Posted on 06/29/2012 4:16:11 AM PDT by saywhatagain
"While we strongly advocate the provision of care for the millions of uninsured Americans who will benefit from the legislation, we are concerned that there are key aspects to this law that will, ultimately, hurt this nation’s ability to provide widespread care for its citizens," the statement said.
"Since the PPACA was passed in 2010, organizations representing urologists nationwide have been working with lawmakers and regulators to demonstrate how certain provisions of the PPACA—including the establishment of the Independent Payment Advisory Board [IPAB] and the value-based modifier—will negatively impact physicians’ ability to provide quality care to patients. Though we applaud the altruistic motives behind the legislation, it is a disservice to millions to provide health care without also providing a strong infrastructure through which care can be provided."
If the Pubbies had any brains at all....they would make a wreath of this to hang around the neck of every opponent in the coming Senate and House races.
How can one Congress, without amending the Constitution, bar a future Congress from passing any law that is constitutional, INCLUDING repeal of IPAB at any time, before or after 2017?
This and other provisions in the bill that has never been talked about that will destroy this country
IPAB is the only federal body whose existence is perpetual unless Congress repeals its enabling legislation by 2017.”
“Urologists Concerned About “key aspects” of Law”
Really? Are they “pissed” off? They should embrace their tyranny. Its apparently fashionable these days.
‘Death Panel” is the correct designation and should always be identified as such.
Death Panel aka IPAB
“Urologists Pi$$ed Off about Obamacare”
It was too easy...
Independent Payment Advisory Board Review Put on Hold
Friday, February 10th, 2012 at 9:57 am, by Sara Margolis
Source: http://cblr.columbia.edu/archives/11968
On January 17, Judge Snow ordered a stay in Coons v. Geithner, an Arizona District Court case in which the constitutionality of the Independent Payment Advisory Board (IPAB) is being challenged. The IPAB is a new administrative agency, created by the recent landmark healthcare reform legislation, the Patient Protection and Affordable Care Act (PPACA). The IPAB is charged with reducing the per capita rate of growth in Medicare spending. Coons v. Geithner has been put on hold pending the Supreme Court’s decision in the upcoming health care reform case.
IPAB Structure
The IPAB is comprised of fifteen members appointed by the President with the advice and consent of the Senate. Beginning in 2013, the IPAB will be charged with making cuts to Medicare if the Medicare per-capita spending growth rate exceeds a targeted rate of spending growth. In January of each year, the IPAB will propose cuts to Congress and the President. Debate on the proposals will be limited to no more than thirty hours. If, by August, Congress does not pass legislation achieving the required reductions in Medicare spending, the IPAB recommendations will automatically go into effect. No administrative or judicial review of IPAB decisions will be permitted.
Congress has only one opportunity to repeal the IPAB: it must introduce a Joint Resolution to dissolve the IPAB by February 2017. This resolution must pass both Houses, with a three-fifths supermajority, by August 2017. If these hurdles are cleared, the IPAB would be abolished in 2020.
Constitutional Challenges to the IPAB
Republican lawmakers have consistently raised concerns about the constitutionality of the IPAB. In Coons v. Geithner, several members of the Arizona Congressional delegation have filed a complaint challenging the constitutionality of IPAB on several grounds. First, the complaint argues that the IPAB circumvents Congress’ “power and right to consider, review, debate and vote on the legislative proposals of IPAB like any other legislative proposal. . . .” Since debate on IPAB proposals is extremely limited, these legislators argue that their ability to perform their duty to debate and vet legislation is compromised.
Second, the complaint argues that the entrenchment of the IPAB exceeds Congressional power by binding future Congresses to accept this Congress’ legislation. Citing Article I § 5 of the Constitution, the complaint states, “the parliamentary rulemaking power of each House does not include the power to entrench, by statute, parliamentary rules from alteration by the Houses of future Congresses.”
Finally, the complaint argues that the lack of administrative or judicial review makes the IPAB especially problematic. The complaint states, “[e]ven where the legislative power of Congress is delegated to an executive agency with an intelligible principle to guide its exercise, judicial review must be preserved to ensure the agency stays within the bounds set by Congress.”
The attorney for the plaintiffs in Coons v. Geithner sums up the constitutional challenges to the IPAB as follows: “No possible reading of the Constitution supports the idea of an unelected, stand-alone federal board that’s untouchable by both Congress and the courts.”
However, the Supreme Court has held at least one delegation structure similar to the IPAB to be constitutional. In 1990, Congress created the Defense Base Realignment and Closure Committee (BRAC) to make recommendations to the President about military base closures. Multiple states sued, and the Court held that BRAC recommendations were not final agency action, and, therefore, not reviewable under the Administrative Procedure Act. The BRAC is still carrying out its duties. Proponents of the IPAB point to its parallels with the BRAC when defending the constitutionality of the IPAB.
Industry Concerns About the IPAB
Alongside the constitutional concerns raised by lawmakers, representatives from multiple industries have argued that the IPAB will negatively impact private sector health care providers and insurers. Last June, a coalition of 270 health care stakeholders sent a letter to Congress arguing that the IPAB will negatively impact providers. Since the IPAB is statutorily prohibited from “rationing” care, the letter argues that the bulk of spending reductions will almost certainly come from payment cuts to Medicare providers. 31% of primary care doctors have been forced to limit the number of Medicare patients served by their practice. The letter argues that IPAB reductions will exacerbate this trend.
