IPAB: Are you ready for rationing? by Dr. Mark G. Neerhof

October 16, 2012

IPAB: Are you ready for rationing?

As a physician, I would like to make you aware of the Independent Payment Advisory Board, or IPAB, a key element in President Obama’s federal takeover of medicine.

IPAB is a board consisting of 15 unelected, appointed bureaucrats whose task it is to cut the growth of Medicare spending, and the cuts they are mandated to make will be deep. The decisions IPAB makes behind closed doors can only be overturned by a supermajority of Congress, something almost impossible to achieve. So the politicians have set up a system where they can say to seniors “it was those bureaucrats that cut your Medicare, not me.”

How does IPAB achieve these cuts? The supporters of the law say, “it says right in the statute IPAB cannot ration.” But what IPAB can do, and in fact is their only option for controlling costs, is to cut reimbursement rates to doctors and hospitals. They decide what procedures are important, not your doctor, and they decide what Medicare will pay for them. When services are no longer available to seniors because reimbursements for those procedures have been drastically cut, that’s rationing.

You have also been promised that “if you like your doctor, you can keep your doctor.” As a physician I have watched reimbursement rates fall below cost and more and more of my colleagues are refusing to take on new Medicare patients, or they are getting out of medicine altogether. Seniors complain and then Congress runs in with a temporary “doctor fix.” But with IPAB there is no “doctor fix.” Physician reimbursements will be slashed to unsustainable levels. It is a simple fact that no doctor or hospital can offer services below cost and stay in business.

When government takes over health care you become a budget item. Medical decisions are made based upon the amount of money available not on what is best for patients.

In November we will choose what kind of health care system our aging parents, our children and we ourselves will enjoy. President Obama’s approach is top-down, government controlled medicine that gets between you and your doctor, stifles the innovation that has made American medicine the best in the world and controls costs by offering you less medicine and fewer doctors.

By contrast, Romney/Ryan offers seniors a choice: Stay with traditional Medicare or use your Medicare benefits to choose a plan better suited to your needs.

Millions of seniors are already doing something similar by choosing a Medicare Advantage Plan and Medicare’s Part D Prescription Drug Plan is entirely run by private companies. Medicare Part D is given high marks by seniors and currently cost 40% less than it was projected to cost when it was passed into law.

Competition can work in medicine to drive down costs and encourage quality and innovation. Medicare Advantage and Medicare Part D are proof that competition works. We don’t have to settle for rationing but that is what we will get with four more years of President Obama moving us “Forward” to government medicine.

A version of this Op Ed was published at CNS news on October 15 at http://cnsnews.com/blog/dr-mark-g-neerhof/obamacare-s-ipab-when-government-takes-over-health-care-you-become-budget

Dr. Mark G. Neerhof
Attending physician, NorthShore University HealthSystem
Clinical Associate Professor of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicin
Executive Board Member, Docs 4 Patient Care

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