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No Room for IPAB in the Patient-Doctor Relationship


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Health care reform should empower patient access and choice. Chief among the health care law's failures is the fact that it increases government control instead. Few provisions of the law highlight this better than the creation of a Medicare rationing panel of unelected bureaucrats.

The Independent Payment Advisory Board, or IPAB, is a committee of fifteen Presidential-appointees tasked with cutting Medicare if spending is deemed "too high." The President has yet to tell us who he might nominate for IPAB.

To meet its spending target, the board would be tasked with drastically cutting reimbursement rates to Medicare physicians, possibly to the point where these caregivers would stop seeing patients or providing certain services. Medicare physicians already receive reimbursement rates that are about twenty percent lower than those from private health plans. Slashing rates further would make it difficult for doctors to cover the costs of providing quality care to seniors.

What's more: because TRICARE reimbursement rates are directly tied to Medicare, health care for military personnel would be affected by IPAB cuts, as well.

Some will tell you that IPAB is prohibited from rationing care. However, the health care law never defines the word "ration." IPAB is free to deem a procedure or service unnecessary and cut reimbursement rates for them so low that no provider will offer the care. Whether a decision is rationing or results in the rationing of care is completely up to the fifteen appointed members of IPAB.

IPAB is not even required to account for its decisions or their consequences. The health care law does not require the board to meet in public or consider public comments, and the recommendations are not be subject to judicial review. Fast-track rules limit congressional review of any recommendations and make it nearly impossible to overrule them.

This panel embodies the very thing Americans fear most about the health care law: unaccountable Washington bureaucrats empowered to make unilateral medical decisions behind closed doors. If we want patients and their doctors to have control over their healthcare decisions, Congress must repeal IPAB.

I joined 222 of my House colleagues in passing the Protecting Access to Healthcare (PATH) Act (H.R. 5), a bill to repeal IPAB. More than 390 organizations support repeal of IPAB, including Easter Seals, the National Military and Veterans Alliance, and the American Medical Association. H.R. 5 now awaits Senate action.

We all know that the Democrat-controlled Senate has become a burial ground for bills to repeal the health care law and many of the law's most harmful provisions. That does not mean the House will stop trying. Consumer choice in health care -- the very thing that IPAB denies -- is too important to ignore.

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