The Medicare Advantage industry has also argued that IPAB actions could hit small Medicare Advantage plans the hardest. Medicare Advantage plans are offered by private insurers approved by Medicare and provide consumers with both hospital insurance and outpatient insurance. Again, because the IPAB may not ration benefits, one of the main targets for reduction of spending will be bulk payments to Medicare Advantage plans. This might cause small Medicare Advantage plans to retrench to urban areas, leaving rural areas with fewer (if any) Medicare Advantage options.
Stay in Coons v. Geithner
Coons v. Geithner was not filed until August 2010, months after the first cases challenging the constitutionality of the PPACA had been filed. Coons v. Geithner is the only suit challenging the constitutionality of the IPAB, and the case had not yet been heard when the Supreme Court granted certiorari on the consolidated health reform cases. Therefore, when the Supreme Court hears the consolidated health reform cases in March, it will not consider the constitutionality of the IPAB.
In March, the Court will consider whether the PPACA provision that requires nearly all individuals to purchase health insurance, called the individual mandate, is constitutional. If the Court finds the individual mandate unconstitutional, the Court must next decide whether the individual mandate is severable from the rest of the statute––that is, whether the entire PPACA would collapse without the individual mandate. If the Court finds that the individual mandate is not severable, the IPAB will be struck down along with the rest of the PPACA. Coons v. Geithner will be irrelevant.
However, if the Court decides that the individual mandate is constitutional, or that some portions of the PPACA are severable from the individual mandate, the IPAB will likely stand. In this case, Coons v. Geithner will likely progress and the Supreme Court may well be deciding on the constitutionality of the IPAB before long.
I have a urologist story. Not too long ago I attended a reception for diplomats and key business leaders from an Asian nation we have strong ties to. One of the local community leaders who came from that nation decades ago also attended. Turns out he’s one of the most important urologists in a nearby city. After the dinner and bowing had all died down we were sitting around socializing and he pulls out an old fashioned black doctors’ bag that you would think had standard doctors’ tools. Instead it’s jammed full with sample packages of Cialis. The foreigners were all bowing and thanking the guy profusely. It was surreal. There we are, about a dozen diplomats, elected officials and political staffers all dressed in our best suits and ties, sitting in a downtown restaurant, each with a package of erectile dysfunction medication on the table next to our drinks.
Perspective is as unique as ones culture. Tradition here, of not that long ago, offering an honored guest the services of a young women from the village for a night. Technology certainly influences tradition.
Certainly that ruling will affect many aspects of the bill.
We are already seeing the results of government directed treatments. Look at the recent “recommendations” of government bean counters about the frequency of PSA testing. The government “experts” looking at statistical data tell us that annual PSA testing makes no “statistical difference” in outcome and leads to too many “expensive” tests. Further many prostate cancers according to these “studies” do not need to be treated especially in older males. Under Obamacare these “recommendations” will become enforceable regulations that will force physicians into treatment options not in the best interest of their patients. Under Obamacare many older men will get diagnosed with prostate cancer far later and then be denied any treatment because of their age.
This IPAB is the scary death panel thing we were warned about I think...
The PPACA IPAB is a federal body whose existence is perpetual unless Congress repeals its enabling legislation by 2017.
The IPAB is comprised of fifteen members appointed by the President with the advice and consent of the Senate. Beginning in 2013, the IPAB will be charged with making cuts to Medicare if the Medicare per-capita spending growth rate exceeds a targeted rate of spending growth. In January of each year, the IPAB will propose cuts to Congress and the President. Debate on the proposals will be limited to no more than thirty hours. If, by August, Congress does not pass legislation achieving the required reductions in Medicare spending, the IPAB recommendations will automatically go into effect. No administrative or judicial review of IPAB decisions will be permitted.
Congress has only one opportunity to repeal the IPAB: it must introduce a Joint Resolution to dissolve the IPAB by February 2017. This resolution must pass both Houses, with a three-fifths supermajority, by August 2017. If these hurdles are cleared, the IPAB would be abolished in 2020.
What other goodies are hiding in this mess???
“While we strongly advocate the provision of care for the millions of uninsured Americans who will benefit from the legislation...”
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WHO specifically is going without essential medical care because they are “uninsured”?
I would add that the vast majority of “uninsured” are in that state by CHOICE.
Maybe not directly connected to this, but there was a report a while back that the death panels would be able to deny dialysis if the patient was over 65. Probably the majority of people who need dialysis are over 65. That could mean literally cutting years off their lives.
Personally I hope I never need it--it isn't fun--but I had a close relative who lived three more years because of dialysis.
I suspect they are complying with some written house rules??
A previous post expressed how this part of the bill has been challenged in court separately. But more importantly how important is for the conservatives to rally and win the both the house and the presidency.
I suppose we have to win at the ballot box. If we lose, and they start taking things away from us . . . am sure the guns will come out
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