{"id":16972,"date":"2017-06-14T10:40:57","date_gmt":"2017-06-14T14:40:57","guid":{"rendered":"http:\/\/www.megalextoria.com\/wordpress\/?p=16972"},"modified":"2022-01-21T09:27:48","modified_gmt":"2022-01-21T14:27:48","slug":"15-faceless-bureaucrats-will-decide-what-health-care-youre-allowed-to-have","status":"publish","type":"post","link":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/2017\/06\/14\/15-faceless-bureaucrats-will-decide-what-health-care-youre-allowed-to-have\/","title":{"rendered":"15 Faceless Bureaucrats Will Decide what Health Care You’re Allowed to Have"},"content":{"rendered":"

\"\"<\/a><\/h2>\n

15 Faceless Bureaucrats Will Decide what Health Care You’re Allowed to Have<\/h2>\n

President Trump and congressional Republicans have a second<\/span> chance to take a whack at the Obamacare pi\u00f1ata \u2013 and the beauty of it is that this time, <\/span>Democrats<\/span> may want to take a swing at it, too.<\/span><\/p>\n

\u201cIt\u201d being the Independent Payment Advisory Board (IPAB), a.k.a the <\/span>death panel<\/span> that was much in the news during the debate over passage of the Affordable Care Act but which then quietly faded away. For the time being.<\/span><\/p>\n

And for good reason \u2013 especially as far as Democrats are concerned.<\/span><\/p>\n

The IPAB\/death panel is to be composed of 15 bureaucrats appointed to six-year terms by the President. Future tense because the 15 bureaucrats haven\u2019t been appointed yet. Because the IPAB hasn\u2019t been \u201cconstituted\u201d yet. Thankfully.<\/span><\/p>\n

It is, however, slated by statute to come online once Medicare spending reaches a certain threshold relative to the Consumer Price Index. Kind of like an alarm clock you hope never goes off. <\/span><\/p>\n

Given the continued rise in health care costs, especially Medicare costs (the \u201cAffordable\u201d Care Act\u2019s easy promises of reduced costs notwithstanding), this could happen as early as next year. As soon as the actuary for Medicare\/Medicaid Services issues a report \u2013 already overdue for 2017 \u2013 that the “targets” have been exceeded, the IPAB <\/span>automatically<\/span> rises to life \u2013 in order to dispense death.<\/span><\/p>\n

And <\/span>that<\/span> is what has Democrats worried.<\/span><\/p>\n

Bureaucrats Directing Your Doctor<\/strong><\/p>\n

Nominally, the IPAB was created to control Medicare spending \u2013 supposedly by cutting red tape and so on. In practice, and notwithstanding assurance to the contrary, it would inevitably become a <\/span>de facto<\/span> price control\/care-rationing body, cutting costs by unilaterally reducing “authorized” payments to doctors and other providers and by the simple expedient of declaring various treatments \u201cnot cost-effective,\u201d thereby denying treatment outright.<\/span><\/p>\n

To paraphrase Joe Stalin: No care, no problem.<\/span><\/p>\n

It is Orwellian that the same Democrats who endlessly accuse Republicans of seeking to “deny care” to people have done exactly that by legislative and bureaucratic fiat.<\/span><\/p>\n

By statute, the IPAB is <\/span>required<\/span> to cut costs in line with arbitrary \u201ctargets\u201d \u2013 regardless of the effect on care. There is no provision for judicial or administrative review. Even the President is powerless to remove IPAB bureaucrats, once they are appointed. The IPAB is effectively both omnipotent and unaccountable. <\/span><\/p>\n

It is, in a very real sense, the not-yet-popped kernel of a UK-style single payer system in which neither you nor your doctor decide what care is needed, nor what care you\u2019ll get. Instead, faceless bureaucrats \u2013 people neither you nor your doctor will ever meet or even talk with \u2013 would determine the care you\u2019ll be <\/span>allowed<\/span> to get.<\/span><\/p>\n

This, perhaps, is what former Speaker of the House Nancy Pelosi \u2013 an ardent backer of the Affordable Care Act \u2013 meant when she said, “You have to pass it in order to find out what’s in it.”<\/span><\/p>\n

Well, surprise. <\/span><\/p>\n

The Chance to End the IPAB Before It Happens<\/strong><\/p>\n

It’s no surprise that almost everyone who has found out \u2013 or will soon \u2013  what the IPAB actually is either loathes it or is uneasy about defending it. Which presents a fantastic opportunity to do away with it. <\/span><\/p>\n

Republicans have of course always objected in principle to the idea of empowering government bureaucrats to interpose themselves between patients and doctors and to the rationing of care \u2013 and to government death panels. <\/span><\/p>\n

