NRL News

Even Worse than ObamaCare? Yes, that’s what the President Proposed Last Week

by | Apr 20, 2011

By Dave Andrusko

National Review’s Rich Lowry is one of my favorite writers. He is blessed with a straightforward writing style and a real knack for translating very complicated issues into understandable language.

That’s what he did in a piece I read today, titled “The Road to IPAB.” IPAB is an acronym for the Independent Payment Advisory Board, a panel of 18 unelected—read presidentially appointed—experts.

Lowry’s opening paragraph is caustic but true: “What Pres. Barack Obama’s budget speech last week lacked in details, it made up for in an obnoxious faith in the surpassing wisdom of unelected experts.”

As Lowry later points out, “Under Obamacare, IPAB is to hit a target for Medicare’s growth that significantly squeezes the program beginning in 2014 (in his budget speech, Obama said he wants to ratchet down the cap even further).” And “Through arbitrary reductions on payments to providers, it will simply reduce the supply of care. Even before the advent of a new, more powerful IPAB and a new, tougher limit on spending, Medicare’s chief actuary warned that Obamacare will drive providers out of the program.”

No one has done as much research into the rationing dangers posed by ObamaCare in general, the IPAB specifically, than National Right to Life . The following is an analysis that appears on the blog of the Robert Powell Center for Medical Ethics.  Please take a few minutes to read it.


In the much ballyhooed debt-reduction “framework” President Obama revealed last week in a speech at George Washington University, the President proposed a dramatically graver limit on what Americans will be allowed to spend for our own healthcare than what will be imposed by the Obama Health Care Law, if it is not repealed before 2015.

As now enacted, the Obama Health Care Law directs an unelected 18-member panel called the “Independent Payment Advisory Board” to limit what Americans are permitted to spend on health care out of their own, nongovernment, funds to less than enough to keep up with medical inflation.

However, Obama is now proposing what the White House framework calls “a more ambitious target of holding . . . cost growth . . . to GDP [gross domestic product] plus 0.5 percent beginning in 2018, through strengthening the Independent Payment Advisory Board.”

Suppose this proposal had been in effect in 2009, the most recent year for which statistics are available. In 2009, because of the recession the overall real GDP per capita, as reported by the Bureau of Labor and Statistics, actually shrank by 2.1 percent. If you use President Obama’s proposed formula for that period of time (after adding .5%), Americans would have been forced to decrease what we would be allowed to spend to save our lives and preserve our health by 1.6 percent.

In 2009, the actual rate of medical inflation was 2.7%. Had the Obama Health Care Law (ObamaCare) been in effect, Americans would have been able to increase their medical spending, but not enough to keep up with the 2.7% medical inflation rate.

But under the Obama proposal announced this week, what Americans of all ages would be permitted to spend for health care, taking into account the increased cost of medical goods and services, would in real terms be 3.3% less than in the previous year.

While there has been increasingly widespread opposition to the Independent Medical Payment Advisory Board from physician groups, Republicans, and an increasing number of Democrats, the public focus has been on its mission to make cuts in government Medicare spending. Far too little attention has been given to the rationing it would impose through limits on the resources Americans will be allowed to devote to our own health care.

Under the Obama Health Care Law, these limits will be subject to enforcement by the federal Department of Health and Human Services, which will be empowered to impose so-called “quality” and “efficiency” measures on health care providers. Any doctor who dares to provide life-saving treatment in excess of these limits will be disqualified from contracting with any of the insurance plans which, under the individual mandate, Americans will be required to purchase.

The Obama Health Care Law must be repealed, and his still more draconian proposals defeated. If not, as is now true of Canadians who must often come to the United States to obtain life-saving health care, Americans will increasingly have to find locations abroad if we want to be able to use our own money effectively to save their own lives.

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Categories: ObamaCare