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Sunday, July 1, 2012

Mandated Rationing

How the Affordable Care Act will keep Americans from paying 'too much'

Burke J. Balch, Director of the Robert Powell Center for Medical Ethics at National Right to Life, highlighted the aspects of the health care law upheld by the Supreme Court on Thursday that create the possibility of limiting the availability of healthcare for those who wish to pay for it—a process referred to as “rationing.”

While the court struck down penalties on states if they refuse to participate in extending Medicaid coverage, Balch explained in an interview with the Free Beacon that the court’s decision did not effect “the provisions in the law that risk rationing.”

“The fundamental provisions in the law that give federal bureaucrats the authority to limit what Americans are allowed to choose to spend to save the lives of their family members remain intact,” Balch said. He outlined three specific provisions with these results.

The law gives the U.S. Department of Health and Human Services (HHS) the authority to issue “quality standards” that “control all providers of healthcare: doctors, hospitals, nurses, and so forth.” If a doctor does not comply with these standards, he “will be unable to get reimbursement from any of the insurance plans that all Americans will be required to have” under the individual mandate, which was ruled constitutional under the Congress’ power to tax.

Congress set up the Independent Payment Advisory Board (IPAB). This group of regulators “is directed, starting in 2015 and every two years thereafter, to make recommendations … to limit the ability of Americans to put resources into healthcare so that they stay below certain goals set forth in the legislation.” IPAB sets a price cap, a dollar amount beyond which Americans cannot pay for care. All of those limits are required to be below the rate of medical inflation.

To illustrate this principle, Balch used an analogy with food prices. “Imagine a situation where Congress said, ‘Whenever you go out to buy food, if the price of food has risen by ten percent next year, you’re not allowed to pay that extra ten percent to get the same food that you got this year. You’re only allowed to pay five percent more.’” Such a policy would force citizens to buy less food, or lower quality food, each year.

IPAB aims to “reduce the treatment that doctors are allowed to give to their patients.”


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