everyone having the same goals, Instead of the rich having private plans and creating plans/schools for poor people.

take schools for example, if white rich kids had to go to the same schools as poor black kids you think the schools would receive more tax money and be more of a priority? you bet they would. But instead we send them to private schools and say **** the public schools and then wonder why we have such high crime rates in those areas.
Obamacare rationing cannot be justified just because rationing already exists. Rationing will hide under the title of efficiency.

Public schools are funded by property taxes and citizens balk when taxes are raised. Federal money thrown at schools is too easily wasted on non essentials.
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Old 06-12-2012, 02:07 PM  
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The Secretary notes that the board will be “made up of 15 health experts,” including “economists.” This admission – coupled with the statutory requirement that a majority of IPAB members NOT be practicing medical providers – effectively means that many of the members of the board will be proverbial bean-counters, focusing on bottom-line ways to contain costs rather than ways to improve care.
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