by Diane Cohen, general counsel with the Liberty Justice Center
During last night’s debate, Vice President Joe Biden literally laughed off suggestions that ObamaCare sets up a death panel for Medicare recipients. This follows President Obama’s claim in the first debate that ObamaCare’s more than $700 billion cut to Medicare will not directly reduce Medicare benefits but only cut payments to providers. But they both fail to recognize the obvious: when providers are not paid for their services, they will either cut back or stop providing their services altogether. And whatever one calls it – and it is far from funny ObamaCare sets up a panel that will make life and death decisions for America’s seniors.
ObamaCare’s Independent Payment Advisory Board, or IPAB, will have the power to dictate whether and how much medical providers can be reimbursed for medical care provided to seniors. This means that IPAB can decide not to reimburse for services in any manner it sees fit, which translates to seniors being denied medical care. That is why IPAB is a rationing board. And despite the law’s so-called prohibition on rationing, that term is not actually defined in the law. Therefore, “rationing” will be whatever IPAB says it will be because there is no judicial check or meaningful congressional oversight on its decisions.
IPAB will be composed of 15 presidentially-appointed, unelected bureaucrats who will have sweeping powers to control the entire health care industry. Because IPAB is not required to be bipartisan, President Obama could use his power to make recess appointments, as he has done before. That means he could stack the board entirely with members of his own party, who could then exercise all of the board’s powers. Even worse, while the board is meant to have 15 members, there’s no requirement that it must. The President could give all of this power to just one person by appointing only one board member, or appoint none, in which case his Secretary of Health and Human Services would exercise the power.
Supporters claim that if other parts of ObamaCare work as hoped to keep costs down, there will be no need to invoke IPAB’s powers. We know this won’t work out as planned. ObamaCare is not working to keep costs down. Instead, the average family premium has increased $2,200 since 2010, while the projected cost of the law has doubled, from its original estimate of $900 billion to $1.7 trillion.
To be sure, IPAB is not about keeping “cutting costs” either; it is about cutting access to care. In fact, IPAB will do nothing but cut access to care as a result of having the unchecked power to dictate whether and how much medical providers can be reimbursed for medical care.
It is quite ironic to hear criticism of the Medicare reform plan jointly proposed by Mitt Romney’s running mate, Rep. Paul Ryan, and Sen. Ron Wyden (D-Oregon). The Ryan-Wyden plan would keep the traditional Medicare option available to seniors, but also give seniors the freedom to choose among an array of private insurance options, building off the successes of the popular Medicare Part C program. Under the plan, seniors would always have two insurance options at no additional cost to them, and if they would prefer higher cost plans, they would be asked to make up the difference. Lower income seniors and those with chronic conditions would receive extra help, and those with higher incomes would receive less.
Far from being “Mediscare,” as opponents have named it, Rep. Ryan’s plan is true reform. Individuals are put in charge of their own health care decisions, from the insurance they purchase, to the providers they see, to the treatment they choose.
But IPAB is now the law. And giving 15 bureaucrats the power to decide your fate? That is something to be truly scared about.
Read more about Cohen's analysis of IPAB.