In the fall, House Republicans intend to vote on legislation (HR 452) that would repeal the Independent Payment Advisory Board created by the federal health reform law, CQ HealthBeat reports (Adams, CQ HealthBeat, 7/15).
IPAB will consist of 15 health experts tasked with making recommendations to Congress to reduce Medicare spending growth. The panel is designed to include various health care stakeholders and researchers, including physicians, health economists, insurers and consumer advocates.
IPAB has become steeped in controversy, with some Republicans alleging it will ration care (California Healthline, 7/13). Republicans' push to eliminate IPAB comes as some Democrats have begun to waver on the panel, questioning the wisdom of an entity other than Congress making entitlement spending decisions (CQ HealthBeat, 7/15).
HHS Secretary Kathleen Sebelius last week at a House Budget Committee hearing defended the panel, saying that it cannot make suggestions that would ration care, raise premiums, increase cost-sharing, cut benefits or alter Medicare eligibility (California Healthline, 7/13).
Despite the recent attention the panel has garnered, experts note that it will be at least a decade before any recommendations it makes affect Medicare (CQ HealthBeat, 7/15).
Republicans lately have continued their criticisms of the panel. At a recent press conference of the GOP Doctors Caucus, Rep. Phil Gingrey (R-Ga.) said, "Under this IPAB … a bunch of bureaucrats decide whether or not you get care, such as continuing on dialysis or cancer chemotherapy," adding, "I'll guarantee you, when you withdraw that [care], the patient is going to die."
Meanwhile, GOP presidential candidate Rep. Michele Bachmann (Minn.) recently said that IPAB will leave Medicare beneficiaries without "control over what they actually get in Medicare" because the panel "will make the decisions about what care we get and what care we don't" (Alonso-Zaldivar, AP/Sacramento Bee, 7/18).
The Power of 'Rationing' as a Rhetorical Tool
Experts say that Republicans continue to employ the tactic of raising the specter of rationing in regard to IPAB because U.S. residents seem to respond strongly to such criticisms, CQ HealthBeat reports. For example, Democrats last year abandoned a plan to have Medicare pay for voluntary end-of-life consultations between patients and doctors because the GOP said the sessions qualified as rationing, labeling them "death panels."
American Enterprise Institute Scholar Joe Antos said that "the average citizen will say, 'I'm worried about what [IPAB] can do.'" He added, "Really, people imagine the worst: Their loved one or child has a terrible diagnosis and they won't be able to get the $100,000 treatment they need because of this board. For Republicans, all they have to do is say 'rationing,' and that's it" (CQ HealthBeat, 7/15).