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THE ONLY THING I CAN FIGURE OUT IS THE IPAB.....RATIONING BOARD TO SAVE MEDICARE....THIS IS THE OBAMA PLAN TO SAVE MEDICARE...THIS IS THE OBAMA PLAN TO SAVE MEDICARE....
THE IPAB RATIONING BOARD.
Medicare is one of two significant entitlements having the greatest impact on the national debt. Regardless of ones political persuasion Medicare is well liked by most Americans. Those two factors make it very difficult to change or even to talk about in political circles, but not only talk we must, we have to change the system dramatically. That is the key word, dramatically.
The President, while appearing to recognize the problem, seeks a near “business as usual” approach and is still willing to play the Medicare scare card for seniors. The essence of his proposal, actually the only new component is a fifteen person panel to seek ways to save money. The other components include, reducing payments to providers, eliminate fraud and abuse and the use of Accountable Care Organizations (and a total of 165 new trial initiatives in various areas). All of which are unproven, perhaps impractical or unworkable.
Let’s focus on the 15 person board set up by the Patient Protection Affordable Care Act. What is it’s job, when can it do it and what can it not do?
Here are a few key points to consider in making your own assessment of the potential effectiveness of this approach:
- Proposals are to primarily focus on payments to MA and PDP plans and reimbursement rates for certain providers. That means focus not on basic Medicare, but on Medicare Advantage Plans (MA) and Prescription Drug Plans (PDP) . Payments to MA plans were already cut under the Affordable Care Act and PDP benefits were expanded at additional cost
- The Board will be prohibited from developing proposals related to Medicare benefits, eligibility, or financing
- Proposals, which will only be required in certain years, will have to meet specific savings targets.
- The first year the Board’s proposals can take effect is 2015.
- Proposals must include only those recommendations that improve the health care delivery system, including the promotion of integrated care, care coordination, prevention and wellness and quality improvement and protect beneficiary access to care, including in rural and frontier areas. This sounds quite incidental to cutting costs.
- As appropriate, each proposal is required to include recommendations that would reduce spending in Medicare Parts C and D. But what about the largest parts A and B?
- The Board is prohibited from making recommendations that would ration care, raise revenues, increase beneficiary premiums, increase beneficiary cost-sharing, restrict benefits, or modify eligibility. Additionally, proposals submitted before December 2018 for implementation in 2020, cannot include recommendations that would reduce payments to providers and suppliers scheduled to receive a reduction in their payment updates in excess of a reduction due to productivity. You have to ask yourself, what is left that can meaningful impact costs.
IS THIS THE ONLY OBAMA PLAN TO SAVE MEDICARE? IF SO, IT WILL GO BROKE IN LESS THAN 10 YEARS.