Wednesday, May 9, 2012

Death of 'death panel' greatly exaggerated

Congressman Pat Meehan has found the "death panel" Sarah Palin claimed was in the Affordable Care Act back and he has struck a blow for freedom by voting to kill it dead, dead, dead!
I know this because Congressman Meehan called me personally to tell me about it a couple of weeks ago. Well, he didn't just call me, he held one of those telephone town halls. You know one of those things where you're sitting in your house minding your own business when out of the blue, you get a call and it's Meehan saying "I'm having a town hall right now, so listen up!"
So anyway, the really, really big thing he wanted to share was that he had voted to repeal the Independent Payment Advisory Board, a panel created as part of the Affordable Care Act that will begin in 2015 to develop and submit proposals to slow the growth of Medicare and private healthcare spending.
The IPAB -- once it comes into existence --will be made up of 15 members, doctors, insurers and consumers, who will be confirmed by Congress and served for staggered six-year terms. Its job will be to step in and recommend savings needed to meet the Affordable Care Act's limits on the growth of Medicare spending if other cost-saving measures fail to work to keep Medicare growth down to a limit of 7 percent or less, the average rate of growth for the last decade. 
The IPAB may not make recommendations to ration health care, cut benefits, increase premiums or restrict eligibility for the Medicare program. It can draw on studies and pilot projects to develop cost-effective ways of slowing the cost of Medicare and other health spending instead of imposing across-the-board cuts in payments to providers or increases in beneficiaries' premiums.
It is, as its name suggests, an "advisory" panel that may not even be needed for some time as the increase in health care spending has been running at about 3 percent for the last couple of years.   Congress can override its recommendations, but it is not subject to the intense special interest lobbying that Congress falls prey to.
So after the congressman was done bragging about having voted to kill the IPAB, he then went on to talk a lot about he was how he was all about cutting government spending, saving us money, preserving our freedom, blah blah blah.
What he didn't tell us is that the provision to repeal the IPAB was ensconced in a bill called Protecting Access to Healthcare Act, whose main objective is to put a $250,000 cap on noneconomic, or pain-and-suffering, damages in medical malpractice cases nationwide.
The bill passed the house 223 to 181, pretty much along partisan lines.  It will now go to the U.S. Senate where it will die a quiet death, as it has for the last 15 years or so.  And if it doesn't, President Obama will veto it.
So the vote was pretty much symbolic, or even less than symbolic since it wasted a lot of the House's time that it could have been spending on meaningful legislating, but it gave Congressman Meehan something to brag about when he came home last week to meet with constituents, that is, raise money for his re-election.
He and his colleagues will tell you that he has voted to save Medicare.  He hasn't. 
Measures to cap noneconomic damages in medical malpractice cases are really a bad idea, especially at the level of $250,000, which is already proven to be completely inadequate in California and Texas. It means that  if you are the victim of medical malpractice, chances are good you will not be able to find a lawyer to take your case.
Economic damages -- lost wages, medical expenses, home health care -- are what pay for your actual expenses if you are ever unfortunate enough to be a victim of medical malpractice.  Noneconomic damages are where lawyers get paid after they have put up tens or even hundreds of thousands of dollars in upfront costs to find and hire expert witnesses, take days of depositions, develop trial materials, file motions and in extreme cases (about 2 percent of all lawsuits) go to trial on your behalf.  Of course it would be nice if medical malpractice victims did not have to sue their doctors or hospitals, but they do and their lawyers have to get paid for those suits.
Conservatives think limiting non-economic damages keeps medical costs down by limiting your access to the courthouse door and this bill, should it ever get to be federal law, would do just that.  Actually, your access is already pretty limited as the courts are clogged with suits by businesses suing each other or consumers of every stripe suing businesses.  
What keeps health care costs down?  First of all, making insurance companies cover everyone and making everyone pay for coverage (the individual mandate), as well as practical measures to prevent health care providers from giving you the wrong medication or the wrong dosage, to prevent hospital-acquired infections, to prevent operating room accidents and to prevent health care providers from submitting false claims. 
The Independent Payment Advisory Board could be a big part of that if the Affordable Care Act survives the US Supreme Court and if the IPAB provision is needed.  If it is, it is projected to save taxpayers about $3 billion over the next 10 years with no reduction in Medicare services or coverage.
If the ACA does not survive, we will get vouchers that will lose value each year, instead of the guaranteed coverage that Medicare recipients now receive.  This will cost us each a lot more each year as we get older without any corresponding increase in the level of services.
So if Congressman Meehan really champions cuts to government spending and saving taxpayers money, why isn't he busy voting on legislation that is desperately needed to keep student loan costs low, to fund transportation projects to rebuild our roads and bridges, to cut the massive defense budget and to raise much needed revenues by making millionaires and billionaires pay their fair share of taxes? 
Why did he vote to repeal the IPAB?  And why is he so proud of it? 

1 comment:

  1. This sounds like a great read. I have heard a lot about it online and i am totally intrigued by the post.Thanks!! American Medicare