House of Representatives Votes to Repeal IPAB

The USA Today was the first to respond to the outcome of vote to repeal the IPAB this afternoon.  In their article, the author describes the quandary currently being faced by lawmakers in Washington, D.C.

The GOP has branded the Independent Payment Advisory Board a rationing panel, and Republicans hope the symbolic 223-181 vote to repeal it will persuade seniors that they, and not the Democrats, are the best stewards of Medicare.

IPAB would have the power to force cuts to service providers like drug companies if Medicare costs rise beyond predetermined levels. A Republican Medicare plan announced this week would also limit Medicare cost increases, but rely more on market competition.


All sides agree that Medicare as currently structured will not be able to pay its bills in the long run. The main options to control costs are unpalatable: tax increases, benefit cuts and cost shifts to middle- and upper-income retirees. Most Republicans and Democrats also agree now that there has to be a limit on future Medicare increases. The question is how.

Republicans would convert Medicare into a system dominated by private health insurance plans closely regulated by the government. Future retirees would get a fixed payment to buy either private coverage or sign up for a new government plan modeled on traditional Medicare. They count on competition among the plans to help keep costs in check, but the annual government payment would also be limited by tying it to a measure of economic growth.


Obama and the Democrats would take a far different approach to cost control, and that’s where the IPAB board comes in.

IPAB has the power to force payment cuts to service providers if costs rise beyond certain levels and Congress fails to substitute its own plan for savings. But the law explicitly forbids the board from rationing care, shifting costs to seniors, or cutting their benefits. The Democrats would put the burden on service providers, such as drug companies, insurers and eventually, hospitals

I’ll give the USA Today this much credit…most of the points from the article that I’ve included above are true.  Both Republicans and Democrats agree that Medicare costs are on an unsustainable path.  They do have very different ideas about how to solve the problem.

But this is as much truthfulness as was included in the article.  The author had the opportunity to expand on one of the most significant points pertaining to IPAB when they included this in the article:

Obama has yet to name anyone to the panel, whose 15 members must be confirmed by the Senate. Government economists are forecasting a period of manageable Medicare costs, meaning that IPAB’s services may not be needed until sometime around the end of the decade.

Since the author of the USA Today could not bring themselves to be totally honest about the subject with their readers, I’ll attempt to elaborate on the key point now.

The members of IPAB are appointed by the President, not elected.  The Independent Payment Advisory Board is just that…Independent, with no constraints, not even from Congress itself.  So the choice made by the President could have a tremendous impact on not only on our entire health care system but also in regards to who lives and who dies in this country.  The voices of those we elect to represent us, locally, would become completely and totally moot.

In considering the facts stated above about IPAB….let’s suppose for a second that President Obama wins the election in November, 2012.  We’ll take it even further and speculate that appointees to IPAB could have the same kind of mindset that has been displayed by Ezekiel Emanuel, who has served as health care advisor to President Obama. What kind of impact could this have on IPAB’s role in our society?

Well, we can evaluate this for ourselves by recalling earlier remarks that Mr. Emanuel has made:

Dr. Emanuel says that health reform will not be pain free, and that the usual recommendations for cutting medical spending (often urged by the president) are mere window dressing. As he wrote in the Feb. 27, 2008, issue of the Journal of the American Medical Association (JAMA): “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely ‘lipstick’ cost control, more for show and public relations than for true change.

True reform, he argues, must include redefining doctors’ ethical obligations. In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the Hippocratic Oath for the “overuse” of medical care: “Medical school education and post graduate education emphasize thoroughness,” he writes. “This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath’s admonition to ‘use my power to help the sick to the best of my ability and judgment’ as an imperative to do everything for the patient regardless of cost or effect on others.”


In the Lancet, Jan. 31, 2009, Dr. Emanuel and co-authors presented a “complete lives system” for the allocation of very scarce resources, such as kidneys, vaccines, dialysis machines, intensive care beds, and others. “One maximizing strategy involves saving the most individual lives, and it has motivated policies on allocation of influenza vaccines and responses to bioterrorism. . . . Other things being equal, we should always save five lives rather than one.


Dr. Emanuel concedes that his plan appears to discriminate against older people, but he explains: “Unlike allocation by sex or race, allocation by age is not invidious discrimination. . . . Treating 65 year olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not.”

The youngest are also put at the back of the line: “Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments. . . . As the legal philosopher Ronald Dworkin argues, ‘It is terrible when an infant dies, but worse, most people think, when a three-year-old dies and worse still when an adolescent does,’ this argument is supported by empirical surveys.” (thelancet.com, Jan. 31, 2009). (emphasis mine)

And for those who might be questioning whether the likes of someone such as Ezekiel Emanuel could be genuinely sincere in their viewpoint regarding the very young, you’re more than welcome to view recent reports of post-abortion discussions by medical ethicists.  They are sincere in this….deadly sincere, as the case may be.

It would all come to down to who is appointed to IPAB to implement these “cost-saving decisions”.  Actually, it all comes down to the mentality, mindset and ideology of the President who appoints the members of IPAB.

Obamacare is a horrible piece of legislation.  It’s more than a threat to just our freedoms and liberties…it’s a threat to our autonomy on even having the right to live.

I know that as Conservatives we should be waiting for and pursue full repeal of this legislation, but I for one would be thankful beyond what I could name if this single part of  the legislation is repealed NOW.

The likelihood that it will be is slim.  All the same, I hope that anyone reading this will recognize the tremendous threat that IPAB via Obamacare represents to all Americans, present and future, and that they will share this information with others to ensure that the truth is known.

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