11 August 2013

Dr. Dean's Delayed Diagnosis of IPABs

Although  former Vermont Governor and 2004 Presidential Candidate Howard Dean (D-VT) has been out of the practice of medicine for a number of years in lieu of politics, the Doctors delayed diagnosis of IPABs is right on the money.

Recently, Howard Dean wrote an opinion piece for the Wall Street Journal in which he prognosticated:  "The IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them."  

For those who did not thoroughly study the 2,700 pages of legislation that comprised the ironically titled "Affordable Care Act", otherwise know as Obamacare, IPABs are the 15 member Independent Payment Advisory Board which the HHS Secretary Sebilus appoints that decides the amount that the government will reimburse physicians for medical procedures. 

This was  supposedly intended as a cost control mechanism for Medicare, but in reality will act as a rationing board.  The IPAB name implies that these opinions are advisory, but those opinions become the reality. A medical advisory board made the modest proposal in 2011 that yearly mammograms are unnecessary for women between 40 and 49, and HHS suggesting that self-examinations of breasts.  It did not seem that there were medical breakthroughs which prompted these changes in practice but it certaily would save costs for a single payer system.

At the start of his first term, Dr. Betsy Mc Caughey observed that President Obama's former Health Advisor Dr Ezekiel Emanuel (the brother of then Chief of Staff now Mayor of Chicago Rahm Emanuel .D-Chicago) believed that doctors serve two masters: the patient and society and that medical students should be trained  to provide socially sustainable, cost-effective care."  

While public pressure forced the Obama Administration in January 2011 to drop "Complete Lives System" inspired end-of-life counseling during the elderly's annual check ups, the philosophy of cost cutting during the last 18 months of a person's life remains with IPABS.  Instead of cajoling vulnerable senior citizens to just "take a pill", the patient is cut out of the process by "Advisory Boards" which make certain treatments financially unviable, depending upon one's status. 

When Sarah Palin labled IPABs as "death panels", she was roundly criticized as a scare monger who was stupid, don't cha know?  

A couple of years later,  Dr. Dean  diagnosed IPABs as rationing boards,  it makes  more sense, right?

Howard Dean suggested that: "Getting rid of the IPAB is something Democrats and Republicans ought to agree on."  Obviously, the former DNC chair has not gotten with the program to think that Obamacare is about improving healthcare in America.  It seems that it more about control.

Unless Tea Party House Republicans are successful in defunding Obamacare from the FY2014 budget, all Americans will be mandated to participate in the program or pay a tax.  Nevertheless, the IRS will be in charge of collections and monitoring all of the health information.  Recent reports have indicated that health records will be vulnerable to hackers and scammers.  In addition, the IRS has shown political partisanship in vetting Tea Party tax exempt applications and for surrepticiously sharing this information.  Why couldn't the Obamacare cost cutting extend to denying treatment to political opponents?

Allow me to dispense a rhetorical palliative to Obamacare opponents– as P.J. O’Rourke put it: “If you thought that health care is too expensive now, wait until you see what it costs when it’s free.”  Alas, the Affordable Care Act is doubling many peoples’ rates and may cost some their hides. 

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