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    Broad Coalition Urges IPAB Repeal

    This week, a broad coalition of citizen groups sent two powerful messages to Congress with the following pair of letters, which urge the immediate repeal of ObamaCare's health care rationing board, better known as IPAB.

    March 19, 2012

    Dear Member of Congress:

    On behalf of the 26 undersigned members of the Health Care Freedom Coalition and our ally organizations, representing industry, policy, taxpayer, and medical professional groups, and their millions of patients and members, we are writing to express our concerns regarding the Independent Payment Advisory Board provision of the Patient Protection and Affordable Care Act and the disastrous impact of its implementation on both patient care as well as Congressional authority.

    Section 3403 of the Patient Protection and Affordable Care Act (PPACA) established the Independent Payment Advisory Board (IPAB) to reduce Medicare spending. But ultimately this panel of 15 independent, unelected bureaucrats with unilateral authority and whose decisions are freed from judicial and administrative review will most certainly cut payments to physicians under Medicare, will limit patient access to, and quality of, medical care. 

    Independent, Unelected, Politically-Appointed Bureaucrats

    Of the 15 members, twelve  will be appointed by the President, and the law actually prevents practicing medical professionals- like doctors - from membership. The rules almost guarantee that the members will be academics. The highly-paid bureaucrats will likely be paid more than many of the doctors they are second-guessing. These six-year terms come with an anticipated paycheck of $165,300 - more than the average family practice physician earns in many cities in Ohio, Pennsylvania and Florida.

    Undemocratic, Unilateral Authority and Lack of Redress or Review

    The decisions cannot be challenged in the courts and are freed from the normal administrative rules process - require no public notice, public comment or public review.   IPAB "recommendations" carry the full force of the law, unless 2/3 of the House and Senate vote to override.  In essence, Congress has given this Board the authority to legislate.

    Decisions Will Impact Physicians & Patients

    The board is specifically forbidden from "any recommendations to ration health care", but PPACA fails to define the word "ration.” Instead, it allows IPAB to pay doctors reimbursement rates below costs, which in essence would constrict a physician's ability to treat patients. Longitudinal studies already show that about one-fourth of doctors already refuse new Medicare patients, and as many as 50% restrict the services they are willing to perform for their current patients.  And this is expected to worsen, as even more doctors will be unable to afford to take Medicare patients.

    Absolves Congress from Oversight & Decision-Making

    IPAB is intended to take tough decisions about Medicare spending out of the purview of Congress, in effect, delegating away its legislative responsibilities under the Constitution to either a 15-member Board, or by default, the Secretary of Health and Human Services.  IPAB was simply created to absolve Congress of having to make decisions that directly impact the quality and access of care for Seniors, and also insulate them from having to make tough decisions.

    The ill-advised quest for “cost effectiveness” is doomed to failure. As we have seen in Great Britain, any de facto price controls are likely to do nothing to control the growth of spending.  Further, this one-size-fits-all approach to dictating medical care in a country of more than 300 million is ill-advised.

    If Congress believes that these decisions handed over to IPAB are too much of a hot political potato for it to decide, then perhaps it is a clear indication that this is the wrong course of action.

    Sincerely,

    Kathryn Serkes, CEO & Chairman, Doctor Patient Medical Association

    Grover Norquist, President, Americans for Tax Reform

    Dean Clancy, Legislative Counsel & VP, Health Care Policy, FreedomWorks

    Jim Martin, Chairman, 60 Plus Association

    Heather Higgins, President & CEO, Independent Women's Voice

    Colin A. Hanna, President, Let Freedom Ring

    Ken Hoagland, Chairman, Restore America's Voice Foundation

    Christopher M. Jaarda, President, American Healthcare Education Coalition

    HSA Coalition

    Tim Phillips, President, Americans For Prosperity

    Amy Ridenour, Chairman, The National Center for Public Policy Research

    Mario H. Lopez, President, Hispanic Leadership Fund

    David Williams, President, Taxpayers Protection Alliance

    Andrew Langer, President, Institute for Liberty

    Jane Orient, MD, Executive Director, Association of American Physicians & Surgeons

    Eric Novak, MD, US Health Freedom Coalition

    Andrew F. Quinlan, President, Center for Freedom and Prosperity

    Grace-Marie Turner, President, Galen Institute

    Hal C. Scherz, MD, FACS, FAAP, President & CEO, Docs 4 Patient Care

    Amy Kremer, Chairman, Tea Party Express

    Penny Nance, CEO and President, Concerned Women for America

    Dr. Joseph L. Bridges, President & CEO, The Seniors Coalition

    Pete Sepp, Executive Vice President, National Taxpayers Union

    Judson Phillips, Tea Party Nation

    Stephani Scruggs, President, Unite In Action, Inc 

    Ana Puig, Co-Founder, Kitchen Table Patriots

    and:

    An Open Letter to the U.S. House of Representatives:

    Stand Up for Pro-Taxpayer Health Care Reform, Support H.R. 452!

