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Full-Year Continuing Appropriations Act, 2011

Floor Speech

Location: Washington, DC


Ms. HAYWORTH. Mr. Chairman, I have an amendment at the desk.

The Acting CHAIR. The Clerk will designate the amendment.

The text of the amendment is as follows:

At the end of the bill (before the short title), insert the following:

Sec. __. None of the funds made available by this Act may be used to implement section 1899A of the Social Security Act (42 U.S.C. 1395kkk), as added by section 3403 of the Patient Protection and Affordable Care Act (Public Law 111-148).

The Acting CHAIR. Pursuant to the order of the House of February 18, 2011, the gentlewoman from New York (Ms. Hayworth) and a Member opposed each will control 3 minutes.

The Chair recognizes the gentlewoman from New York.

Ms. HAYWORTH. Mr. Chairman, section 3404 of the Patient Protection and Affordable Care Act created the Independent Payment Advisory Board, known by the acronym ``IPAB.'' Beginning in 2014, this 15-member board will be charged with cutting the growth rate of Medicare spending. IPAB is designed as a bureaucracy that will be looking not at how to improve patient care but how to hit an expenditure target.

PPACA limits what IPAB would be able to do to restrict cost growth. For example, IPAB cannot recommend higher cost sharing, or otherwise restrict benefits or eligibility. The primary means of achieving expenditure targets will be to reduce payments to physicians and hospitals. This, in turn, will reduce access to providers--access that Medicare patients need to have--as the providers will find that they will not be able to afford to accept Medicare's reimbursement rates.

Furthermore, Congress ceded a tremendous amount of power to the IPAB. If Members believe that the cuts proposed by IPAB won't work or are too draconian, it will take an affirmative act by future Congresses to overturn its recommendations. This represents an abdication of responsibility by Congress, whose Members are expected to make these decisions, not unelected, unaccountable Federal bureaucrats. Equally troubling, the IPAB bears more than a passing resemblance to the British National Institute for Clinical Excellence, which governs payment for the National Health Service.

From my vantage point as an ophthalmologist, one example will demonstrate why a similarity between IPAB and NICE, which is the ironic acronym for this powerful British entity, should give all of us pause. Up until a couple of years ago, NICE refused to pay for treatment for a form of macular degeneration that led, in most cases, to legal blindness if the sufferer had good vision in the other eye. This is nearly impossible for an American to fathom that a government agency would compel a doctor to, in effect, calmly watch a patient go blind in one eye even though vision-saving treatment was available.

If an unelected board of advisers is compelled to make decisions primarily on the basis of cost, then this is the kind of awful choice our doctors and patients may well be forced to accept; and this is one of many reasons the Affordable Care Act was repealed by the House last month. We honor the goals of this law to allow all Americans to have access to good care with affordable, portable health insurance; but we need to go about achieving those goals while preserving the choice, quality and innovation that Americans expect and deserve.

As we craft alternatives that will honor the best of American medicine, we will best serve our citizens by prohibiting any funding towards the implementation of the Independent Payment Advisory Board.

I strongly urge the support of all Members for the amendment I am sponsoring, and I thank you.

I yield back the balance of my time.


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