Dirty Little Secret: Rationing is at Heart of ObamaCare

There is a dirty secret about health care that President Obama hopes will escape the headlines. In his newly released plan to “reform” Medicare as part of overall deficit reduction, Obama has punted actual cost-cutting and instead proposed a panel – the Independent Payment Advisory Board – to recommend savings for the financially doomed program. Translation: Welcome to the world of rationing.

The board, which was an original part of Obamacare (remember the death panel debate?), consists of 15 unelected bureaucrats who will have unchecked, binding power in the interest of supposedly greater efficiency and lower costs. That means that instead of you or your doctor making decisions about your care, a group of Washington micromanagers will do it for you.

Oh, and the rationing panel will be immune to lawsuits. According to The New York Times, “In general, federal courts could not review actions to carry out the board’s recommendations.”

The panel is one of the scariest policy moves made by this administration and is the epitome of government interference in our lives at the most personal of levels. If you’re not eligible for Medicare, you will be one day, which is why everyone should be very afraid of what’s to come when the panel starts its work in 2014 with a report to the President. Though defenders claim that Obamacare bars rationing, the panel will do just that.  (Full Story Below)

There is a dirty secret about health care that President Obama hopes will escape the headlines. In his newly released plan to “reform” Medicare as part of overall deficit reduction, Obama has punted actual cost-cutting and instead proposed a panel – the Independent Payment Advisory Board  – to recommend savings for the financially doomed program. Translation: Welcome to the world of rationing.

The board, which was an original part of Obamacare (remember the death panel debate?), consists of 15 unelected bureaucrats who will have unchecked, binding power in the interest of supposedly greater efficiency and lower costs. That means that instead of you or your doctor making decisions about your care, a group of Washington micromanagers will do it for you.

They will do this by cutting reimbursements to doctors and hospitals and restricting patients from costly end-of-life care by enforcing caps on how much a patient can spend to stay alive. Most at risk will be the disabled, who require special and often expensive care. Cancer patients will be at risk, as well, since chemotherapy and other oncological treatments are some of the priciest.

In fact, there is very little Congress will be able to do to stop the panel. It will only be able to block its rulings with a two-thirds vote to override an expected presidential veto.

In the past, Obama has hinted that we'll need a way to address these patients. "The chronically ill and those toward the end of their lives are accounting for potentially 80% of the total health care bill out here," he said shortly after taking office. "There is going to have to be a very difficult democratic conversation that takes place."

But there was no real conversation. Democrats inserted the rationing panel into the Affordable Care Act (i.e., Obamacare), and when the opposition tried to draw attention to the risks involved by invoking rationing, they were branded by the left and the mainstream media as crazies.

But this is far from fantasy. In fact, it's already reality across the pond.

In many ways, Obama and congressional Democrats copied the British, who have a similar model called the National Institute for Health and Clinical Excellence, or NICE. According to The Wall Street Journal, the acronym is quite the oxymoron when one looks at what passes for standard practice: "NICE has rejected a number of pricey drugs for cancer and other diseases in the past. . . .

Sometimes NICE rejects drugs for all patients with the disease, and sometimes just for patients with a specific form of the disease, where the efficacy doesn't appear to justify the price. NICE's decisions often anger patients, their families and drug companies."

Most recently, NICE made the decision to deny the use of several new drugs to treat chronic leukemia patients. This showcases how deficit savings will be achieved under Obama's plan.

First, it's baffling to me that with countless government health officials on the federal payroll, nobody has been able to definitively figure out how to save Medicare from fiscal ruin. But somehow, these 15 Independent Payment Advisory Board pencil pushers will do the trick? Unless Superman, Wonder Woman and the Flash are entering the world of public service, there is no reason to believe that the same bureaucrats who got us into this mess will be able to solve the problem simply because they've joined a newly created panel.

It does, however, give Washington air cover. Just like in England, when the panel makes a controversial decision, lawmakers will be cleared of any direct involvement, claiming they aren't responsible for cutting your mother's cancer treatments.

In fact, there is very little Congress will be able to do to stop the panel. It will only be able to block its rulings with a two-thirds vote to override an expected presidential veto.

Oh, and the rationing panel will be immune to lawsuits. According to The New York Times, "In general, federal courts could not review actions to carry out the board's recommendations."

So, to break it down: Democrats are against limits on private-sector lawsuits but are in favor of preventing patients from suing government bureaucrats. But if this rationing panel has been designed to be so efficient and good at its job, as the President and his administration claim, then why do Democrats fear litigation in the first place?

Even some on the left are unsettled about Obama's solution to lowering the deficit through a medical panel with frighteningly unchecked powers. Rep. Pete Stark (D-Calif.), a notorious liberal, said this of Independent Payment Advisory Board-style rationing: "In its effort to limit the growth of Medicare spending, the board is likely to set inadequate payment rates for health care providers, which could endanger patient care."

