The part of health care reform you should fear most

Commentary by Devon Herrick

Source: The Washington Examiner

The recent health care law is facing renewed scrutiny from the Supreme Court for its individual mandate -- the provision by which all American citizens living in the U.S. must purchase health insurance or pay a fine.

But a lesser-known provision -- the Independent Payment Advisory Board -- is one that deserves your attention if you value the quality of the medical care you receive.

In creating President Obama's health care law, policymakers recognized the need to reform Medicare. For instance, the most recent report by the Medicare Trustees predicts that funds will be depleted by 2024. To solve that problem, the new health care law created IPAB, a board of 15 people who are not elected, and will not be accountable to taxpayers or Medicare beneficiaries. They -- not patients, doctors or even legislators -- will make difficult decisions about funding for health care.

IPAB is a board with the power to make recommendations to limit or lower reimbursements for Medicare providers beginning in 2014. If Congress does not adopt the recommendations, or meet targeted spending reductions of its own, the recommendations of the board will automatically become law. This is a massive delegation of congressional power and a vast overreach of bureaucratic authority. The new health care law empowers IPAB to impose indiscriminate price controls. Decisions about the medical care that is available will be reduced to the impersonal will of 15 bureaucrats charged with the task of slowing the growth of Medicare spending. While the law prohibits rationing of care or reducing benefits, it does not prohibit policies that would ultimately have the same effect. Faced with the limitation on rationing, the board will have few options other than reductions of payments to providers. Seniors already face difficulty finding primary care physicians who will treat them. IPAB will exacerbate that problem. The American Medical Association reports the cuts could harm patient access to care.

When the politicians in Washington give bureaucrats the power to make decisions about cutting reimbursements for medical providers, choice and competition disappear. Patients are forced to sacrifice quality and access to care. Lawmakers have an obligation to the Medicare recipients, but instead, it has been delegated to an unelected panel.

To Washington, it's all about the numbers. It should be about the people. IPAB is a hasty mechanism created to cut costs. In the end, it is patients who will suffer.

Devon Herrick is senior fellow at the National Center for Policy Analysis. StopIPAB,, is a project of the NCPA.

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