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The Independent Payment Advisory Board, the big diamond sitting atop the crown of the Obamacare crown. Problem is, the big diamond has one massive flaw in it.
President Obama has yet to appoint a single person to any seat. why? Given that this is his baby, his crown, his golden piece of legislation, you would figure he would announce with great fanfare, that he has chosen a group to be on this board.
Perhaps, no one who is qualified wants the job? it pays $165,300 a year, which would be a pay cut to those qualified to be on the board. Also, the people on the board are barred from any other employment. Maybe that could be the point? either way, if there is no board, the job calls to the Secretary of Health and Human Services, so no biggy, right?
the board doesn't seem to do much except find ways to cut medicare costs if the costs get too high and it takes a 3/5 majority of congress (good luck getting that many to agree on ANYTHING) in order to reject their proposals. They can't touch hospitals and hospices til 2020, which, if Medicare continues as predicted is no big deal until after 2020.
the problem arises after 2020 when the costs do rise, or sooner if something unexpected happens. with no one serving on the panel, the job falls to the Secretary of HHS. if it DOES rise sooner than 2020, they can't touch hospitals, hospices, equipment manufacturers/sellers/etc. what's left? about the only thing I could come up with would be private doctors who work in their own offices. Perhaps that's the point. tie the hands of the board to go after anyone but the small guy to bring them down and force them into the hospitals?
for clarity sake, this panel is (currently) prohibited from being a 'death panel' in denying people treatment.
I'm not crazy, everyone else is.
There are more than just three places that provide health services.
There are hospitals, hospice centers, and private doctors as you mentioned. There are also other nursing home facilities, pharmacies/pharmaceutical companies, HMOs, non-doctor medical companies (such as the company that handles my dialysis), and a few more.
I think the reason hospitals and hospices are being untouched originally, is that, of all medical providers, they handle the most indigent care. Obamacare is geared to dramatically lower the number of indigent patients, but it will take time for that to fully go into effect. In order to not harms those who will be still picking up the slack as Obamacare gets running, they are protecting these places from getting medicare cuts.
As far as the medicare cuts go, it is unlikely the patients will see any loss in coverage. What will more likely happen is that Medicare will cut how much they pay to the providers per service. I'm guessing the cuts will be relatively small per unit provided, but the nature of aggregations means that will still add up. (cutting a mere $1 off of routine doctor appointments, could easily become hundreds of millions saved a year).
All I hope is that the health industry responds to these cuts in the proper way, by trimming the fat (imagine our healthcare system is a walrus) instead of charging other patients more to cover.