Obama’s Death Panels resurrected under IPAB
Two years ago, then vice-presidential candidate Sarah Palin denounced ObamaCare and spoke in earnest about the possibility of Death Panels that would be created under the Patient Protection and Affordable Care Act (PPACA). President Obama firmly denied such claims. Now Congress is considering the role the Independent Payment Advisory Board (IPAB) will play when PPACA becomes fully effective. Added to the heath care bill before it was voted on, the section creating the IPAB faced opposition from more than 100 House members. On April 13, Obama gave a speech at George Washington University calling for strengthening the IPAB and made it a central element of his agenda to reduce the deficit.
Under the law, the 15-member panel would be appointed by the president to determine a way to decrease Medicare spending. The concern both Democrats and Republicans have voiced is the unprecedented power the members would wield over Medicare spending, and eventually, their ever-expanding control of private health care fees. IPAB would not face any judicial review or check and balances by any other government agency.
The 15-member panel would not only mandate Medicare cuts that a Congressional majority may not be able to reduce or repeal, but the IPAB could ultimately reduce what Americans are permitted to spend privately for health care. Under ObamaCare, the IPAB would issue recommendations to restrict what citizens may pay for treatments and what individual health insurance plans would cover. To ensure recommendations are applied, the Department of Health and Human Services (DHHS) is able to impose quality and efficiency measures on doctors and other health care providers. If a doctor violates the quality standard imposed by the IPAB and prescribes treatment beyond its merits, that doctor may be disqualified from contracting with health insurance plans mandated by the PPACA.
Burke J. Balch, Head of National Right to Life’s Robert Powell Center for Medical Ethics submitted testimony for the Congressional hearing to discuss the rationing implications of IPAB:
These will be standards specifically designed to limit what ordinary Americans may choose to spend on health care so that it is BELOW the rate of medical inflation. 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 is willing and able to pay for it. In effect, there will be one uniform national standard of care, established by Washington bureaucrats and set with a view to limiting what private citizens are allowed to spend on saving their own lives. [sic]
Wisconsin Republican Paul Ryan, House Budget Chairman, proposed an alternative to IPAB regarding Medicare. Congressman Ryan’s plan is based on the health care system congressional members now enjoy that essentially converts Medicare into a program where future beneficiaries—those who are 54 and younger today—would be given a voucher-like subsidy to purchase their own health insurance. It would shift the program to a premium support system for buying private health insurance by 2022, thus allowing the health care costs to be decided upon by American citizens, rather than the government.
Although the majority of those who oppose Obama’s IPAB are Republicans, there are some Democrats who have spoken out against it. Allyson Schwartz (D-PA) called Obama’s policy flawed:
Congress is a representative body and must assume responsibility for legislating sound health care policy for Medicare beneficiaries, including those policies related to payment systems. Abdicating this responsibility, whether to insurance companies or an unelected commission, would undermine our ability to represent the needs of the seniors and disabled in our communities.
Congressman Phil Roe (R-TN) has drafted legislation to repeal the IPAB; Senator John Cornyn (R-TX) has written similar legislation. One member of the Texas House of Representatives, however, has warned Representative Ryan that if he continues pushing his plan, he could see adverse affects in the next election. Elliot Naishtat (D-Austin) and other Texas Democrats opposed similar legislation in the Texas House this session. Naishtat opposes Ryan’s alternative plan and supports the Obama Health Law and the IPAB.
While the 15 member board may not literally “pull the plug on grandma,” if they implement drastic reductions in the amount Americans can spend on treatment that may save or prolong their lives, they could effectively hasten grandma’s death. The government requires Americans over 65 to enroll in the government-funded Medicare program. Medicare covers approximately 80% of Medicare approved treatments. The remaining 20% must be covered by that individual using a supplemental plan or paid for out of pocket. Under IPAB’s recommendations, the amount citizens spend of their own money to cover additional health costs would be limited. Who will stop the IPAB from deciding whose life is deemed more qualified for treatment?