This week, an article appeared in Medical Economics entitled “Doctor-patient relationship will be damaged by Medicare panel, critics warn” written by Brenda L. Mooney. In this constant swirling controversy of healthcare reform, her comments regarding Medicare is definitely worth a read. You may find the article below.
Although the Patient Protection and Affordable Care Act (PPACA) has many controversial provisions, perhaps none has been quite as much of a lightning rod as the formation of an Independent Payment Advisory Board (IPAB).
Opposed by more than 70 healthcare-oriented associations before the law was passed, the provision has continued to generate controversy. One of the most controversial aspects is the IPAB mandate that automatically triggers spending reductions when spending exceeds arbitrary levels.
Detractors warn that would lead to rationing of care reimbursed by Medicare, thereby interfering with a physician’s ability to determine appropriate treatment for an individual patient.
In introducing a hearing before the House Energy & Commerce Subcommittee on Health, the chairman, U.S. Rep. Fred Upton (R-MI) said, “The IPAB can certainly be counted among the issues that have only increased in controversy as lawmakers, patients, and doctors learn more about its vast power and potentially devastating consequences.”
Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services, disagreed with the criticisms of IPAB in her statement to the subcommittee. Reforms in the PPACA have extended the life of Medicare, which otherwise would be insolvent in 5 years, Sebelius said, and the IPAB is “a backstop to ensure Medicare remains solvent for years to come.”
The IPAB, which will be made up of 15 health experts and would begin making recommendations in 2014, is designed to improve Medicare and control costs, Sebelius said. “The IPAB is specifically forbidden from making any recommendations that would ration care, reduce benefits, raise premiums or cost-sharing, or alter eligibility for Medicare. And all final decisions remain in the hands of Congress.”
In addition to healthcare industry groups and a few Democrats concerned about perceived weakening of congressional authority over Medicare, Republicans—especially the GOP Doctor’s Caucus—have been among the most vehement opponents of the panel.
A few months ago, the caucus, composed of 21 medical providers in Congress, sent a letter to President Obama calling the IPAB “a blunt tool that ignores the needs of individual patients.”
“As doctors and nurses, we all agree that a Medicare reform plan based on one-size-fits-all economic model that prioritizes cutting areas of growth over the needs of individual patients is discriminatory,” the letter said. “Simply put, creating a board to cut patient services and provider rates will make it harder for those in need to find the care and life-saving treatments they require.”
After the hearing, U.S. Rep. Phil Gingrey (R-GA), founder of the caucus, expressed concernabout the IPAB’s effect on the doctor-patient relationship and strongly disagreed with Sebelius’ assessment that it would be positive.
“As a physician with almost 30 years of experience treating patients, I can tell you that this unelected, unaccountable, and undemocratic denial of care board will negatively impact the quality of healthcare that our seniors receive,” he said.
Republicans are expected to introduce a bill this fall to repeal the IPAB provision of the health reform law.
