After months of denial that healthcare reform would involve rationing of healthcare for those who are the most vulnerable, the senior citizens who depend on Medicare, the President has come up with a proposal to decrease healthcare costs and guess what....it’s rationing.
Under Obamacare, a 15 member panel known as the Medicare Independent Payment Advisory Board (IPAB
) was created to ‘oversee healthcare costs’. This panel consists of individuals appointed by the President and confirmed by Congress - two ingredients that make it highly unlikely that they would be truly independent. In addition, there is no requirement that members be practicing physicians which is a recipe for cuts that are highly likely to affect the delivery of quality individualized patient care.
Under his deficit reduction plan, the President proposes to expand the power of this unelected entity to increase the GDP growth per capita cut from the current 1% to 5%. In addition, under his proposal Medicaid payments to states would also be tightly controlled and access to drugs would be limited through spending on prescription drugs.
There are two things that make this proposal doomed to fail if the goal is to decrease health costs while providing quality care:
- It does nothing to change the exemptions that were given to the hospitals, and other Medicare providers that make up a majority of Medicare spending thereby protecting them from the reach of the IPAB.
- It will further decrease the already below market rate of Medicare reimbursements to doctors making it even more difficult to provide both quality care for the Medicare patient and to keep their practices open.
However, if the goal is to limit healthcare costs by reducing access to physicians
, restricting choice of treatments, restricting access to medication and technology, and/or hoping that people will either be to sick or too frustrated to access the system while playing the crony politics of rewarding those who helped craft Obamacare, then it is well on its way.