Democrats, on the other hand, are boxed into a corner. The whole point of Obamacare was to increase access to care \u2013 or so they claimed. But the ugly fact is that the IPAB will reduce access to care. Will ration care. Will deny people care. In particular, to older people \u2013 those dependent on Medicare. <\/span><\/p>\n

This time, it won’t be hard-hearted insurance companies that pull the proverbial plug on grandma. It will be the much harder-hearted government. One can always change insurance policies. But there is no way to get away from government.<\/span><\/p>\n

If the IPAB is ever \u201cconstituted,” it will be <\/span>compulsory<\/span>. You will not be allowed to say \u201cno, thanks\u201d to it. You will not even be <\/span>asked<\/span>. The 15 unelected bureaucrats will simply <\/span>decree<\/span>.<\/span><\/p>\n

Democrats will have a tough time facing their constituents once they find out what the IPAB is all about.<\/span><\/p>\n

The good news \u2013 the huge news \u2013 is that it’s politically feasible to prevent the IPAB from ever being \u201cconstituted\u201d if action is taken within the next couple of months. A provision was built into the arcana of the Affordable Care Act that makes it possible to hit the \u201ddelete\u201d button on the IPAB without broaching the broader issue of the ACA itself.<\/span><\/p>\n

In other words, it is not necessary to repeal and replace Obamacare in order to get rid of the IPAB death panel. It’s an <\/span>a la carte<\/span> opportunity to nix a dangerous provision of Obamacare.<\/span><\/p>\n

This must, however, be done by August 15, 2017 \u2013 just two months from now.<\/span><\/p>\n

Republicans not only oppose the IPAB as a matter of principle, they very much need a legislative victory, particularly on the health care issue.<\/span><\/p>\n

Democrats may not be particularly interested in helping them win one, of course. But they aren’t in a strong position to prevent one, either.<\/span><\/p>\n

It will be very politically difficult for them to defend rationing health care \u2013 and denial of care outright \u2013 to their constituents. They may not smile and shake hands for the cameras over this, but it’s not likely they’ll mount a vigorous opposition, either. Democratic Sen. Ron Wyden of Oregon has already joined with Republican John Cornyn of Texas on <\/span>bipartisan legislation<\/span><\/a> to repeal the IPBA \u2013 and there is a <\/span>companion repeal measure<\/span><\/a> in the House that has 124 co-sponsors. <\/span><\/p>\n

Republicans could easily jump-start the effort to get repeal and replace Obamacare by getting rid of it one piece at a time.<\/span><\/p>\n

And with the help of Democrats this time.<\/span><\/p>\n


\nEric Peters
\n<\/a><\/p>\n

Eric Peters is an automotive journalist<\/a>. Eric started out writing about cars for mainstream media outlets such as The Washington Times<\/em>, Detroit News<\/em> and Free Press<\/em>, Investors Business Daily<\/em>, The American Spectator<\/em>, National Review<\/em>, the Chicago Tribune<\/em> and Wall Street Journal.<\/em><\/p>\n

This article was originally published on FEE.org. Read the original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

15 Faceless Bureaucrats Will Decide what Health Care You’re Allowed to Have President Trump and congressional Republicans have a second chance to take a whack at the Obamacare pi\u00f1ata \u2013 and the beauty of it is that this time, Democrats may want to take a swing at it, too. \u201cIt\u201d being the Independent Payment Advisory Board (IPAB), a.k.a the death panel that was much in the news during the debate over passage of the Affordable Care Act but which then quietly faded away. For the time being. And for good reason \u2013 especially as far as Democrats are concerned. The IPAB\/death panel is to be composed of 15 bureaucrats appointed to six-year terms by the President. Future tense because the 15 bureaucrats haven\u2019t been appointed yet. Because the IPAB hasn\u2019t been \u201cconstituted\u201d yet. Thankfully. It is, however, slated by statute to come online once Medicare spending reaches a certain threshold relative to the Consumer Price Index. Kind of like an alarm clock you hope never goes off.  Given the continued rise in health care costs, especially Medicare costs (the \u201cAffordable\u201d Care Act\u2019s easy promises of reduced costs notwithstanding), this could happen as early as next year. As soon as the actuary for Medicare\/Medicaid Services issues a report \u2013 already […]<\/p>\n","protected":false},"author":1,"featured_media":16973,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[2712,2711,1252],"class_list":["post-16972","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news-and-politics","tag-death-panel","tag-ipab","tag-obamacare"],"_links":{"self":[{"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/posts\/16972","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/comments?post=16972"}],"version-history":[{"count":0,"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/posts\/16972\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/media\/16973"}],"wp:attachment":[{"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/media?parent=16972"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/categories?post=16972"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.megalextoria.com\/wordpress\/index.php\/wp-json\/wp\/v2\/tags?post=16972"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}