It could also lead to a doctor shortage. If the panel cuts reimbursements to physicians, they will simply stop treating Medicare patients, thus forcing patients to purchase their own health care. Already, "Obamacare's passage has led as many as two-thirds of physicians to drop out of government-run health programs," reports the Senate Republican Policy Committee.

The panel is one of the scariest policy moves made by this administration and is the epitome of government interference in our lives at the most personal of levels. If you're not eligible for Medicare, you will be one day, which is why everyone should be very afraid of what's to come when the panel starts its work in 2014 with a report to the President. Though defenders claim that Obamacare bars rationing, the panel will do just that.

Donald Berwick, the President's controversial Medicare administrator, already stated that "The decision is not whether or not we will ration care - the decision is whether we will ration with our eyes open."

Although Obama and many congressional Democrats are hoping the complexity of the Independent Payment Advisory Board will keep people from paying attention, our eyes must be open, too. The fate of the elderly, the sick and the disabled depends on it.
andrea@andreatantaros.com

Andrea Tantaros, whose column appears on Thursdays on NYDailyNews.com and often in the print edition of the newspaper, is a political commentator as well as a corporate communications executive. She previously served as a senior adviser on a number of political campaigns and as communications director for former Massachusetts Gov. Bill Weld and Rep. Thomas Reynolds (R-N.Y.) and on Capitol Hill as press secretary for Republican leadership. Tantaros lives in New York City.

By ANDREA TANTAROS

The Dems, the White House and the media are trying to scare seniors about the Ryan Plan.  It is another diversion.  The real issue is the rationing or death panel headed by Donald Berwick that Sarah Palin and a few others warned us about and then were demonized by the same people who are hiding true facts of ObamaCare from you, until it is too late! Take it from someone who read as much of every version as possible during the ObamaCare battle… the panel and rationing are in there along with many other scary provisions.  And a vote to re-elect Obama is a final vote to destroy America’s healthcare as well as freedom!

Obama Embraces 'Death Panel' Concept in Medicare Rule

Sunday, 26 Dec 2010 06:41 PM

During the stormy debate over his healthcare plan, President Barack Obama promised his program would not "pull the plug on grandma" and Congress dropped plans for death panels and "end of life" counseling that would encourage aged patients from partaking in costly medical procedures.

Opponents of Obama's plan, including former vice presidential candidate Sarah Palin, dubbed such efforts as "death panels" that would encourage euthanasia.

But on December 3rd, the Obama administration seemingly flouted the will of Congress by issuing a new Medicare regulation detailing -- "voluntary advance care planning" that is to be included during patients' annual checkups. The regulation aimed at the aged "may include advance directives to forgo aggressive life-sustaining treatment," The New York Times reported.

The new provision goes into effect Jan. 1, 2011 and allows Medicare to pay for voluntary counseling to help beneficiaries deal with the complex and decisions families face when a loved one is approaching death. Critics say it is another attempt to limit healthcare options for the elderly as they face serious illness.

Incoming House Speaker John Boehner said during the healthcare debate that, “This provision may start us down a treacherous path toward government-encouraged euthanasia.”

Specifically, the measure was known as Section 1233 of the bill passed by the House in November 2009. It was not included in the final legislation, however. It allowed Medicare to pay for consultations about advance care planning every five years. In contrast, the new rule allows annual discussions as part of the wellness visit.

Elizabeth D. Wickham, executive director of LifeTree, a pro-life Christian educational ministry, told the Times was concerned that end-of-life counseling would encourage patients to forgo or curtail care, thus hastening death.

“The infamous Section 1233 is still alive and kicking,” Ms. Wickham said. “Patients will lose the ability to control treatments at the end of life.”

The rule was issued by Dr. Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Services, according to The New York Times. He is a longtime advocate for rationing medical procedures for the elderly.

Before being tapped by Obama to his Medicare post, Berwick had long applauded Britain's National Health Service, which uses an algorithm to determine if the aged are worthy of additional expenditure for medical care and advanced treatments.

Berwick has argued that rationing will have to eventually be implemented in the U.S, stating, “The decision is not whether or not we will ration care. The decision is whether we will ration with our eyes open.”

Seniors appear to be a major target for precious resources under the Obama healthcare plan. According to the Congressional Budget Office, the Obama plan cuts nearly $500 million in Medicare benefits to seniors as the federal government adds 30 million uninsured Americans to private and public health care systems.

The cost of caring for the elderly has not been lost on Berwick.
“The chronically ill and those towards the end of their lives are accounting for potentially 80 percent of the total health care bill out here… there is going to have to be a very difficult democratic conversation that takes place,” he said.

During the heated healthcare debate, supporters of the Obama vigorously denied rationing for seniors would take place and scoffed at "death panel" critics like Palin.