    March 21, 2012

    Dear Representative:

    We, the undersigned organizations, representing millions of Americans who seek limited government and economic freedom, urge you to enact H.R. 452, the Medicare Decisions Accountability Act. This legislation would repeal provisions relating to the Independent Payment Advisory Board (IPAB) contained in the so-called Patient Protection and Affordable Care Act (PPACA). While each of us advocates completely abolishing the fiscally disastrous 2010 law, H.R. 452 would remove a major obstacle to consumer-based, pro-taxpayer health care reform.

    Aside from its economically devastating tax increases, oppressive individual mandates, and onerous dictates for businesses, PPACA would dramatically expand government’s already meddlesome role in the health services marketplace. One way the law achieves these undesirable ends is through IPAB. A coalition of organizations led by the Doctor Patient Medical Association has offered many worthy arguments against this bureaucratic nightmare, including its unjustified grant of authority and its detrimental impact on retired Americans’ access to services. There are, however, additional reasons why fiscal conservatives of both parties should support H.R. 452:

    • IPAB’s most expedient tools for holding down Medicare costs would closely resemble price controls, which have been a proven failure here and abroad for many areas of the economy. In IPAB’s case they could mean cost-shifting to non-exempt providers inside Medicare and beneficiaries outside Medicare, as well as reduced investment in researching new medical treatments that could save lives and money. Such has been the case with blockbuster drug development, which until now has advantaged the U.S. because our nation serves as an island of pricing freedom. Ultimately, the real “winner” from price controls would be big government, not consumers.

    • Because its mission is defined by PPACA’s framework, IPAB will focus on cost-containment measures whose scoring windows are narrow. At best, IPAB would be an institutional distraction from reforms whose highest savings might occur beyond the next fiscal year or two, such as the premium support model. At worst, IPAB would serve as an institutional impediment to progress, by relegating much of the health policy process to debating marginal changes in reimbursements.

    • IPAB’s mechanics would work against fiscal discipline as well as transparency. In the past, expert panels such as the military Base Realignment and Closure Commission have helped to break political logjams for taxpayers’ benefit. IPAB, on the other hand, reflects Congress’s worst impulses to avoid accountability to taxpayers, much in the way the Commission on Legislative, Executive, and Judicial Salaries provided cover for lawmakers to obtain pay raises without voting for them. Clearly, the American people will still blame Congress for abdicating its constitutional role to IPAB over matters affecting the fundamental well-being of patients and taxpayers. 

    We understand that some view the dissolution of IPAB as a strategy to deflect political criticism away from other parts of PPACA, thereby easing their integration into the health care system. However, we believe that in addition to holding votes on repealing PPACA as a whole, it is vital to take every legislative opportunity for protecting Americans from PPACA’s most harmful facets. H.R. 452 would make an admirable contribution toward this end.

    As many of us warned more than two years ago, PPACA has led to adverse consequences such as higher rather than lower insurance premiums as the law takes effect, and a rising gross cost spiral that assumes more businesses will be trapped by penalties. Given these ominous signs, IPAB’s capacity to make fatally flawed decisions for the health care system, the federal government’s finances, and the entire economy is all the more alarming.

    Elected officials must reassert responsibility over health policy and change direction away from PPACA’s government-dominated approach. H.R. 452 is a key element in this course correction, and we urge its immediate passage.

    Sincerely,

    Duane Parde, President, National Taxpayers Union

    Tim Phillips, President, Americans for Prosperity

    Grover Norquist, President, Americans for Tax Reform

    Andrew F. Quinlan, President, Center for Freedom and Prosperity

    Tom Schatz, President, Council for Citizens Against Government Waste

    Kathryn Serkes, Chair and Co-Founder, Doctor Patient Medical Association

    Dean Clancy, Legislative Counsel and Vice President, Health Care Policy, FreedomWorks

    Mario H. Lopez, President, Hispanic Leadership Fund

    Heather Higgins, President and CEO, Independent Women’s Voice

    Kerri Toloczko, Senior Vice President for Policy, Institute for Liberty

    Colin Hanna, President, Let Freedom Ring

    Dr. Joseph L. Bridges, President and CEO, The Seniors Coalition

    TAKE ACTION: Tell your Congressman to Vote YES on H.R. 452 to Repeal the IPAB Health Care Rationing Board!