Posts Tagged ‘Independent Patient Advisory Boards’


Obamacare imageEffective programs start with targets. This was certainly true of The Affordable Care Act (ACA). During the preliminary arguments for passing a universal healthcare bill, proponents reminded us of rising costs, the plight of the uninsured, and the financial toll that often accompanies serious illness.


Those who campaigned for the bill, succeeded in convincing many Americans the target was providing affordable healthcare, but the REAL targets were far more complex. Cloaked in compassion, the crisis-speak was compelling, but the facts were misleading. The number of uninsured, that was repeated over and over, was grossly inaccurate. The projections of future costs were unrealistic, and the promise of lower costs are already proving false. Read the rest of this entry »

The Right to Life, The Right to Choose.

Listening to defenders of The Affordable Care Act (The ACA, aka ObamaCare),it’s easy to believe the  lynchpin issue is whether one is Pro-Life or Pro-Choice.

Those who fully understand The ACA would agree–but in a completely different way.

The big issue is NOT whether or not we should be providing contraception or abortion, but whether patients and their doctors should an active role in making choices, AND  whether or not the right to live should be more important than cost-effectiveness as interpreted in Patient Care Guidelines.

Doctor Affordable Healthcare act imageThe notion that opposition to The ACA is evidence of greedy indifference by those who don’t care about others is misguided. Most Americans are generous and compassionate.  Without coercion, Americans willingly give to churches, charities and causes.  When disasters, like the 2011 earthquake in Japan occur, Americans eagerly reach out to help. I was reminded of another American outpouring of compassion, on the anniversary of September 11th.  The Wall Street Journal reported a private fund has already awarded more than 80 million dollars in scholarships to children of the victims of that terrible tragedy.

The biggest misconception about socialized medicine is that it is free and/or paid for by the government.  Neither is true–unless you don’t consider the money you work for your own.  The money that pays for nationalized healthcare comes from ordinary working folks, who may have trouble paying their bills, providing for their families, or saving for the kid’s college or their own retirement.  Though it isn’t unreasonable for us to be expected to use some of what we make to take care of the medical needs of  our families, when we share the cost of paying for others, there isn’t anyway healthcare can remain affordable.

Whether or not you consider The Affordable Care Act (ACA) to be the “socialization” of medicine, it is built on certain amount of collectivism.  That’s not necessarily a bad thing.  Most forms of health insurance today, utilizing health management groups–like HMOs, also rely on collectivism to keep them solvent–meaning that expenses and resources are shared.

In one way, it is not so different from joining a joining a grocery co-op.  A grocery co-op requires a buy-in, but in return members get a share of whatever the co-op has to offer  In a farmer’s market cooperative, members may get juicy peaches, fresh picked berries, eggplants or Brussels sprouts.  The value to members is contingent on their willingness to sacrifice some choice, because offerings are limited to what’s available–whether or not it is what members would ordinarily buy.

If you don’t mind giving up some choice, cooperatives can offer great value, but Americans are used to making their own choices. Whether it be what flavor of toothpaste, what clothes, or foods we eat, free markets offer multiple choices as a way of competing.  Because the ACA is designed to stifle competition, it aims too eliminate the ability of Americans (and their doctors) to make individualized healthcare choices.

In addition to the things yet to be decided by The Secretary of Health and Human Services, like what you will be required to pay, what insurers will cover, which treatments will approved, and what kinds of drugs can be prescribed, are Patient Care Guidelines–which also currently under construction.  These guidelines will do to healthcare what McDonald’s has done to fast food by eliminating room for interpretation.

Neither you,  nor you doctor will be able to get around the federally mandated Patient Care Guidelines.  There will be no more experimental or alternative treatments–unless they are established and approved by Patient Care Guidelines. Every patient will have access only to what government has approved.  There will no longer be any flexibility for doctors who want to try something different, when a patient doesn’t respond to what has already been tried. The choice to have a c-section or a vaginal birth will no longer be yours to make, because the Patient Care Guidelines will determine for you when a c-section is appropriate.

The Patient Care Guidelines will prescribe whether or not elderly patients will be treated, despite differences between health active seniors and their peers.  Patient Care Guidelines will also determine “End of Life”  (state-sanctioned euthanasia) guidelines like those already in use by  The U.K.’s National Health Service. Being “fully-covered” will provide a false sense of security, until America’s collective consciousness, comes to terms with the way in which Patient Care Guidelines, assign a price tag to life.

Patient Care Guidelines are necessary to control costs, and will be used in conjunction with another cost-controlling mechanism–The Independent Payment Advisory Boards (IPABs).  In our current insurance-based system, insurers routinely deny costly treatments, but  patients still have the right to appeal those decisions.  The Federal Government will not offer the same flexibility.

These board will be comprised of 15 presidential appointees, who are given the authority to propose cuts to Medicare (without congressional approval) whenever Medicare spending exceeds government targets.  (This in in direct contrast to the arguments that the ACA is good for seniors, as there is no way to know what kinds of cuts will be necessary in the future.)  Though this provision is written in such a way as to make “rationing” care illegal, the Patient Care Guidelines provide a legal (if underhanded) way of doing exactly that.

So, like a co-op member who becomes dissatisfied after getting too many Brussels sprouts, and not enough berries,  it may take a few years before Americans become disillusioned by the implications of The Great American Healthcare Cooperative.  In the meantime, American goodwill will be tested, as we collectively absorb the costs of paying for things we aren’t getting or don’t want.

It is unlikely that paying for contraceptives and abortions would ever have enough financial impact, to have justified making it a recurrent theme at the recent Democratic convention, but it won’t be long before ordinary Americans begin realizing the impact of federal mandates that dictate not only what isn’t covered, but what MUST be.  Already, there has been an outcry from those whose religious beliefs are compromised by being required to share costs for things the oppose.  Catholics and other pro-life believers are justified in feeling this is an unfair impingement on their religious beliefs, if for no other reason than the waivers given to Scientologists and Muslims, and The Church of Big Labor on the basis of theirs.

However, even the non-religious may take issue with the ACA, upon realizing they have to buy into a plan that pays for gender-reassignment surgeries, while putting limits on breast, and other, reconstructive surgeries.  So, thought you may not require or desire gender reassignment surgery, and may not be opposed to anyone else having one, when you are denied a surgery you do require, you may begin to feel the ill-fit of of one-size-fits-all coverage.  Americans must now decide whether the illusory security of “full coverage” under nationalized healthcare, is of more value than the ability to make their own choices regarding life and death.  In the meantime, there is an upside…Americans won’t be forced to share the medical costs for Scientologists like Tom Cruise, Greta Van Susteren or John Travolta.

Deb’s Note: This is the fifth post devoted to explaining the Affordable Care Act–aka ObamaCare.  I have chosen to write about this subject, because I believe women need to know how it will affect their families and/or loved ones.  It is always my intention to uplift and empower women with what I write, but last week’s post re: the ACA was so depressing, even I was in a funk–which is why last week’s post ended up in the trash bin.  Just a couple more posts to wrap this subject, then I hope to move on to less-serious subjects.



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