Yes, It Is Rationing
by Carol Tobias
It’s four years overdue, but America is finally beginning to have the debate about Obamacare we were promised. Barack Obama had assured us – another in his long series of broken promises – that the meetings held to devise the plan would be televised on C-SPAN. Americans would have every opportunity to know what the law is, and how it would affect them.
That never happened. The law was put together behind closed doors. Nancy Pelosi later arrogantly told us “we have to pass the law so you can know what’s in it.”
Now we’re finding out.
National Right to Life was a lone early voice exposing how the law would cause rationing of life-saving care. But Obamacare supporters have mocked the claim. Their standard line has been “the ACA is designed to expand coverage, not reduce it.”
But that’s only one part of the law. Central to this overhaul of our healthcare system is a harsh regime of rationing – denial of care. And it’s finally being admitted.
Americans don’t yet realize the law will prevent you from spending
your own money to get treatments deemed “ineffective” in an Orwellian way
by the unelected, largely unaccountable IPAB board.
Last summer, former Vermont governor, Democratic presidential candidate, physician and Obamacare supporter Howard Dean made headlines when he spilled the beans. The Independent Payment Advisory Board set up by Obamacare, Dean said, was “essentially a health care rationing board.”
Further clarification about the role of this board, known as IPAB, came in a series of interviews and tweets last week by Time magazine Senior Political Analyst Mark Halperin. Coming from an avowed supporter of universal coverage, as Halperin is, the interviews were very instructive, containing insights every American should know.
Halperin first discussed rationing on a November 25th Newsmax TV program. “It’s built into the plan. It’s not like a guess or like a judgment. That’s going to be part of how costs are controlled.”
Later that day, Halperin clarified in a tweet that his comments were not about so-called “death panels,” as the show’s host had termed it, but about rationing. This is an important distinction for pro-lifers to understand so we (unlike Obama) are completely clear and honest about what the Affordable Care Act does when we discuss it with others.
“Death Panels” vs. broad government-generated rationing in the ACA
The British National Health Service (NHS) has appeals committees to review “individual funding requests.” They meet to determine whether treatments in a specific case will or won’t be paid for by the government health care system, NHS. These have sometimes been termed “death panels” because if a patient needs a treatment to save or extend his life and can’t afford to pay for it himself, a verdict of “no” by the committee means the patient could die – hence, the term “death panel.”
Obamcare’s Independent Payment Advisory Board (IPAB) will not operate this way. It won’t review individual cases; in fact, the law is written to preclude this type of direct rationing. That’s why some Obamacare supporters protest that the law actually bars IPAB from rationing.
But Obamacare actually gives IPAB far more power to ration than if it was acting as judge and jury to individual patients. Broadly speaking, IPAB is given sweeping powers to recommend to the Department of Health and Human Services (HHS) whether and how whole categories of treatments are to be reimbursed – and is required to use these powers to prevent overall health care spending from being allowed even to keep up with medical inflation. Thus, they can (in fact, it is their job to) limit reimbursement and ration care from thousands or millions of people at a time.
For example, IPAB might decide that a new, promising treatment for breast cancer is not “cost-effective,” given the board’s calculation of the number of lives it might save versus the cost to offer the treatment. HHS might then issue a “quality measure” binding on health care providers that does not authorize use of the treatment.
Effectively, HHS would have the power to drive most doctors out of business if they ignore its directives to ration. Women who might have been saved by the new treatment would die if the older, cheaper treatments don’t cure them.
Halperin was open about the law’s intention to ration in a follow-up interview on CNBC last Tuesday.
“Those decisions that are made by that board are going to lead to what I think could be described perfectly reasonably as rationing, “ Halperin said. “Again, as I said, that’s built into the system.”
“The Independent Payment Advisory Board, which is a big part of the Affordable Care Act that is central to cost control, is something that hasn’t been debated in a real way . . . we need to have that debate in this country.”
Currently, if an insurance company, doctor or hospital denies you a treatment or payment for a treatment, you have several options. States have insurance commissions to which you have a right to appeal payment denials by insurance companies. You can go to another doctor or hospital to get care.
Under Obamacare, these avenues will be largely closed off to you and your loved ones. If the government says you can’t get a treatment, your current ability to appeal to a government body will be curtailed. And Americans don’t yet realize the law will prevent you from spending your own money to get treatments deemed in an Orwellian way “ineffective” by the unelected, largely unaccountable IPAB board.
That makes it absolutely critical that National Right to Life inform Americans, warn Americans, empower Americans to overturn this law that will be so deadly to so many of their loved ones – and ultimately to many of us. Please take the time to see one way we’re spreading the truth about Obamacare rationing at www.nrlc.org/medethics/healthcarerationing.
Help us get the word out to the public and public officials alike about what this law does to innocent human lives and why it must be overturned.