The Affordable Care Act — also called the health care reform act or “Obamacare” — is still being debated even though it passed over a year ago. Many provisions in the ACA pertain to Medicare, which makes it of particular importance to many mesothelioma patients. This deadly lung cancer is most often diagnosed in people who are in or approaching their Medicare years.
One provision of the ACA generating controversy is the Independent Payment Advisory Board, or IPAB. IPAB will be a panel of health care experts — including doctors and patient advocates — who will look for ways to save money in the Medicare program.
IPAB won’t exist until 2013. Even then, it has no responsibilities unless Medicare spending grows faster than projected. In that event, the IPAB will make recommendations to Congress about how to more efficiently run Medicare to keep costs low, without compromising care.
Congress may accept or reject these recommendations. However, if it rejects a recommendation, under some circumstances Congress may have to find another way to save the same amount of money.
There are some kinds of changes IPAB is not allowed to recommend. These include health care rationing, raising taxes, raising premiums, or changing eligibility. The panel may not dictate to doctors how to care for Medicare patients. And the scope of its authority is strictly limited to Medicare alone.
Even with the limitations, however, the IPAB is expected to help contain costs. Henry J. Aaron wrote in the New England Journal of Medicine,
“In enacting the ACA, Congress created a broad and potentially powerful portfolio of cost-control instruments, containing virtually every method that analysts have advanced for slowing growth of spending in a rational fashion — accountable care organizations, comparative-effectiveness analysis, bundled payments, value-based insurance design, limits on the exclusion of employer-financed premiums from personal income tax, and health insurance exchanges to promote competition among insurance plans.”
So what’s the problem? In a word — politics.
The health care industry is lobbying to repeal the IPAB. Saving money on Medicare means some part of the industry will be receiving less money.
But on top of that, some politicians are trying to paint IPAB as the new “death panels.” These politicians claim IPAB will be set up to ration care, even though it is prohibited by law from rationing care.
Last month, Minnesota congresswoman Michele Bachmann, a candidate for the Republican presidential nomination, said that under IPAB seniors would lose control of Medicare. A “politically appointed 15-member board that’s unelected and unresponsive to the will of the people called IPAB will make the decisions about what care we get and what care we don’t,” she said.
Criticism of IPAB has increased in recent weeks, after a Republican proposal to privatize Medicare proved to be hugely unpopular and a political liability. Democrats have been getting traction with voters by bashing the so-called “Ryan plan.” Observers say Republicans are turning IPAB into the bogyman as a way of fighting back.
The fact is that the IPAB will have no authority to decide what health care anybody gets. It is the Independent Payment Advisory Board, not the independent medical care advisory board. Its task will be to look at how medical care is paid for through the Medicare program and find ways to save money. And those ways may not include rationing.
This entry was posted on Monday, July 18th, 2011 at 2:15 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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