By Donald J. Palmisano, M.D., published in the The Hill's Congress Blog

As lawmakers and patients learn what the Affordable Care Act's (ACA) Independent Payment Advisory Board (IPAB) really will mean for seniors, the topic has become a contentious one across the country.

IPAB is a 15-member panel of unelected and unaccountable bureaucrats responsible for making recommendations to cut Medicare costs in years when spending exceeds targeted growth rates. Congress has given a small group the power to make decisions by majority vote with only the necessity that a quorum of 8 be present. This panel has, in essence, eternal life, and can determine what funding is given to pay for medical care. The law says no rationing but cutting off funds can have the same effect and stifle innovation.

Physicians well remember Section 1801 in the original Medicare law that said no federal interference in the practice of medicine. That turned out to be a cruel joke. IPAB’s cuts are expected to, at the least, exacerbate the shortage of doctors who see Medicare patients — a problem that already has made it difficult for thousands of patients across the country to get the care they need, when they need it. IPAB follows the path of the failed Sustainable Growth Rate Formula (SGR) except it has more power and difficult for Congress to reverse.

But IPAB’s cuts could come in a form far more hurtful to patients: It has the power to bring about rationing by cutting the payment for medical services to a point where access to care is jeopardized. In effect, that power is equivalent to health care rationing. The board will have the power to prevent Medicare from covering certain treatments, leaving many patients who require those treatments unable to afford the care they need. Read More