ObamaCare's IPAB Spells Medicare Rationing


During my career as a heart surgeon, I often treated patients who had difficulty finding a primary care doctor because they were on Medicare.  The problem persists today, and the new health law will make it worse.  One out of five seniors report delays in seeing a doctor.

Medicare doctors face almost $300 billion in automatic cuts during the next decade.  Under current law, Medicare’s independent actuary predicts physician payments will “fall to 27% of private health insurance levels” and “less than half of the projected Medicaid rates.”

The new health care law creates more life-threatening delays for seniors under President Obama’s Independent Payment Advisory Board (IPAB).  This 15-member panel of presidential appointees will make new cuts to meet annual spending targets.  IPAB will have unprecedented control over patients’ personal medical decisions, but limited medical expertise.  The law limits membership of doctors with real experience caring for patients, instead selecting numbers-crunchers focused only on costs.  Experts in “technology assessment” will help devise payment formulas that prevent new lifesaving medical breakthroughs.

In defending this new rationing board, Health and Human Services Secretary Kathleen Sebelius called IPAB’s new automatic cuts “recommendations.”  She neglected to explain that IPAB’s decisions carry the force of law unless two-thirds of the House and Senate vote to stop them.  In a shameless power grab, ObamaCare also prohibits judicial review of cuts harmful to seniors.

Sebelius insists IPAB may not “ration” care, but she admits the new law fails to define the word.  By slashing payments below costs, IPAB will deprive patients of needed care.  While IPAB can’t outlaw needed treatments, it can force frail patients to wait longer or travel farther.  It can also penalize doctors who offer a new and more effective treatment.

Even the left-leaning Kaiser Family Foundation agrees IPAB must cut below annual spending targets “even if evidence of access or quality concerns surfaced.”  Sebelius mentions her responsibility to improve access … for all our Medicare beneficiaries,” but will she define rationing in the final IPAB rule to protect seniors’ timely access to needed care?

We cannot serve patients’ best interests by allowing unelected bureaucrats to make critical medical decisions.  Even Democrats who voted for ObamaCare support repealing IPAB before it begins.  Rather than defending IPAB, Sebelius should side with the seniors it would harm and call for its repeal.