“The Independent Payment Advisory Board (IPAB) was created based on the premise that decisions about the pricing of health benefits offered by Medicare are simply too contentious to be adequately handled by our present political system. But these decisions are precisely the kinds of consequential choices that should be subject to close public scrutiny and an open, rigorous, and transparent decision-making process that engages with Medicare’s stakeholders. Changes to the way Medicare pays for and covers medical services affect too many people in significant ways to be made behind the closed doors of an insulated committee.”
“Democrats don’t use such hyperbole, but more than half a dozen have signed on as cosponsors of a bill that would repeal the board. And many more, particularly Democrats in the House, never supported creating the board in the first place… [I]t could end up driving Medicare payments so low that providers will simply leave the program, or else go bankrupt if they can’t.”
“Yesterday, the Department of Health and Human Services (HHS) released its proposed regulations for the Obamacare version of health insurance exchanges. State lawmakers are a key audience for these regulations, which is why HHS wrapped its announcement in talk of ‘state flexibility.’
In truth, the proposed regulations don’t give states any additional flexibility beyond what they are permitted under Obamacare anyway, and in some places they may further limit state lawmakers’ options.”
“ObamaCare doesn’t just create IPAB. It also sets in place a series of barriers designed to make it extremely difficult to repeal. So if Congress wants to get rid of IPAB, it will have to jump through a complex set of hoops first. That means acting swiftly and with great unity. The health care overhaul contains a provision labeled Joint Resolution Requirements to Dissolve the Board that lays out exactly the steps that Congress must follow if it wants to take down IPAB. The provision lays out in great detail what a joint resolution to dissolve IPAB would have to look like, and then sets out a further requirement that it must be introduced between January 1 and February 1, 2017—meaning Congress would have to act in just a few working days.”
“IPAB is fatally flawed, structured to punish innovative health care providers and threaten seniors’ access to care — while leaving the largest sources of Medicare spending untouched. It continues Washington’s obsession with price-fixing in Medicare’s separate ‘silos’ rather than changing the incentives that have led to rampant overspending, fraud and uneven care quality.”
“It is three years before most of the new health-care law kicks in, but already some of America’s largest employers are peppering the Internal Revenue Service with concerns that making the changes will be far more complex than they anticipated. At issue is one of the law’s central requirements: employers with 50 or more full-time workers must offer affordable insurance or pay a penalty. It sounds simple enough. But in crafting the rules, the IRS and two other federal agencies are now tackling basic yet messy questions, such as who counts as a full-time worker and how do companies measure whether insurance is ‘affordable.'”
“Clearly, the IPAB is unprecedented in the
power given to unelected officials to direct
hundreds of billions of dollars in federal
spending. The IPAB will give unelected,
unaccountable government appointees the
power to make decisions about payment
policy in Medicare that will ultimately
determine whether millions of seniors have
access to the care they need.”
“After all, how can there be a moral case for a 2,700 page bill that was shaped and molded by self-seeking interests, with no more regard for principle than one would find in a game of musical chairs? Isn’t asking for a moral defense of ObamaCare sort of like asking what is the moral case for the IRS Code?
Even if you believe that some of us have a moral obligation to others in the matter of health care, what does that belief have to do with legislation in which costs and benefits are strewn about with all the care of a drunken sailor? Isn’t the Affordable Care Act (ACA) self-evidently immoral? Or at least amoral?”
“The 2010 health care law, the Patient Protection and Affordable Care Act (PPACA), hits small business with a barrage of inequities. Among the most egregious is the health insurance tax (HIT) launched by the law’s Section 9010. Ostensibly a tax on insurers, its real effect will be hundreds of billions of dollars of taxation on people who purchase coverage in the fully-insured market – mostly small business employers and employees and the self-employed. These are the people who usually generate around two-thirds of America’s new jobs.”
“No one wants to be ‘average,’ but when it comes to medicine, being treated as an individual takes on a whole different meaning. Every patient’s treatment should be informed by the best evidence and the best science we have, but at the end of the day the best outcomes depend on a doctor using his or her best medical judgment to help the patient sitting in their office — not an abstract ‘average’ patient as defined by large studies that are more designed to cut costs than optimize outcomes.”