President Obama’s ACA established the Independent Payment Advisory Board (IPAB),
a 15-member panel of unelected federal employees; its members to be appointed by the president and confirmed by the Senate.
The law does not require the IPAB to be bi-partisan in structure, as is required for almost all other independent agencies. Its mission is specific – to restrict payments to doctors and hospitals in order to achieve a reduction in Medicare spending beneath a specified cap.
The reality is that the IPAB represents an unprecedented shift of power from individual Americans and their families to a centralized authority, a controlling Board of political appointees that is virtually unaccountable, and destined to become President Obama’s version of the NICE rationing board in Britain’s socialized medical system, the National Health Service.
But wait – President Obama and the ACA supporters point to specific language in the ACA law that explicitly prohibits “rationing.” Beyond the obvious – the absence of any definition of rationing in the law –
is that this is implausible deniability, since all evidence points to the de facto rationing that will clearly result from IPAB’s dramatic payment cuts to doctors and hospitals.
We know that doctors cite the money-losing reimbursement rates for government insurance as the Number One reason for refusing new Medicaid and Medicare patients. And we know, even before the ACA payment cuts of 31 percent in 2013, more than
20 percent of primary care doctors already were not accepting any new Medicare patients (five times the rate of doctors who refuse private insurance), and about 40 percent of primary care doctors and 20 percent of specialists already refused most new Medicare patients. By 2019, Medicare cuts under
the Obama law will be so severe that payments will become even lower than Medicaid, a system by which almost one half of doctors already refuse to accept new patients.
IPAB: President Obama's NICE Way To Ration Care To Seniors - Forbes