Last month, however, economist and New York Times columnist Paul Krugman told ABC News that rising Medicare costs could only be dealt with by "death panels and sales taxes."

He added: "Medicare is going to have to decide what it's going to pay for. And at least for starters, it's going to have to decide which medical procedures are not effective at all and should not be paid for at all. In other words, it should have endorsed the [death] panel that was part of the healthcare reform.’"

Read more: Obama Embraces 'Death Panel' Concept in Medicare Rule

The NY Times Concedes Governor Palin “Forced [Obama] Onto the Defensive.”

The NY Times concedes that Governor Palin put Obama “onto the defensive” with “death panels” (emphasis added):

Sarah Palin, the 2008 Republican vice-presidential candidate, and Representative John A. Boehner of Ohio, the House Republican leader, led the criticism in the summer of 2009. Ms. Palin said “Obama’s death panel” would decide who was worthy of health care. Mr. Boehner, who is in line to become speaker, said, “This provision may start us down a treacherous path toward government-encouraged euthanasia.” Forced onto the defensive, Mr. Obama said that nothing in the bill would “pull the plug on grandma.”

Has any other potential Republican presidential candidate other than Palin been able to force the New York Times to concede that he or she put Obama on the defensive? Has any other potential Republican presidential candidate other than Palin destroyed a liberal policy to such an extent that the Democrat Party is afraid to publicize what it is doing and can only get it implemented through channels outside of the legislative arena?

“Death Panels” Regulation Begins Obama’s Rule by Fiat

by Ben Johnson – Posted at

In a foretaste of outrages to come, the Obama administration managed to sneak out a federal regulation paying doctors to provide “end of life counseling” to those covered by ObamaCare. The Medicare rule, which Congress never voted on, may encourage thousands to forego lifesaving treatment. This move is a voluntary precursor to the inevitable rationing engendered by socialized medicine. Many conservative media outlets have objected to the pro-death aspects of this decision. However, they have ignored a vital aspect of this story: the way he implemented the policy. This federal regulation inaugurates Obama’s two-year strategy to rule by executive order. The New York Times reports:

When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

Although the NYT just discovered this, Steven Ertelt at LifeNews.com reported the regulation nearly a month ago. (We covered it at the time.) For once, the Times included some salient facts along with its whitewash of the administration’s activities.

This program will be overseen by the Administrator of the Centers for Medicare and Medicaid Services, Dr. Donald Berwick, a fanatical believer in limiting (read: denying) care. The paper quotes Berwick as saying, “Using unwanted procedures in terminal illness is a form of assault. In economic terms, it is waste.” Berwick added advanced directives were one of “several techniques” that led “to both lower cost and more humane care.” There is no question they lead to lower costs, in addition to providing an economic stimulus to tombstone carvers, morticians, and cemetery plot salesmen.

The Times reports the regulation was pushed by two Congressional Democrats: Rep. Earl Blumenauer of Oregon and Sen. Jay Rockefeller IV of West Virginia. This backing unintentionally reveals the measure’s greater significance: The liberals could not ram a death panels provision through even the Democratic-controlled 111th Congress, so Obama is imposing it with the stroke of a pen, without a single vote. The New York Times admits this is the wave of the future:

While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with a strengthened Republican opposition in Congress.

This author first exposed Obama’s plan to rule by executive order, in October. The following month, the Center for American Progress released a lengthy report compiled by Sarah Rosen Wartell calling for the president to implement a “progressive” agenda by fiat over the next two years. In its foreword, CAP president and CEO John Podesta called on Obama to rule through:

• Executive orders
• Rulemaking
• Agency management
• Convening and creating public-private partnerships
• Commanding the armed forces
• Diplomacy

Just last week, the inside-the-Beltway Bible Politico featured an article by John F. Harris and James Hohmann which concluded, “Republican gains in Congress make it essential for [Obama] to use new avenues of power,” including regulations and executive orders.

The Left is irresistibly drawn to collecting as much unbridled power as possible, because its agenda is so unpopular it could never receive sufficient popular support to pass an election. Since the November election, Obama, Reid, and company have followed the authoritarian path I predicted. I wrote in November, “Look for an aggressive agenda in the lame duck session of Congress, focused especially on passing the DREAM Act and repealing ‘Don’t Ask, Don’t Tell.’” Harry Reid unleashed precisely these two measures (and passed one of them) in his lame duck power grab, cramming in a bid to pass a $1.27 trillion budget besides. Next, I wrote, “After January, Cabinet agencies will issue regulations at a faster clip.” This follows that prediction. Finally, I wrote, “Obama will rule increasingly through executive orders and appeals to the United Nations.” If this regulation means anything, it means we have not seen anything yet.

How fitting one of the first expressions of Obama’s new strategy was a measure to let people die. He seems to have the same fate planned for the U.S. Constitution.