Even Obamacare’s Supporters Don’t Support the Rationing Board
The House Energy and Commerce Committee just scheduled hearings for next month on one of the most controversial components of ObamaCare the Independent Payment Advisory Board (IPAB).
This 15-member, unelected Board will be charged with making recommendations for reducing Medicare spending if costs exceed a specified cap. Those recommendations will automatically become law unless Congress blocks them and offers equivalent spending cuts in their place.
Although IPAB was a central part of the presidents health care reform law, its only beginning to attract Congresss attention. A bill introduced by Phil Roe, R-Tenn., that would scrap it has attracted 124 co-sponsors both Republicans and Democrats.
Theyre right to do so. IPAB amounts to little more than a rationing board that will neither lower health costs nor improve American health care.
Supporters of the Board claim that the text of ObamaCare actually prohibits it from rationing. But the panel will have the power to slash reimbursement rates for Medicare providers including both physicians and drug firms.
So IPAB may not directly inform seniors that they cant have access to a specific drug or a particular doctor. But by cutting the rates that drug companies or physicians are paid, the Board may artificially limit the supply of medications or doctors appointments.
For instance, a doctor may decide that lower reimbursement rates dont offset the costs of seeing additional or even existing Medicare patients. As a result, seniors will face longer waits for appointments or may be turned away altogether.
Similarly, arbitrarily cutting payments for prescription drugs in Medicare may result in fewer drugs being available. Seniors may be saddled with restrictive formularies that dont offer access to the latest medications.
In both cases, IPAB may not directly ration care but seniors will sure feel like it did.
Other countries have attempted to control costs by fiat before. Their experiences are not comforting.
The British National Health Services version of IPAB known by the oh-so-inappropriate acronym NICE denied access last month to a wide array of life-saving cancer drugs because it couldnt justify their cost. Patients and their families, of course, may beg to differ.
Such rationing doesnt even save money. In NICEs first decade 1999 to 2008 health expenditures grew in the United Kingdom at an average rate of 7.2%, compared to 5.9% in the United States.
The nonpartisan Congressional Budget Office predicted in a March report that IPAB would have a similar impact on spending in this country that is to say, none.
As the IPABs drawbacks have become clearer, some strange political bedfellows have lined up to call for the panels repeal. Led by Congresswoman Allyson Schwartz, D-Pa., seven House Democrats now find themselves sharing common cause with House Budget Chairman Paul Ryan, R-Wisc., and the entire Republican caucus on this issue.
In fact, IPAB has never been popular with some of the staunchest defenders of President Obamas health care plan. More than 70 House Democrats called on President Obama and former Speaker Nancy Pelosi, D-Calif., to drop it during the debate before ObamaCares passage.
Leading liberal Congressman Pete Stark, D-Calif., has called IPAB a dangerous provision that sets [Medicare] up for unsustainable cuts and endangers patients health. And the National Committee to Preserve Social Security and Medicare a prominent supporter of Obamacare is now agitating for the Boards repeal.
Many more foes of IPAB may be waiting in the wings. According to a recent POLITICO report, several Democrats have privately acknowledged that they would vote to scrap the panel if the matter came to a vote.
After next months hearings, they may have that chance.