Relatively unknown, the IPAB or Independent Payment Advisory Board that was created in the health care reform bill is potentially powerful.

This group is an independent panel consisting of 15 members appointed by the president and confirmed by the senate. With their primary responsibility in implementing a ceiling on how much the government spends on Medicare each year.

This panel has the power to make recommendations that will ultimately cut Medicare’s spending to make sure it stays within the annual limits. Now here’s the important part, this group is so powerful that it will literally take an act of congress to change the IPAB’s recommendations.

Here’s where it gets a bit tricky. Given all of the power that the IPAB has, they’re actually limited as far as to what changes they can recommend. They only way they can realistically reduce spending is by cutting the payments made to the health care providers who treat Medicare patients. This will cause a real problem, both financially and logistically for the hospitals, doctors, and many others who treat these patients.

What’s most likely to happen is that we’re going to face an even greater shortage of physicians who are willing to accept and treat Medicare patients. These folks are going to find it harder and harder to get the necessary access to care that they need. So unfortunately what we’ll be left with are fewer doctors to choose from, waiting rooms filled with a long list of people trying to get seen, and the potential for a decrease in the quality of care. The reason for this is quite simple. Because doctors will be paid so little to treat Medicare patients, they only way it’ll make sense for them to do so is to see as many patients as possible. In order to this they’ll be forced to limit the amount of time they spend with each patient in exchange for a higher quantity of patients. And a model like that is a prescription for errors and problems to occur.


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