Weekly Columns

The IPAB is Bad Medicine for Seniors

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Washington, February 29, 2012 | comments

This week, the House Energy and Commerce Health Subcommittee marked up H.R. 452, the Medicare Decisions Accountability Act, legislation I introduced to repeal the dangerous rationing board created by the Affordable Care Act – the Independent Payment Advisory Board (IPAB).

Next week, the House Ways and Means Committee is holding a hearing to examine the impact IPAB will have on the Medicare program.  There is bipartisan concern about this board and how it could harm Medicare.  It is important for these committees to shine light on the dangers posed to seniors by the IPAB.

The IPAB will consist of a group of fifteen unelected bureaucrats who will decide what constitutes “necessary care,” and who will create a “one size fits all” solution when it comes to medical care.  As a physician, I can tell you firsthand how troubling this mindset can be.  In medicine, every case is unique and must be treated that way.

IPAB has two significant structural problems—it is both unaccountable and unworkable. The board is empowered to make recommendations regarding Medicare without any input from the Congress. Don’t just take my word for it – President Obama’s former Budget Director Peter Orszag has called IPAB the “single biggest yielding of power to an independent entity since the creation of the Federal Reserve.”

The IPAB is duplicitous for many reasons: it shifts health care decision-making power away from the patient; it will operate without transparency or accountability, bypassing all Congressional oversight; and it places the focus on slashing Medicare costs, rather than on improving the quality of care.  If Congress fails to change IPAB’s recommendations, they go into effect automatically, and it’s important to note that Congress can only change where, but not how much, to cut.

Even after the IPAB makes its recommendations, the hands of the legislature are still tied. The proposal would be considered under “fast-track” procedures and, without a three-fifths vote of the Senate, Congress can only modify the type of cuts, not their size. And if Congress fails to act on the board’s recommendations, they automatically go into effect. This isn’t government by the people; it is instead government by the bureaucrats.

While it seems there is little that our two parties can agree on in the current environment, both sides have acknowledged that the IPAB is a terrible idea. That’s why my bill to repeal the IPAB—the Medicare Decisions Accountability Act—has more than 226 bipartisan cosponsors. The American Medical Association has endorsed my legislation, as did a broad coalition of more than 270 health care-related organizations.

Regardless of political party, our common goal should be to protect and preserve Medicare, not expand the scope and amount of the cuts the IPAB is tasked with, as President Obama has proposed in his budget.  We need to focus on repealing this board before it affects the care of our seniors. I urge a bipartisan repeal of the IPAB.


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