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Monday, April 05, 2010

Section 10320 of health care bill-reason to be afraid

Section 10320 of the health care bill changes the focus and greatly enhance the influence of the IMAB.Again h/t to DrRick. The phrase "greatly enhanced" does not begin to capture the enormity of what that change could be.

The IMAB ( Independent Medicare Advisory Board) has been characterized as a rather benign entity merely existed to make suggestions regarding how to improve Medicare and benefit everyone over 65. But things seem to get really interesting in 2014. The initials changes to IPAB or the Independent Payment Advisory Board.

The title of section 10320 is illuminating ;“Expansion Of The Scope Of, And Additional Improvements To, The Independent Medicare Advisory Board.”

"Improvements" are in the eye of the beholder but in what way is the scope expanded? The board is directed to periodically (every 2 years) to submit recommendations to slow the growth in national health expenditures for private (non-Federal) health care programs.,such recommendations to be implemented administratively by the HHS Secretary and/or other such Federal agency heads.

Is it even possible for a federal agency to control private health care expenditures? Does this mean that the HHS secretary, a political appointee, could deny what would otherwise be a lawful contractual relationship between a person and an insurance company? For example HHS could write regulations forbidding an insurance company from paying for a brain MRI in a patient over 65. Having control of insurance coverage is a powerful tool that has now been taken over by the federal government.

Would the power of HHS extend to control private ( non insurance related) activities between a patient and a physician? It is easy to imagine how that could happen. Simply issue a regulation (aka edict) that disallows a physician who receives CMS funds from taking part in any private financial arrangements with a patient.

Does the creation of the IPAB make it possible for a government appointed administrator basically determine if health care in this country will go the way of Great Britain or Canada, with "allowed"private care in the former and not in the latter.

Here is more detail on 10320 and how it activities morph further as times goes by, e.g taking GNP into its calculus to control national (public and private) health care costs.

This topic deserves far more discussion and recognition by the public and by the medical profession. It deserved much more discussion before it was passed.When you Google "section 10320" and my earlier blog entry shows up on the first page of hits (as of 4.4.2010), you know that this needs more widespread discussion.

Here is a letter sent from dozens of health related organizations opposing the creation of the IPAB.

Interestedly, absent from the list are the AMA and ACP.

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