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Some Democrats Want to Abolish Death Panel


DP Veteran
Jul 19, 2012
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The Death Panel, officially called the Independent Payment Advisory Board (IPAB), decides what will get paid for and what types of patients will get certain types of care. It will not decide individual cases.

Howard Dean called attention to the fact that this would limit care for Medicare patients and claims it is a form of rationing.

Supporters of the IPAB say that it is forbidden to ration care and that it is supposed to transition from fee for service medicine to diagnosis based reimbursement. But the effect of that shift will undoubtedly mean less care as doctors and hospitals will be encouraged to do as little as possible for sick patients. The difference will be pretty remarkable; whole classes of surgical care will simply disappear, for example. Even procedures as basic as coronary angioplasty and stenting are not immune.

The idea will be to keep people healthy, and woe betide those who do not stay healthy.

Some have pointed out that insurance companies have done this all along, but there is one big exception, which is that insurance companies are accountable and can be brought to court, and this has a big effect on how they do things. The IPAB is unaccountable, and there will be no appeal.

As recognition of this has spread an increasing number of Democrats have come out against the IPAB.
Of course the health care industry is going to "convince" politicians that moving away from fee-for-service is a bad thing. Can't reward doctors for being more effective, that would be terrible. Better to keep rewarding defensive medicine!

How is it a "death panel" when it doesn't review individual cases, again?
Rational commentary on this can be found here:

Death Panels in Oregon | The Incidental Economist

Money quotes:

First of all, I’m always a bit confused by the fact that it’s often the same people, and organizations, who rail against rationing within Medicaid while simultaneously railing against the Medicaid expansion. Evidently, they are fine with completely denying Medicaid to many of the poorest among us, but against making Medicaid less robust once they get it. Odd.

But my larger concern is one of philosophy. We simply cannot afford to pay for everything. We must own that. And so, there will at some point have to be discussions as to what we might not pay for....but please don’t pretend to be outraged by that serious discussion while simultaneously being ok with denying much more to many more in the name of “fiscal responsibility”.
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