The Independent Payment Advisory Board, or IPAB, is one of the lesser-known features of "healthcare reform" tucked away in the thousands of pages of the "Stimulus Bill" from 2009 and the healthcare law passed in March 2010.
Just exactly what is IPAB and how does it affect your life and health, and your access to medical care? And how does IPAB fit with our Constitutional Republic and our guarantees to "life, liberty and the pursuit of happiness" under the US Constitution?
IPAB is a panel of unelected, government-appointed bureaucrats set up under the guise of "efficiency" and "clinical effectiveness" to "recommend" cuts to Medicare services in order to "bend the cost curve downward." That is government-speak for "spend less money on patient care."
IPAB is a threat to your health, and your life, if you are the patient whose care is denied because of your age, your condition, and cost based on how many "quality" years you are expected to live.
IPAB is set up to function exactly like the rationing board of the National Health Service (NHS) in Britain, called National Institute of Clinical Excellence (NICE). The strong arm of NICE prevents NHS doctors from prescribing state-of-the-art drugs for breast, stomach, lung, and prostate cancer or diseases like multiple sclerosis, rheumatoid arthritis, and many others.
IPAB is also charged with slowing the growth of payments to doctors and hospitals, reducing the rate of medication reimbursement under Medicare, and "reducing waste" in Medicare spending. "Waste," however, is defined solely by bureaucrats, and may include medicine you actually need.
An 80-year-old patient recently said, "The pharmacist just told me that Medicare is no longer going to pay for my heart medicine because I am now too old." His choice? Pay out of pocket or die.
Recently, the government quietly directed Medicare to cut reimbursement for 4 million diabetic seniors by 66% and also reduced the number of companies that are allowed to supply blood sugar monitoring supplies from more than a thousand to 15. Older patients are already being hurt by Obamacare reductions in Medicare services.
Dr. Jane Orient, Executive Director of the Association of American Physicians and Surgeons said "Even the American Medical Association (AMA), which endorsed ObamaCare, is calling for repeal of IPAB, citing worries about payment cuts, lack of 'meaningful dialogue' with Congress, and potentially limited access to care."
The AMA avoids strong words like "death," "dictatorship," "rationing," and "unconstitutional." But as physicians, we do use those terms because our focus is on the lives of our patients. And IPAB is very bad "medicine" for older patients whose medical care is being cut so that Medicaid can be expanded for younger people.
What about IPAB and abuse of power as a threat to the Constitution? In her new book, Beating Obamacare, Betsy McCaughey explains it like this: "IPAB is a radical departure from Medicare as we've known it. In creating IPAB, Congress cedes nearly all control over Medicare spending to unelected bureaucrats. Congress is admitting it doesn't want to make unpopular cuts and then face seniors. The Obama health law says the whatever cuts IPAB 'recommends' automatically go into affect unless Congress enacts a different set of Medicare changes with the same net savings. That arrangement-making IPAB into a lawmaking body-turns the U.S. Constitution on its head, many argue."
As a physician who took an Oath to serve the individual patient to the best of my ability and judgment, I believe it is a major assault on our very right to life to have unelected, politically appointed bureaucrats making medical decisions-especially without any right of appeal or Congressional oversight or judicial review. In passing the healthcare law, the Democrats ruled out any review of IPAB diktats now or in the future-an astonishing abuse of power.
Life is a gift from our Creator, not the government. IPAB must be repealed before we become like Britain: a place where old people are condemned to die sooner than God intended.