American Elephants


Political Rationing of Care for the Elderly—A Good Idea? by The Elephant's Child

Paul Ryan’s “Pathway to Prosperity” shows a way to bring our nation’s deficit and debt under control in a reasonable time frame. Democrats object strenuously.  They are not prepared to cut back much on spending, and they would prefer to raise taxes sharply on “the rich” and cut spending on the military.  To no one’s surprise, they have declared class warfare, and are busily demonizing “the rich” and pretending that raising taxes on the rich will solve everything. Unfortunately the rich don’t have enough money—even if you strip them of everything they have— it’s not enough.

Obama also demonized the Ryan plan’s approach to Medicare.  Obama extolled his own plan for reducing the costs of Medicare.  He briefly pointed to the Independent Payment Advisory Board (IPAB) as a way to control costs.  Remember that acronym —IPAB.

This is a panel of ‘experts’ to be appointed by the president who will control prices, decide what services can be offered and who can have them.  ObamaCare has, from the first, been focused on the fact that the greatest medical expense comes from seniors in their final years, and controlling costs has to deal with that fact.

That doesn’t sound too bad, until you realize that it means rationing, denying service, and cutting back on payments to doctors, hospitals and medical services. The experts cannot by law decide what treatment you can have, but they can decide what they will pay for it. They are charged with bringing costs below the costs of Medicaid. Socialist medicine is uninterested in the individual and excuses that lack of concern by referring to the greater good for the greater numbers.  Does this all sound a little familiar? Of course, it’s the death panels!  Fifteen bureaucrats get to decide who lives and who dies.  You don’t get to question or argue. Their decisions are final, and you can’t get them fired.

Under ObamaCare, IPAB is to hit a target for Medicare’s growth that significantly squeezes the costs of the program beginning in 2014.  (In his budget speech, Obama said he wants to ratchet down the cap even further)  Congress has very limited options.  It can pass the IPAB recommendations, substitute its own version of them, or by a three-fifth’s majority in the Senate vote to waive the requirements.  If Congress does none of these things, the Secretary of HHS automatically implements the IPAB plan.

Congress is difficult.  Members argue, they disagree.  Everything would work so much more smoothly if their key functions were handed off to a panel of experts.  If you are deeply impressed with the Obama cabinet and Obama’s appointments, then you might be impressed with his ‘experts.’ I’d rather take a chance on me and my doctor.  I don’t believe in ‘experts.”

No one can predict the future, but the Obama administration is so interested in cutting back on payments to doctors and hospitals — and the bills for major life events can be huge — yet they seem not to have considered the consequences on the medical profession. Current Medicaid patients often cannot find doctors who will see them. The IPAB is supposed to reduce Medicare cost below Medicaid cost.

We have a current shortage of primary care physicians.  If they cannot receive a fair recompense for their effort, if the government keeps ratcheting up the number of patients they must see in an hour, will there be a flood of new students wanting to become doctors? How long would it be before ObamaCare nationalized the doctors?

All of the bright ideas that Obama and the Democrats have had about government controlled health care— and they have admitted that their goal is single-payer health care—has been tried and failed in England, Europe, Canada.  Theodore Dalrymple (the pen name of Anthony Daniels, a British physician) wrote a couple of weeks ago in the Wall Street Journal that Obama’s claims for vast new efficiencies in health care would not produce the savings claimed —the British had been there and done that, and it doesn’t work. The incentives are all wrong. The world is more complex than health-care economists assume.

Remember the acronym—IPAB, Independent Pay Advisory Board.  You really don’t want the president’s, any president’s, bureaucratic appointees deciding, by looking at the cost,  what medicine you can have, what help you can have when you are ill or if you can have any at all and are just too old or too much of a drag on the system, and have to be unplugged from life support, however many productive years you might have left.

A fairly important reason to repeal ObamaCare — it just might be the death of you.

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